Interventions for ADHD in childhood and adolescence: A systematic umbrella review and meta-meta-analysis

Clin Psychol Rev. 2023 Jun:102:102271. doi: 10.1016/j.cpr.2023.102271. Epub 2023 Mar 25.

Abstract

There are several meta-analyses of treatment effects for children and adolescents with attention deficit hyperactivity disorder (ADHD). The conclusions of these meta-analyses vary considerably. Our aim was to synthesize the latest evidence of the effectiveness of psychological, pharmacological treatment options and their combination in a systematic overview and meta-meta-analyses. A systematic literature search until July 2022 to identify meta-analyses investigating effects of treatments for children and adolescents with ADHD and ADHD symptom severity as primary outcome (parent and teacher rated) yielded 16 meta-analyses for quantitative analyses. Meta-meta-analyses of pre-post data showed significant effects for pharmacological treatment options for parent (SMD = 0.67, 95% CI 0.60 to 0.74) and teacher ADHD symptom ratings (SMD = 0.68, 95% CI 0.54 to 0.82) as well as for psychological interventions for parent (SMD = 0.42, 95% CI 0.33 to 0.51) and teacher rated symptoms (SMD = 0.25, 95% CI 0.12 to 0.38). We were unable to calculate effect sizes for combined treatments due to the lack of meta-analyses. Our analyses revealed that there is a lack of research on combined treatments and for therapy options for adolescents. Finally, future research efforts should adhere to scientific standards as this allows comparison of effects across meta-analyses.

Keywords: ADHD; Adolescence; Attention deficit hyperactivity disorder; Children; Intervention; Second-order; Systematic overview; Treatment; meta-meta-analysis.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity* / psychology
  • Attention Deficit Disorder with Hyperactivity* / therapy
  • Child
  • Humans
  • Parents