Efficacy of Non-pharmacological Treatments on Emotional Symptoms of Children and Adults with Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis

Abstract

Background: The present meta-analysis aimed to evaluate the efficacy of various non-pharmacological interventions on comorbid emotional symptoms such as depression, anxiety, and emotional dysregulation (ED) in children and adults with ADHD. Method: Forty-four randomized controlled trials (23 studies with ADHD children and 21 studies with ADHD adults) were included. Risk of bias, heterogeneity assessment, and subgroup analyses were conducted. Results: We found that therapies targeting the relationship between children and others (i.e., parent-training [on ED and depression] and social skills training [on ED]) were efficacious in the treatment of emotional symptoms in children with ADHD at post-intervention. As for adults with ADHD, cognitive behavioral therapy was found to be effective for the improvement of emotional symptoms at both post-intervention and follow-up. Conclusion: Our findings demonstrate that the efficacy of non-pharmacological interventions varies substantially across children and adults with ADHD. These results provide important implications for the selection of non-pharmacological interventions for children with ADHD.

Effectiveness of Physical Activity Intervention on ADHD Symptoms: A Systematic Review and Meta-Analysis

“…Although the results might be biased by the high heterogeneity, it provided further evidence in young patients. A meta-analysis indicated that the efficacy of non-pharmacological interventions can vary substantially between children/adolescents and adults with ADHD ( 70 ). Some animal studies showed that the capacity of exercise-induced neuroplasticity decreases with age increase, so early brain rehabilitation in young children might play a key role in the treatment of ADHD symptoms ( 57 , 71 ).…”

Effectiveness of cognitive behavioural‐based interventions for adults with attention‐deficit/hyperactivity disorder extends beyond core symptoms: A meta‐analysis of randomized controlled trials

“…However, appraisals of the available evidence disagree on whether the balance of evidence is for or against the efficacy of nonpharmacological interventions for adults with ADHD (Caye et al, 2019). Several systematic reviews and meta-analyses have explored whether CBT also benefits adults with ADHD in core symptoms (De Crescenzo et al, 2017;Knouse et al, 2017;Young et al, 2020), internalizing symptoms (Lopez et al, 2018;López-Pinar et al, 2020) and emotional symptoms (Guo et al, 2021). Previous systematic reviews and meta-analyses have included relatively few studies (Knouse et al, 2017;Lopez et al, 2018;Young et al, 2020), comprised of open-label studies (Knouse et al, 2017;Nimmo-Smith et al, 2020), analysed both children and adults populations (Guo et al, 2021) and yielded inconclusive results (De Crescenzo et al, 2017).…”

“…Several systematic reviews and meta-analyses have explored whether CBT also benefits adults with ADHD in core symptoms (De Crescenzo et al, 2017;Knouse et al, 2017;Young et al, 2020), internalizing symptoms (Lopez et al, 2018;López-Pinar et al, 2020) and emotional symptoms (Guo et al, 2021). Previous systematic reviews and meta-analyses have included relatively few studies (Knouse et al, 2017;Lopez et al, 2018;Young et al, 2020), comprised of open-label studies (Knouse et al, 2017;Nimmo-Smith et al, 2020), analysed both children and adults populations (Guo et al, 2021) and yielded inconclusive results (De Crescenzo et al, 2017). More studies are thus necessary to demonstrate or disconfirm the effectiveness of CBT in reducing the severity of symptoms or improving the overall functioning of adults with ADHD.…”

Practitioner Review: Attention‐deficit hyperactivity disorder and autism spectrum disorder – the importance of depression

“…In ADHD, numerous psychological therapies for depression have been evaluated. One meta‐analysis examined studies targeting emotional symptoms (depression, anxiety and emotional dysregulation) in children and adults with ADHD, using cognitive behavioural therapy (CBT), mindfulness‐based therapy (MBT), parent training, social skills training and (dialectical) behavioural therapy (Guo, Assumpcao, & Hu, 2022 ). Results suggested that, in children, parent training was effective in reducing depressive symptoms, social skills training was effective for emotional dysregulation, but CBT did not have a significant effect.…”