<i>The Cochrane Library</i> and Non‐Pharmacological Treatments for Attention Deficit Hyperactivity Disorder in Children and Adolescents: An Overview of Reviews
Notice bibliographique
Résumé
Abstract Background Attention deficit hyperactivity disorder (ADHD) is a chronic behavioural disorder that affects 5–8% of children. It is characterized by age‐inappropriate levels of inattention, hyperactivity and impulsivity that cause functional impairment in multiple settings. The most common treatment of ADHD involves prescription of stimulant medications, which often cause undesirable side effects and pose unknown long‐term health risks. Therefore, alternative treatment options for ADHD are becoming increasingly popular and need to be further investigated. Objectives This overview of reviews aims to synthesize evidence from the Cochrane Database of Systematic Reviews (CDSR) on the efficacy and safety of non‐pharmacologic treatments to improve symptoms of ADHD in children and adolescents. Methods Issue 12, 2010 of the CDSR was searched using the terms “attention deficit hyperactivity disorder”, “hyperkinetic disorder” and “ADHD” restricted to the title, abstract or keywords, and all systematic reviews examining non‐pharmacologic treatments for ADHD in children and adolescents were identified. Data were extracted, complied into tables and synthesized using qualitative and quantitative methods. Main Results Three systematic reviews (containing ten trials and 594 participants) were identified for inclusion in this overview. Children assigned to Hatha yoga versus a non‐specific physical activity control condition showed significantly less symptoms of inattention when measured using both parent ratings (MD: − 0.73; 95% CI: − 1.25, − 0.21) and child‐completed tests (MD: − 4.01; 95% CI: − 6.23, − 1.79). There was no significant benefit of homeopathy compared to homeopathy placebo in decreasing symptoms of ADHD. There was also no significant difference between family therapy and standard treatment for parent and teacher ratings of inattention and hyperactivity/impulsivity; however, when overall symptoms were judged by a blinded third party observer in the classroom setting, standard treatment was significantly more effective (MD: 0.11; 95% CI: 0.05, 0.17). There was no significant difference between meditation therapy compared to both drug therapy and standard treatment without drugs for decreasing symptoms of inattention, hyperactivity, impulsivity, distractibility or overall symptoms. Authors' Conclusions The three Cochrane reviews suffered from a lack of high‐quality, adequately powered randomized controlled trials using standardized tools to measure clinically important outcomes over adequate periods of time. Therefore, the trials included in this overview are not sufficient to provide evidence of no positive benefit of treatment, nor are they sufficient to recommend the use Hatha yoga, family therapy, meditation therapy or homeopathy for the treatment of ADHD in children and adolescents. Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».