非药物治疗对ADHD成人的短期和长期影响:系统性审查和网络元分析
Xinyue Yang1, Lin Zhang2, Jing Yu1
1College of Sports Science, Shenyang Normal University, Shenyang, China.
Frontiers in psychiatry
|February 17, 2025
概括
认知行为疗法 (CBT) 是治疗成人注意力缺陷/多动障碍 (ADHD) 和相关情绪问题的最有效的非药物治疗方法. 基于正念的认知疗法 (MC) 对于那些没有并发症的人来说是一种替代方案.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 临床心理学 临床心理学
背景情况:
- 注意缺陷/多动障碍 (ADHD) 是成年人中普遍存在的神经发育疾病,全球影响2.5%至6.7%.
- 非药物干预已被认为是对成人多动症的有效管理,无论是独立的还是与药物一起使用.
- 对于各种与ADHD相关的结果,需要对这些干预措施的有效性和长期影响进行比较研究.
研究的目的:
- 评估和比较成人ADHD非药物治疗的短期和长期影响.
- 评估这些疗法对ADHD核心症状 (不注意,过度活跃,冲动) 和情绪障碍 (抑郁,焦虑) 的影响.
- 为了对成年ADHD的不同非药物干预措施的疗效进行排名.
主要方法:
- 在主要数据库 (Web of Science,PubMed,Cochrane Library,EMBASE) 进行了随机对照试验 (RCT) 的系统搜索,直到2024年9月.
- 用随机效应的网络元分析来估计标准化平均差异.
- 使用Cochrane ROB2工具和CINeMA分别评估了偏见风险和证据确定性.
主要成果:
- 分析了37个RCT,包括2,289名参与者和10项干预措施,在许多研究中发现了显著的偏差.
- 认知行为疗法 (CBT) 与对照人群相比,对核心ADHD症状的短期和长期有效性显著.
- 在短期和长期随访中,CBT还在减少ADHD成年人抑郁和焦虑症状方面表现出显著的有效性.
结论:
- 认知行为疗法 (CBT) 成为ADHD成年人,包括伴随性抑郁症和焦虑症患者的潜在优越干预措施.
- 基于正念的认知疗法 (MC) 被认为是ADHD患者的合适选择,但没有同时发生的情绪障碍.
- 进一步进行高质量的RCT至关重要,以证实这些发现,并为治疗选择提供更强有力的证据.
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