Background There have been various therapies for attention-deficit/hyperactivity disorder (ADHD), but the previous meta-analysis of ADHD efficacy remains unclear. This study aims to systemically meta-regress the effect sizes (ES) of psychostimulant pharmacotherapy (methylphenidate and lisdexamfetamine), non-stimulant pharmacotherapy (atomoxetine and alpha-2 agonists), psychosocial therapy (parental behavioral therapy [PBT]), combination therapy (psychostimulant plus PBT), and alternative/complementary interventions to determine the right treatment for ADHD. Methods We searched various ADHD interventions from the MEDLINE and PubMed databases (National Center for Biotechnology Information) between January 1, 1980, and July 30, 2018. Following the meta-analysis of random effects, the meta-regression analyses were used to explore factors potentially influencing treatment efficacy. The confounding variables included type of treatment, type of study, age, type of symptom scale used, and year of publication. Results A total of 107 trials (n = 9883 participants) were included. After adjustment, compared with the psychostimulant therapy (28 trial, 2134 participants), non-stimulant pharmacotherapy (28 trials, 4991 participants) and alternative/complement intervention (25 trials, 1195 participants) were less effective by the ES of −0.384 (P = .004) and −0.419 (P = .028), respectively. However, compared with psychostimulant, PBT (19 trials, 1122 participants; ES = −0.308, P = .095) and the combination of psychostimulant and PBT (7 trials, 441participants; ES = −0.196, P = .209) did not differ significantly. Conclusions Psychostimulant therapy surpassed non-stimulant pharmacotherapy and alternative/complement intervention. Psychostimulant therapy, PBT, and the combination of psychostimulant therapy and PBT appear to be similar in efficacy according to this meta-regression.

中文翻译：

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探索药物、心理社会和替代/补充干预对患有注意力缺陷/多动障碍的儿童和青少年的影响：元回归方法

背景 注意力缺陷/多动障碍 (ADHD) 有多种治疗方法，但之前对 ADHD 疗效的荟萃分析仍不清楚。本研究旨在对精神兴奋药物治疗（哌醋甲酯和 lisdexamfetamine）、非兴奋药物治疗（托莫西汀和 α-2 激动剂）、心理社会治疗（父母行为治疗 [PBT]）、联合治疗（精神兴奋剂加 PBT）和替代/补充干预措施以确定 ADHD 的正确治疗方法。方法 我们在 1980 年 1 月 1 日至 2018 年 7 月 30 日期间从 MEDLINE 和 PubMed 数据库（国家生物技术信息中心）搜索了各种 ADHD 干预措施。在对随机效应进行荟萃分析后，元回归分析用于探索可能影响治疗效果的因素。混杂变量包括治疗类型、研究类型、年龄、使用的症状量表类型和发表年份。结果 共纳入 107 项试验（n = 9883 名参与者）。调整后，与精神兴奋剂治疗（28 项试验，2134 名受试者）相比，非兴奋剂药物治疗（28 项试验，4991 名受试者）和替代/补充干预（25 项试验，1195 名受试者）的 ES 为 -0.384（P = .004) 和 -0.419 (P = .028)。然而，与精神兴奋剂相比，PBT（19 项试验，1122 名参与者；ES = -0.308，P = .095）和精神兴奋剂和 PBT 的组合（7 项试验，441 名参与者；ES = -0.196，P = .209）没有差异显着地。结论 精神兴奋剂疗法优于非兴奋剂药物疗法和替代/补充干预。根据这一元回归，精神兴奋剂疗法、PBT 以及精神兴奋剂疗法和 PBT 的组合似乎在疗效上相似。