Evidence map›Paper›PMID 23360949›Full record

SynthesisThe American journal of psychiatry2013

Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments.

Edmund J S Sonuga-Barke, Daniel Brandeis, Samuele Cortese, David Daley, Maite Ferrin, Martin Holtmann, Jim Stevenson, Marina Danckaerts, Saskia van der Oord, Manfred Döpfner and 12 more

3 registry-linked trialsAbstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The American journal of psychiatry, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 426 papers, 32 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
426citing papers in PubMed, 32 pooled it
67.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03313349 naunknown statusnot on this mapstarted 2016, after this paper: background citation

A School-Based Intervention to Improve Social Functioning in Children and Adolescents With ADHD: A Pragmatic Randomized Controlled Trial Comparing Standard and Enriched Provision.

TypeinterventionalSponsorBehandlingsskolerneRan2016 to 2019Enrolled32ConditionsADHD - Combined TypeArmsPsychotherapy: 1. cognitive therapy 2.family intervention
NCT05935254 nacompletednot on this mapstarted 2022, after this paper: background citation

Comparative Evaluation of Plaque Removal Efficacy of Electric Toothbrushes Between Children With Attention Deficit And Hyperactivity Disorder And Healthy Children

TypeinterventionalSponsorAydin Adnan Menderes UniversityRan2022 to 2022Enrolled52ConditionsAttention Deficit and Hyperactivity Disorder, Dental PlaqueArmsPlaque removal efficacy of children's electric toothbrush (Oral-B D100 Vitality, Procter & Gamble, Cincinnati, OH, United States), Plaque removal efficacy of children's soft manual toothbrush (Oral-B Stages 6-12 years, Procter & Gamble, Cincinnati, OH, United States)
NCT07309302 narecruitingnot on this mapstarted 2025, after this paper: background citation

Psychosocial Determinants and Impact of a Synchronous Remote Cognitive Remediation Program on Individuals With Post-Traumatic Stress Disorder.

TypeinterventionalSponsorUniversité du Québec a MontréalRan2025 to 2026Enrolled64ConditionsPost Traumatic Stress Disorder PTSDArmsCognitive Remediation Training, Control Group
3 · Its place in the literature

Who cites it

426 citing papers in PubMed, 32 syntheses or guidelines pooled it, 1,158 citations in OpenAlex.

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  11. Could Nature Contribute to the Management of ADHD in Children? A Systematic Review.International journal of environmental research and public health · 2024
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366 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors at 2 institutions in 2 countries.

Edmund J S Sonuga-BarkeDevelopmental Brain-Behaviour Laboratory, Department of Psychology, University of Southampton, UK. ejb3@soton.ac.uk
Daniel Brandeis
Samuele Cortese
David Daley
Maite Ferrin
Martin Holtmann
Jim Stevenson
Marina Danckaerts
Saskia van der Oord
Manfred Döpfner
Ralf W Dittmann
Emily Simonoff
Alessandro Zuddas
Tobias Banaschewski
Jan Buitelaar
David Coghill
Chris Hollis
Eric Konofal
Michel Lecendreux
Ian C K Wong
Joseph Sergeant
European ADHD Guidelines Group
University of Southampton · GBAmerican Academy of Child and Adolescent Psychiatry · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveNonpharmacological treatments are available for attention deficit hyperactivity disorder (ADHD), although their efficacy remains uncertain. The authors undertook meta-analyses of the efficacy of dietary (restricted elimination diets, artificial food color exclusions, and free fatty acid supplementation) and psychological (cognitive training, neurofeedback, and behavioral interventions) ADHD treatments.

methodUsing a common systematic search and a rigorous coding and data extraction strategy across domains, the authors searched electronic databases to identify published randomized controlled trials that involved individuals who were diagnosed with ADHD (or who met a validated cutoff on a recognized rating scale) and that included an ADHD outcome.

resultsFifty-four of the 2,904 nonduplicate screened records were included in the analyses. Two different analyses were performed. When the outcome measure was based on ADHD assessments by raters closest to the therapeutic setting, all dietary (standardized mean differences=0.21-0.48) and psychological (standardized mean differences=0.40-0.64) treatments produced statistically significant effects. However, when the best probably blinded assessment was employed, effects remained significant for free fatty acid supplementation (standardized mean difference=0.16) and artificial food color exclusion (standardized mean difference=0.42) but were substantially attenuated to nonsignificant levels for other treatments.

conclusionsFree fatty acid supplementation produced small but significant reductions in ADHD symptoms even with probably blinded assessments, although the clinical significance of these effects remains to be determined. Artificial food color exclusion produced larger effects but often in individuals selected for food sensitivities. Better evidence for efficacy from blinded assessments is required for behavioral interventions, neurofeedback, cognitive training, and restricted elimination diets before they can be supported as treatments for core ADHD symptoms.

Indexed as

Diet TherapyPsychotherapyAdolescentAttention Deficit Disorder with HyperactivityBehavior TherapyCentral Nervous System StimulantsChildChild, PreschoolCognition DisordersCognitive Behavioral TherapyCombined Modality TherapyFatty Acids, NonesterifiedFood Coloring AgentsFood HypersensitivityHumansNeurofeedbackCentral Nervous System StimulantsFatty Acids, NonesterifiedFood Coloring Agents

Identifiers

PMID23360949
OpenAlexW2131099228

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.