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Review: Methylphenidate and psychosocial treatments either alone or in combination reduce ADHD symptoms

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QUESTION

Question:

How effective are short-acting methylphenidate and psychosocial treatments, alone or in combination, for school-aged children with attention deficit hyperactivity disorder (ADHD)?

Outcomes:

Core ADHD or oppositional defiant disorder/conduct disorder (ODD/CD) symptoms, social behaviour and academic functioning.

METHODS

Design:

Systematic review with meta-analysis.

Data sources:

PubMed, PsychInfo and ISI Web of Science were searched for randomised controlled trials (RCTs) published between 1 January 1985 and 30 September 2006. Reference lists were hand searched to identify other relevant RCTs.

Study selection and analysis:

Eligible studies included RCTs of short acting methylphenidate and psychosocial (behavioural/cognitive behavioural) treatments in school-aged children (aged 6–12 years) with ADHD. (See online notes for list of exclusions.) Within group effect sizes were calculated (Cohen’s d), with positive effect size indicating improvement. Effect sizes were defined as small, moderate and large based on Cohen’s guidelines (0.2, 0.5 and 0.8 thresholds, respectively). Mean weighted effect size was calculated separately for each informant for each outcome using random effects analyses.

MAIN RESULTS:

Twenty-six RCTs met the inclusion criteria but two were missing data that could not be …

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