心理干预
观察研究
致盲
青少年精神病学
心理健康
注意缺陷多动障碍
心理学
透视图(图形)
医疗保健
梅德林
循证实践
医学
循证医学
精神科
临床心理学
随机对照试验
替代医学
病理
法学
经济
人工智能
外科
政治学
经济增长
计算机科学
作者
David Coghill,Tobias Banaschewski,Samuele Cortese,Philip Asherson,Daniel Brandeis,Jan K. Buitelaar,David Daley,Marina Danckaerts,Regina Dittmann,Manfred Döepfner,Maite Ferrín,Chris Hollis,Martin Holtmann,Paramala Santosh,Edmund Sonuga‐Barke,César Soutullo,Hans‐Christoph Steinhausen,Saskia Van der Oord,Ian Chi Kei Wong,Alessandro Zuddas,Emily Simonoff
标识
DOI:10.1007/s00787-021-01871-x
摘要
ADHD is the most common neurodevelopmental disorder presenting to child and adolescent mental health, paediatric, and primary care services. Timely and effective interventions to address core ADHD symptoms and co-occurring problems are a high priority for healthcare and society more widely. While much research has reported on the benefits and adverse effects of different interventions for ADHD, these individual research reports and the reviews, meta-analyses and guidelines summarizing their findings are sometimes inconsistent and difficult to interpret. We have summarized the current evidence and identified several methodological issues and gaps in the current evidence that we believe are important for clinicians to consider when evaluating the evidence and making treatment decisions. These include understanding potential impact of bias such as inadequate blinding and selection bias on study outcomes; the relative lack of high-quality data comparing different treatments and assessing long-term effectiveness, adverse effects and safety for both pharmacological and non-pharmacological treatments; and the problems associated with observational studies, including those based on large national registries and comparing treatments with each other. We highlight key similarities across current international clinical guidelines and discuss the reasons for divergence where these occur. We discuss the integration of these different perspective into a framework for person/family-centered evidence-based practice approach to care that aims to achieve optimal outcomes that prioritize individual strengths and impairments, as well as the personal treatment targets of children and their families. Finally, we consider how access to care for this common and impairing disorder can be improved in different healthcare systems.
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