评估证据：对注意力缺陷多动障碍数字干预措施有效性和安全性综述的系统评价

Evaluating the evidence: a systematic review of reviews of the effectiveness and safety of digital interventions for ADHD.

作者信息

Gabarron Elia, Denecke Kerstin, Lopez-Campos Guillermo

机构信息

Department of Education, ICT and Learning, Østfold University College, Halden, Norway.

Institute for Patient-Centered Digital Health, Bern University of Applied Sciences, Bern, Switzerland.

出版信息

BMC Psychiatry. 2025 Apr 22;25(1):414. doi: 10.1186/s12888-025-06825-0.

DOI:10.1186/s12888-025-06825-0

PMID:40264083

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12016436/

Abstract

BACKGROUND

Attention-Deficit/Hyperactivity Disorder (ADHD) impacts academics, work and social relationships. Digital interventions, such as virtual reality, games, app and other, offer accessible therapeutic options, yet understanding their efficacy and potential adverse effects is crucial for safe use. The objective of this study is to identify and analyze the efficacy and adverse effects reported in systematic reviews of digital interventions for ADHD.

METHODS

We conducted a systematic review of systematic reviews to assess the reported efficacy and safety of digital interventions for ADHD. We searched for relevant publications in Scopus, PubMed, PsycINFO and Cochrane Library. Both study selection and data extraction were performed in duplicate to ensure accuracy and reduce bias. This review followed PRISMA 2020 guidelines, PRISMA-harms checklist, and we used AMSTAR-2 to assess the quality and risk of bias of the included reviews.

RESULTS

A total of 26 systematic reviews on digital interventions for ADHD were included. These reviews collectively involved 34,442 participants, with the majority focusing on children and adolescents. The digital interventions analyzed included video games, computerized cognitive training, virtual reality, apps, and others. The outcomes reported various positive effects, such as improvements in inattention and executive function, though evidence was generally low quality. Adverse effects were reported in 8 of the 26 included reviews (30,1%), and included physical discomfort, emotional reactions, and behavioral issues, such as video game addiction.

CONCLUSIONS

This systematic review of systematic reviews indicates that while digital interventions for ADHD show potential benefits, their effectiveness remains inconclusive due to low evidence quality. Adverse effects, particularly from video games, have been reported but are inconsistently documented. Future research should focus on rigorous safety assessments, standardized reporting, and long-term effectiveness.

TRIAL REGISTRATION

This systematic review is registered in Prospero: CRD42024521084.

摘要

背景

注意力缺陷多动障碍（ADHD）会影响学业、工作和社会关系。数字干预措施，如虚拟现实、游戏、应用程序等，提供了便捷的治疗选择，但了解它们的疗效和潜在不良影响对于安全使用至关重要。本研究的目的是识别和分析在ADHD数字干预措施的系统评价中报告的疗效和不良影响。

方法

我们对系统评价进行了一项系统评价，以评估ADHD数字干预措施报告的疗效和安全性。我们在Scopus、PubMed、PsycINFO和Cochrane图书馆中搜索了相关出版物。研究选择和数据提取均进行了重复操作，以确保准确性并减少偏差。本评价遵循PRISMA 2020指南、PRISMA危害清单，我们使用AMSTAR-2评估纳入评价的质量和偏倚风险。

结果

共纳入26项关于ADHD数字干预措施的系统评价。这些评价总共涉及34442名参与者，大多数关注儿童和青少年。分析的数字干预措施包括电子游戏、计算机化认知训练、虚拟现实、应用程序等。报告的结果有各种积极影响，如注意力不集中和执行功能的改善，不过证据质量普遍较低。26项纳入评价中有8项（30.1%）报告了不良影响，包括身体不适、情绪反应和行为问题，如电子游戏成瘾。