Efficacy of digital mental health interventions for attention-deficit hyperactivity disorder: A meta-analytic review of randomised controlled trials

Abstract

Attention-Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder that significantly impacts various facets of life. While traditional treatments such as medication and behavioural therapy are effective, they often fall short due to limited access and undesirable side effects. In response to these limitations, digital mental health interventions have emerged as a transformative approach in alleviating ADHD symptoms. The current meta-analysis investigates the effectiveness of digital mental health interventions for ADHD synthesising data across 23 randomised controlled trials, with 99 effect sizes across 1472 participants. Results showed small, significant effects of digital mental health interventions in reducing overall ADHD symptoms (g = −0.32, SE = 0.11, 95 % CI = [-0.53, −0.11], p = .003) and inattentive symptoms (g = −0.25, SE = 0.11, 95 % CI = [-0.47, −0.04], p = .020). No significant effect was found for hyperactivity/impulsivity (g = −0.25, SE = 0.11, 95 % CI = [-0.47, −0.04], p = .020). Intervention type significantly moderated the effects of digital interventions, with neurofeedback interventions showing lower effectiveness compared to combination-based interventions, while telehealth and mHealth interventions showed no significant differences. Additionally, no significant differences were found between therapist-guided and self-guided interventions, suggesting that both delivery formats may be viable. Other methodological factors (e.g., intervention duration, informant assessed, measures used to assess ADHD, and control type) and sample characteristics (e.g., age, gender, region) did not significantly moderate intervention effects. These findings highlight the potential of digital interventions for ADHD management while suggesting that neurofeedback interventions may require modifications to enhance their effectiveness.