Randomized Controlled Trial
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2023; 11(14): 3238-3247
Published online May 16, 2023. doi: 10.12998/wjcc.v11.i14.3238
Effect of non-pharmacological treatment on the full recovery of social functioning in patients with attention deficit hyperactivity disorder
Ying-Bo Lv, Wei Cheng, Meng-Hui Wang, Xiao-Min Wang, Yan-Li Hu, Lan-Qiu Lv
Ying-Bo Lv, Wei Cheng, Meng-Hui Wang, Xiao-Min Wang, Yan-Li Hu, Lan-Qiu Lv, Pediatric Health Care Section, Ningbo Women and Children’s Hospital, Ningbo 315000, Zhejiang Province, China
Author contributions: Lv YB and Cheng W proposed concepts for this study; Wang MH and Lv LQ collected data; Lv YB, Wang XM, and Hu YL contributed to formal analysis; Lv YB and Lv LQ contributed to the survey; Lv YB, Lv LQ, and Wang XM contributed to this method; Lv YB, Lv LQ, Hu YL, and Wang MH supervised the study; Lv LQ validated this study; Lv YB and Cheng W contributed to the visualization of research; Lv YB and Lv LQ initially drafted this manuscript; Lv YB, Cheng W, Wang MH, and Wang XM reviewed and edited the manuscript.
Supported by Ningbo Science and Technology Plan Project Public Welfare Plan (Municipal Level), No: 2019C50099; Ningbo Medical Key Supporting Discipline Child Health Science, No: 2022-F26.
Institutional review board statement: The study was approved by the Ethics Committee of Ningbo Women and Children’s Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent.
Conflict-of-interest statement: We declare that there are no conflicts of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lan-Qiu Lv, MD, Attending Doctor, Pediatric Health Care Section, Ningbo Women and Children’s Hospital, No. 339 Liuting Street, Haishu District, Ningbo 315000, Zhejiang Province, China. lulanqiunb@sina.com
Received: March 2, 2023
Peer-review started: March 2, 2023
First decision: March 14, 2023
Revised: March 25, 2023
Accepted: April 7, 2023
Article in press: April 7, 2023
Published online: May 16, 2023
Processing time: 75 Days and 1.2 Hours
Abstract
BACKGROUND

Long-term treatment of attention deficit/hyperactivity disorder (ADHD) is associated with adverse events, such as nausea and vomiting, dizziness, and sleep disturbances, and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients' social functioning.

AIM

To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.

METHODS

A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group (methylphenidate hydrochloride and tomoxetine hydrochloride) or the non-pharmacological group (parental training, behavior modification, sensory integration therapy, and sand tray therapy), with 45 cases in each group. Outcome measures included treatment compliance, Swanson, Nolan, and Pelham, Version IV (SNAP-IV) scores, Conners Parent Symptom Questionnaire (PSQ) scores, and Weiss Functional Impairment Rating Scale (WFIRS) scores.

RESULTS

The non-pharmacological interventions resulted in significantly higher compliance in patients (95.56%) compared with medication (71.11%) (P < 0.05). However, no significant differences in SNAP-IV and PSQ scores, in addition to the learning/school, social activities, and adventure activities of the WFIRS scores were observed between the two groups (P > 0.05). Patients with non-pharmacological interventions showed higher WFIRS scores for family, daily life skills, and self-concept than those in the pharmacological group (P < 0.05).

CONCLUSION

Non-pharmacological interventions, in contrast to the potential risks of adverse events after long-term medication, improve patient treatment compliance, alleviate patients' behavioral symptoms of attention, impulsivity, and hyperactivity, and improve their cognitive ability, thereby improving family relationships and patient self-evaluation.

Keywords: Non-pharmacological treatment; Attention deficit hyperactivity disorder; Social functioning; Recovery; Weiss Functional Impairment Rating Scale scores

Core Tip: This study evaluated the effect of non-pharmacological treatments on the full recovery of social functioning in patients with attention deficit hyperactivity disorder (ADHD). A total of 90 patients with ADHD were included in this study. The non-pharmacological intervention resulted in significantly higher patient compliance than the pharmacological treatment group. Patients in the non-pharmacological intervention group also had significantly higher Weiss Functional Impairment Rating Scale scores on family, daily living skills and self-concept than those receiving medication. Thus, non-pharmacological interventions had a positive impact on the overall recovery of social functioning in ADHD patients compared to long-term pharmacological treatment.