HealthDay News — Under blinded conditions, non-pharmacological treatments for attention-deficit/hyperactivity disorder (ADHD) show limited evidence of symptom improvement, according to a meta-analysis published online Jan. 30 in the American Journal of Psychiatry.

Edmund J.S. Sonuga-Barke, PhD, from the University of Southampton in the United Kingdom, and colleagues conducted a meta-analysis of the efficacy of dietary (restricted elimination diets, artificial food color exclusions, and free fatty acid supplementation) and psychological (cognitive training, neurofeedback, and behavioral interventions) ADHD treatments.

The researchers found that, based on the 54 randomized controlled trials included in the analysis, when raters closest to the therapeutic setting assessed outcome measures, all dietary (standardized mean differences, 0.21 to 0.48) and psychological (standardized mean differences, 0.40 to 0.64) treatments produced statistically significant effects.

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Effects of free fatty acid supplementation (standardized mean difference, 0.16) and artificial food color exclusion (standardized mean difference, 0.42) were the only ones to remain significant when employing the best probably blinded assessment.

“Free fatty acid supplementation produced small but significant reductions in ADHD symptoms even with probably blinded assessments, although the clinical significance of these effects remains to be determined,” the researchers wrote. “The challenge for the future is to improve the efficacy of non-pharmacological interventions on the basis of a growing understanding of ADHD pathophysiology and to better integrate these interventions with pharmacological approaches.”


  1. Sonuga-Barke EJS et al. Am J Psychiatry. 2013; 170: 275-289.