Disruptive behaviour disorders: there were 3 RCTs (396 children) of parent training; 3 RCTs (241 children), 1 quasi-experimental study (30 children) and 1 chart review (270 children) of clinic-based interventions; 6 RCTs (538 children) of community-based interventions; 2 RCTs (194 children) and 1 quasi-experimental study (891 children) of prevention programmes; and 4 RCTs (187 children) of psychopharmacological interventions.
ADHD: there were 5 RCTs (138 children) and 1 crossover study (49 children) of psychosocial interventions; 4 RCTs (324 children), 7 crossover studies (more than 149 children) and 1 quasi-experimental study (84 children) of psychopharmacological programmes; and 6 RCTs (880 children) and 1 crossover study (31 children) of adjunctive interventions.
Disruptive behaviour disorders - psychosocial interventions.
Parent training: the effect sizes ranged from large to medium, with medium effect sizes being obtained for interventions under usual clinical situations. The studies generally focused on younger children.
Clinic-based interventions: a number of these out-patient programmes showed positive effects. Cognitive-behavioural and family-orientated programmes consistently showed positive effects. There was some evidence of benefit for interventions combining child-focused and parent- or family-focused programmes. Psychoanalysis was only assessed in one small study but the results were positive. There was evidence that short-term interventions produced long-term sustainable positive outcomes.
Community-based interventions: the studies were conducted in relatively controlled situations in few settings and with extensive input. The generalisibility of the results was not known.
Prevention programmes: the results suggested that prevention programmes have a positive effect on younger children with disruptive behaviour. The effect sizes ranged from small to quite large.
Psychopharmacological interventions: few studies examined these treatments. The identified studies were generally small, of short duration, and were conducted in in-patients. The effect sizes ranged from medium to large for short-term outcomes.
ADHD.
Psychosocial interventions: there was some evidence of benefit from the interventions. Many studies had small sample sizes and reported only short-term outcomes. Studies with longer term follow-up showed that differences between the groups disappeared at follow-up.
Psychopharmacological interventions: the results suggested positive effects from these interventions. The effect sizes ranged from medium to large. The side-effects were generally mild and dose dependent and they reduced with time. For most studies only short-term outcomes were reported.
Adjunctive interventions: the effect of adjunctive treatments was unclear. The overall results suggested small positive effects for psychosocial treatments, medium to large effects for medication, and slightly larger effects for pharmacological plus psychosocial interventions.