Comparison 1.
PUFA versus placebo ‐ parallel trials
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
|---|---|---|---|---|
| 1 Improvement | 2 | 97 | Risk Ratio (M‐H, Fixed, 95% CI) | 2.19 [1.04, 4.62] |
| 1.1 Omega‐3/6 PUFAs | 2 | 97 | Risk Ratio (M‐H, Fixed, 95% CI) | 2.19 [1.04, 4.62] |
| 2 ADHD symptoms: total ‐ parent | 5 | 413 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.17 [‐0.38, 0.03] |
| 2.1 Omega‐3 PUFAs | 3 | 293 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.06 [‐0.30, 0.18] |
| 2.2 Omega‐3/6 PUFAs | 2 | 120 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.48 [‐0.88, ‐0.08] |
| 3 ADHD symptoms: inattention ‐ parent | 6 | 469 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.04 [‐0.29, 0.21] |
| 3.1 Omega‐3 PUFAs | 3 | 286 | Std. Mean Difference (IV, Random, 95% CI) | 0.10 [‐0.28, 0.47] |
| 3.2 Omega‐3/6 PUFAs | 3 | 183 | Std. Mean Difference (IV, Random, 95% CI) | ‐0.21 [‐0.52, 0.10] |
| 4 ADHD symptoms: hyperactivity/impulsivity ‐ parent | 5 | 416 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.04 [‐0.25, 0.16] |
| 4.1 Omega‐3 PUFAs | 2 | 233 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.05 [‐0.32, 0.22] |
| 4.2 Omega‐3/6 PUFAs | 3 | 183 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.03 [‐0.34, 0.28] |
| 5 ADHD symptoms: total ‐ teacher | 4 | 324 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.05 [‐0.18, 0.27] |
| 5.1 Omega‐3 PUFAs | 2 | 228 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.10 [‐0.17, 0.37] |
| 5.2 Omega‐3/6 PUFAs | 2 | 96 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.05 [‐0.45, 0.35] |
| 6 ADHD symptoms: inattention ‐ teacher | 3 | 260 | Std. Mean Difference (IV, Random, 95% CI) | 0.26 [‐0.22, 0.74] |
| 6.1 Omega‐3 PUFAs | 2 | 227 | Std. Mean Difference (IV, Random, 95% CI) | 0.03 [‐0.24, 0.30] |
| 6.2 Omega‐3/6 PUFAs | 1 | 33 | Std. Mean Difference (IV, Random, 95% CI) | 1.01 [0.28, 1.75] |
| 7 ADHD symptoms: hyperactivity/impulsivity ‐ teacher | 3 | 259 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.10 [‐0.16, 0.35] |
| 7.1 Omega‐3 PUFAs | 2 | 226 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.04 [‐0.24, 0.31] |
| 7.2 Omega‐3/6 PUFAs | 1 | 33 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.48 [‐0.21, 1.18] |
| 8 ADHD symptoms: total ‐ clinician | 1 | Mean Difference (IV, Fixed, 95% CI) | Totals not selected | |
| 8.1 Omega‐3/6 PUFAs | 1 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 9 ADHD symptoms: inattention ‐ clinician | 1 | Mean Difference (IV, Fixed, 95% CI) | Totals not selected | |
| 9.1 Omega‐3/6 PUFAs | 1 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 10 ADHD symptoms: hyperactivity/impulsivity ‐ clinician | 1 | Mean Difference (IV, Fixed, 95% CI) | Totals not selected | |
| 10.1 Omega‐3/6 PUFAs | 1 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 11 Behaviour: internalising ‐ parent | 1 | Mean Difference (IV, Fixed, 95% CI) | Totals not selected | |
| 11.1 Omega‐3 PUFAs | 1 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 12 Behaviour: externalising ‐ parent | 1 | Mean Difference (IV, Fixed, 95% CI) | Totals not selected | |
| 12.1 Omega‐3 PUFAs | 1 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 13 Behaviour: socialisation ‐ parent | 1 | Mean Difference (IV, Fixed, 95% CI) | Totals not selected | |
| 13.1 Omega‐3 PUFAs | 1 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 13.2 Omega‐3/6 PUFAs | 0 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 14 Behaviour: conduct ‐ parent | 1 | Mean Difference (IV, Fixed, 95% CI) | Totals not selected | |
| 14.1 Omega‐3/6 PUFAs | 1 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 15 Behaviour: oppositional ‐ parent | 3 | 266 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.10 [‐0.15, 0.35] |
| 15.1 Omega‐3 PUFAs | 2 | 233 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.12 [‐0.15, 0.39] |
| 15.2 Omega‐3/6 PUFAs | 1 | 33 | Std. Mean Difference (IV, Fixed, 95% CI) | ‐0.02 [‐0.70, 0.67] |
| 16 Behaviour: conduct ‐ teacher | 1 | Mean Difference (IV, Fixed, 95% CI) | Totals not selected | |
| 16.1 Omega‐3/6 PUFAs | 1 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 17 Behaviour: oppositional ‐ teacher | 3 | 257 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.11 [‐0.15, 0.36] |
| 17.1 Omega‐3 PUFAs | 2 | 224 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.10 [‐0.18, 0.37] |
| 17.2 Omega‐3/6 PUFAs | 1 | 33 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.16 [‐0.53, 0.85] |
| 18 Quality of life | 1 | Mean Difference (IV, Fixed, 95% CI) | Totals not selected | |
| 18.1 Omega‐3 PUFAs | 1 | Mean Difference (IV, Fixed, 95% CI) | 0.0 [0.0, 0.0] | |
| 19 Side effects | 3 | Risk Ratio (M‐H, Fixed, 95% CI) | Subtotals only | |
| 19.1 Dermatitis | 1 | 147 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.43 [0.06, 34.36] |
| 19.2 Diarrhoea | 1 | 85 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.73 [0.17, 3.08] |
| 19.3 Gastrointestinal discomfort | 1 | 147 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.71 [0.21, 2.38] |
| 19.4 Headache | 1 | 147 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.16 [0.01, 3.82] |
| 19.5 Hyperactivity | 1 | 147 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.43 [0.06, 34.36] |
| 19.6 Nausea | 3 | 306 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.02 [0.39, 2.70] |
| 19.7 Nose bleed | 1 | 88 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.32 [0.03, 2.95] |
| 19.8 Tics | 1 | 147 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.43 [0.06, 34.36] |
| 19.9 General | 1 | 63 | Risk Ratio (M‐H, Fixed, 95% CI) | 2.91 [0.87, 9.74] |
| 20 Loss to follow‐up | 7 | 589 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.95 [0.69, 1.31] |
| 20.1 Omega‐3 PUFAs | 4 | 386 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.17 [0.78, 1.75] |
| 20.2 Omega‐3/6 PUFAs | 3 | 203 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.66 [0.38, 1.13] |