CLINICAL TRIAL article
Front. Psychiatry
Sec. ADHD
This article is part of the Research TopicAdvancing Clinical Psychology: Current Research, Emerging Therapies, and Future Perspectives - Volume IIView all articles
The Effect of Phosphatidylserine on Behavioral Problems in Children with Attention Deficit Hyperactivity Disorder
Provisionally accepted
- 1Hangzhou Normal University, Hangzhou, China
- 2Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
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Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by attention deficit, hyperactivity, and various internalizing and externalizing behavioral problems. Phosphatidylserine (PS), a nutritional supplement, has shown potential in improving behavioral symptoms. This study aimed to evaluate the effects of PS on core symptoms and associated behavioral problems in children with ADHD. We conducted a randomized, open-label, controlled trial involving 56 children with ADHD. Participants were randomly allocated to receive either phosphatidylserine or atomoxetine for three months. Core symptoms as well as internalizing and externalizing behaviors were assessed using the SNAP-IV rating scale and the Achenbach Child Behavior Checklist (CBCL). The PS group showed no significant improvement in core ADHD symptoms (attention deficit: M = 0.26, SD = 0.60, p > 0.05, d = 0.43; hyperactivity/impulsivity: M = 0.11, SD = 0.46, p > 0.05, d = 0.23; total score: M = 3.82, SD = 10.27, p > 0.05, d = 0.37), whereas the atomoxetine group showed significant improvements in attention deficit (M = 0.40, SD = 0.50, p < 0.05, d = 0.80), hyperactivity/impulsivity (M = 0.26, SD = 0.49, p < 0.05, d = 0.54), and total scores (M = 7.00, SD = 9.38, p < 0.05, d = 0.75). In contrast, the PS group demonstrated significant reductions in internalizing (M = 1.83, SD = 3.28, p < 0.05, d = 0.56) and externalizing behaviors (M = 3.38, SD = 5.20, p < 0.05, d = 0.65), whereas the atomoxetine group improved only in externalizing behaviors (M = 2.54, SD = 5.42, p < 0.05, d = 0.47). Further analysis revealed that both groups showed significant decreases in aggressive behaviors (PS: M = 2.79, SD = 4.24, p < 0.05, d = 0.66; atomoxetine: M = 2.43, SD = 4.90, p < 0.05, d = 0.50). Phosphatidylserine was not associated with significant improvements in core ADHD symptoms but was associated with reductions in internalizing and externalizing behavioral problems, particularly in reducing aggression. These findings suggest that PS warrants further investigation as a promising adjunctive treatment targeting behavioral dysregulation in children with ADHD.
Keywords: attention-deficit hyperactivity disorder, Externalizing Behavior, Internalizing Behavior, non-pharmacological intervention, phosphatidylserine
Received: 08 Jul 2025; Accepted: 02 Feb 2026.
Copyright: © 2026 Jia, Shen, Li, Jiang, Fang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yantong Fang
Hang Zhang
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