Krisanaprakornkit Thawatchai, Ngamjarus Chetta, Witoonchart Chartree, Piyavhatkul Nawanant
Department of Psychiatry, Faculty of Medicine, KhonKaen University, KhonKaen, Thailand, 40002.
Cochrane Database Syst Rev. 2010 Jun 16;2010(6):CD006507. doi: 10.1002/14651858.CD006507.pub2.
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common developmental disorders experienced in childhood and can persist into adulthood. The disorder has early onset and is characterized by a combination of overactive, poorly modulated behavior with marked inattention. In the long term it can impair academic performance, vocational success and social-emotional development. Meditation is increasingly used for psychological conditions and could be used as a tool for attentional training in the ADHD population.
To assess the effectiveness of meditation therapies as a treatment for ADHD.
Our extensive search included: CENTRAL, MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO, C2-SPECTR, dissertation abstracts, LILACS, Virtual Health Library (VHL) in BIREME, Complementary and Alternative Medicine specific databases, HSTAT, Informit, JST, Thai Psychiatric databases and ISI Proceedings, plus grey literature and trial registries from inception to January 2010.
Randomized controlled trials that investigated the efficacy of meditation therapy in children or adults diagnosed with ADHD.
Two authors extracted data independently using a pre-designed data extraction form. We contacted study authors for additional information required. We analyzed data using mean difference (MD) to calculate the treatment effect. The results are presented in tables, figures and narrative form.
Four studies, including 83 participants, are included in this review. Two studies used mantra meditation while the other two used yoga compared with drugs, relaxation training, non-specific exercises and standard treatment control. Design limitations caused high risk of bias across the studies. Only one out of four studies provided data appropriate for analysis. For this study there was no statistically significant difference between the meditation therapy group and the drug therapy group on the teacher rating ADHD scale (MD -2.72, 95% CI -8.49 to 3.05, 15 patients). Likewise, there was no statistically significant difference between the meditation therapy group and the standard therapy group on the teacher rating ADHD scale (MD -0.52, 95% CI -5.88 to 4.84, 17 patients). There was also no statistically significant difference between the meditation therapy group and the standard therapy group in the distraction test (MD -8.34, 95% CI -107.05 to 90.37, 17 patients).
AUTHORS' CONCLUSIONS: As a result of the limited number of included studies, the small sample sizes and the high risk of bias, we are unable to draw any conclusions regarding the effectiveness of meditation therapy for ADHD. The adverse effects of meditation have not been reported. More trials are needed.
注意力缺陷多动障碍(ADHD)是儿童期最常见的发育障碍之一,可持续至成年期。该障碍起病早,其特征是过度活跃、行为调节不良与明显注意力不集中并存。从长远来看,它会损害学业成绩、职业成就和社会情感发展。冥想越来越多地用于心理状况,可作为ADHD人群注意力训练的一种工具。
评估冥想疗法治疗ADHD的有效性。
我们广泛的检索包括:Cochrane系统评价数据库、医学期刊数据库、荷兰医学文摘数据库、护理学与健康照护数据库、教育资源信息中心数据库、心理学文摘数据库、C2 - 频谱数据库、学位论文摘要、拉丁美洲及加勒比地区健康科学数据库、BIREME的虚拟健康图书馆、补充与替代医学特定数据库、健康电子图书馆在线、Informit、日本科学技术信息聚合数据库、泰国精神病学数据库和科学网会议录,以及从创刊至2010年1月的灰色文献和试验注册库。
调查冥想疗法对诊断为ADHD的儿童或成人疗效的随机对照试验。
两位作者使用预先设计的数据提取表独立提取数据。我们联系研究作者获取所需的额外信息。我们使用平均差(MD)分析数据以计算治疗效果。结果以表格、图表和叙述形式呈现。
本综述纳入了4项研究,共83名参与者。两项研究使用曼陀罗冥想,另外两项使用瑜伽,与药物、放松训练、非特异性运动和标准治疗对照进行比较。设计局限性导致各研究存在高偏倚风险。四项研究中只有一项提供了适合分析的数据。对于这项研究,在教师评定的ADHD量表上,冥想治疗组与药物治疗组之间无统计学显著差异(平均差 -2.72,95%可信区间 -8.49至3.05,15名患者)。同样,在教师评定的ADHD量表上,冥想治疗组与标准治疗组之间无统计学显著差异(平均差 -0.52,95%可信区间 -5.88至4.84,17名患者)。在注意力分散测试中,冥想治疗组与标准治疗组之间也无统计学显著差异(平均差 -8.34,95%可信区间 -107.05至90.37,17名患者)。
由于纳入研究数量有限、样本量小以及高偏倚风险,我们无法就冥想疗法治疗ADHD的有效性得出任何结论。尚未报告冥想的不良反应。需要更多试验。