Meppelink Renée, de Bruin Esther I, Bögels Susan M
Research Institute of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, The Netherlands.
Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands.
BMC Psychiatry. 2016 Jul 26;16:267. doi: 10.1186/s12888-016-0978-3.
Attention-Deficit-Hyperactivity-Disorder (ADHD) is, with a prevalence of 5 %, a highly common childhood disorder, and has severe impact on the lives of youngsters and their families. Medication is often the treatment of choice, as it currently is most effective. However, medication has only short-term effects, treatment adherence is often low and most importantly; medication has serious side effects. Therefore, there is a need for other interventions for youngsters with ADHD. Mindfulness training is emerging as a potentially effective training for children and adolescents with ADHD. The aim of this study is to compare the (cost) effectiveness of mindfulness training to the (cost) effectiveness of methylphenidate in children with ADHD on measures of attention and hyperactivity/impulsivity.
METHODS/DESIGN: A multicenter randomized controlled trial with 2 follow-up measurements will be used to measure the effects of mindfulness training versus the effects of methylphenidate. Participants will be youngsters (aged 9 to 18) of both sexes diagnosed with ADHD, referred to urban and rural mental healthcare centers. We aim to include 120 families. The mindfulness training, using the MYmind protocol, will be conducted in small groups, and consists of 8 weekly 1.5-h sessions. Youngsters learn to focus and enhance their attention, awareness, and self-control by doing mindfulness exercises. Parents will follow a parallel mindful parenting training in which they learn to be fully present in the here and now with their child in a non-judgmental way, to take care of themselves, and to respond rather than react to difficult behavior of their child. Short-acting methylphenidate will be administered individually and monitored by a child psychiatrist. Assessments will take place at pre-test, post-test, and at follow-up 1 and 2 (respectively 4 and 10 months after the start of treatment). Informants are parents, children, teachers, and researchers.
This study will inform mental health care professionals and health insurance companies about the clinical and cost effectiveness of mindfulness training for children and adolescents with ADHD and their parents compared to the effectiveness of methylphenidate. Limitations and several types of bias that are anticipated for this study are discussed.
Dutch Trial Register: NTR4206 . Registered 11 October 2013.
注意力缺陷多动障碍（ADHD）是一种非常常见的儿童疾病，患病率为5%，对青少年及其家庭的生活有严重影响。药物治疗通常是首选治疗方法，因为目前它是最有效的。然而，药物治疗只有短期效果，治疗依从性往往较低，而且最重要的是，药物有严重的副作用。因此，需要为患有ADHD的青少年提供其他干预措施。正念训练正成为一种对患有ADHD的儿童和青少年可能有效的训练方法。本研究的目的是在注意力和多动/冲动测量方面，比较正念训练与哌甲酯对ADHD儿童的（成本）效益。
方法/设计：一项多中心随机对照试验，进行2次随访测量，以测量正念训练与哌甲酯的效果。参与者将是被诊断患有ADHD的9至18岁青少年，他们被转介到城市和农村的精神卫生保健中心。我们的目标是纳入120个家庭。使用MYmind方案的正念训练将以小组形式进行，包括8次每周1.5小时的课程。青少年通过进行正念练习来学习集中注意力并提高他们的注意力、意识和自我控制能力。父母将参加并行的正念养育训练，在训练中他们学习以非评判的方式与孩子完全相处在此刻此地，照顾好自己，并对孩子的困难行为做出回应而非反应。短效哌甲酯将单独给药，并由儿童精神科医生进行监测。评估将在预测试、后测试以及随访1和随访2时进行（分别在治疗开始后的4个月和10个月）。提供信息者包括父母、孩子、教师和研究人员。
本研究将告知精神卫生保健专业人员和健康保险公司，与哌甲酯的效果相比，正念训练对患有ADHD的儿童、青少年及其父母的临床和成本效益。讨论了本研究预期的局限性和几种偏差类型。
荷兰试验注册：NTR4206。2013年10月11日注册。
