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正念与心理教育治疗成人注意缺陷多动障碍:一项随机对照试验

Mindfulness vs psychoeducation in adult ADHD: a randomized controlled trial.

机构信息

Department of Psychiatry and Psychotherapy, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Institute for Forensic Psychology and Psychiatry, Saarland University Faculty of Medicine, Homburg/Saar, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2018 Jun;268(4):321-335. doi: 10.1007/s00406-018-0868-4. Epub 2018 Jan 22.

Abstract

BACKGROUND

Mindfulness training is a promising treatment approach in adult ADHD. However, there has not yet been a randomized controlled trial comparing mindfulness to an active control condition. In this study, we assessed the efficacy of a mindfulness training program (MAP) compared to structured psychoeducation (PE).

METHODS

After randomization 81 medication-free adult ADHD patients participated either in an 8-week MAP or PE group program. At baseline (T1), after 8 weeks (T2) and after 8 months (T3), severity of ADHD and associated symptoms (depression, general psychopathology, quality of life) were measured with the Conner's ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Brief Symptom Inventory (BSI) and the SF-36 by self and blind observer ratings.

RESULTS

Both groups showed significant pre-post improvements in observer-rated Inattention scale (p < .001, partial η = 0.18) and in associated symptomatology, which persisted through 6 months of follow-up. There were no significant differences regarding symptom reduction between the treatment groups. Women benefited more compared to men irrespective of treatment group. Men showed the most pronounced changes under MAP.

CONCLUSIONS

In the current study, MAP was not superior to PE regarding symptom reduction in adult ADHD. Both interventions, mindfulness meditation and PE, were efficacious in reducing symptom load in adult ADHD. Furthermore in exploratory post hoc tests the study provides evidence for a potential gender-specific treatment response in adult ADHD.

摘要

背景

正念训练是一种很有前途的成人 ADHD 治疗方法。然而,目前还没有将正念训练与积极对照条件进行比较的随机对照试验。在这项研究中,我们评估了正念训练计划(MAP)与结构化心理教育(PE)相比的疗效。

方法

81 名未服用药物的成年 ADHD 患者随机分为 MAP 或 PE 组,参加为期 8 周的团体项目。在基线(T1)、8 周后(T2)和 8 个月后(T3),通过自我和盲法观察者评定,使用 Conner's ADHD Rating Scales(CAARS)、贝克抑郁量表(BDI)、Brief Symptom Inventory(BSI)和 SF-36 测量 ADHD 及其相关症状(抑郁、一般心理病理学、生活质量)的严重程度。

结果

两组观察者评定的注意力不集中量表均有显著的前后改善(p<0.001,部分η=0.18),并伴有相关症状的改善,这种改善持续到 6 个月的随访期。两组之间在症状缓解方面没有显著差异。无论治疗组如何,女性的获益都高于男性。男性在 MAP 下表现出最明显的变化。

结论

在目前的研究中,MAP 在减轻成年 ADHD 症状方面并不优于 PE。正念冥想和 PE 两种干预措施都能有效减轻成年 ADHD 的症状负荷。此外,在探索性事后检验中,该研究为成年 ADHD 中潜在的性别特异性治疗反应提供了证据。

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