School of Education, Jiangsu Key Laboratory for Big Data of Psychology and Cognitive Science, Yancheng Teachers University, Yancheng, China.
Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, Southampton, UK.
Evid Based Ment Health. 2018 Aug;21(3):87-94. doi: 10.1136/ebmental-2018-300015. Epub 2018 Jul 10.
The efficacy of meditation-based therapies for attention deficit/hyperactivity disorder (ADHD) across the lifespan remains uncertain.
To conduct a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy of meditation-based therapies for ADHD core symptoms and associated neuropsychological dysfunctions in children/adolescents or adults with ADHD.
We searched Pubmed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge with no language, date or type of document restriction, up to 5 May 2018. Random-effects model was used. Heterogeneity was assessed with Cochran's Q and I statistics. Publication (small studies) bias was assessed with funnel plots and the Egger's test. Studies were evaluated with the Cochrane risk of bias (RoB) tool. Analyses were conducted using Comprehensive Meta-Analysis.
13 RCTs (seven in children/adolescents, n=270 and six in adults, n=339) were retained. Only one RCT was double-blind.Meditation-based therapies were significantly more efficacious than the control conditions in decreasing the severity of ADHD core symptoms (inattention+hyperactivity/impulsivity: children/adolescents: Hedge's g=-0.44, 95% CI -0.69 to -0.19, I0%; adults: Hedge's g=-0.66, 95% CI -1.21 to -0.11, I81.81%). No significant effects were found on neuropsychological measures of inattention and inhibition in children/adolescents. In adults, significant effects were detected on working memory and inhibition, although these results were based on a small number of studies (n=3). 57% and 43% of the studies in children/adolescents were rated at overall unclear and high risk of bias, respectively. In adults, 33% and 67% of the studies were deemed at overall unclear and high risk of bias, respectively. No evidence of publication bias was found.
Despite statistically significant effects on ADHD combined core symptoms, due to paucity of RCTs, heterogeneity across studies and lack of studies at low risk of bias, there is insufficient methodologically sound evidence to support meditation-based therapies for ADHD.
PROSPERO 2018 [CRD42018096156].
冥想疗法治疗注意缺陷多动障碍（ADHD）的疗效在整个生命周期中仍然不确定。
对评估冥想疗法治疗儿童/青少年或成人 ADHD 核心症状及相关神经心理功能障碍的随机对照试验（RCT）进行系统评价和荟萃分析。
我们对 Pubmed、PsycInfo、Embase+Embase Classic、Ovid Medline 和 Web of Knowledge 进行了检索，没有语言、日期或文件类型的限制，检索时间截至 2018 年 5 月 5 日。采用随机效应模型。采用 Cochran's Q 和 I 统计量评估异质性。采用漏斗图和 Egger 检验评估发表偏倚。使用 Cochrane 偏倚风险（RoB）工具评估研究。采用 Comprehensive Meta-Analysis 进行分析。
保留了 13 项 RCT（7 项在儿童/青少年中，n=270，6 项在成人中，n=339）。只有一项 RCT 为双盲试验。与对照组相比，冥想疗法在降低 ADHD 核心症状严重程度方面更为有效（注意力不集中+多动/冲动：儿童/青少年：Hedge's g=-0.44，95%CI -0.69 至 -0.19，I0%；成人：Hedge's g=-0.66，95%CI -1.21 至 -0.11，I81.81%）。在儿童/青少年中，对注意力和抑制的神经心理学测量无显著影响。在成人中，发现工作记忆和抑制方面有显著效果，但这些结果基于少数研究（n=3）。在儿童/青少年中，分别有 57%和 43%的研究被评为整体不明确和高偏倚风险，在成人中，分别有 33%和 67%的研究被评为整体不明确和高偏倚风险。未发现发表偏倚的证据。
尽管冥想疗法对 ADHD 综合核心症状有统计学意义上的影响，但由于 RCT 数量少、研究间异质性大以及低偏倚风险研究缺乏，尚无足够的循证医学证据支持冥想疗法治疗 ADHD。
PROSPERO 2018[CRD42018096156]。
