Department of Clinical and Biological Sciences, University of Turin, Italy.
Department of Clinical and Biological Sciences, University of Turin, Italy.
J Affect Disord. 2021 Sep 1;292:475-486. doi: 10.1016/j.jad.2021.05.068. Epub 2021 Jun 5.
BACKGROUND: Mindfulness-Based Interventions (MBIs) have been increasingly proposed as treatment in patients with Attention-Deficit/Hyperactivity Disorder (ADHD), showing promising results on different proposed outcomes, in both children and adults. OBJECTIVES: To systematically review and meta-analyse studies concerning the effects of MBIs on either ADHD and associated features, associated clinical conditions, neurocognitive impairments, mindfulness skills, global functioning and quality of life. METHODS: Searches were conducted on five databases, including controlled and observational studies on both adults and children populations. The review process was compliant to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Meta-analyses and meta-regression models were conducted. RESULTS: Thirty-one full-texts were included. In both adults and children, MBIs showed to be more effective than waiting lists in improving ADHD symptoms and some other outcomes. In adults, a medium pooled effect size was shown by meta-analysis for ADHD symptoms but in some cases a publication bias was detected. Subgroup analysis and meta-regression confirmed the gap detected by our systematic review between the medium/large effect size of inactive-controlled studies and the low/negligible one of active-controlled studies. In children, no active-controlled studies have been conducted. Mindfulness Awareness Practice (MAP) and Mindfulness Based Cognitive Therapy (MBCT) were the most used protocols in adult studies, whereas a combination of MBCT and Mindfulness Based Stress Reduction (MBSR) was more preferred for children and adolescent patients. CONCLUSIONS: Even if further studies with a better methodology are needed, we can suggest the MBIs may be useful as complementation and not as replacement of other active interventions.
背景:正念干预(MBIs)已被越来越多地提议作为注意力缺陷多动障碍(ADHD)患者的治疗方法,在儿童和成人中,对不同提出的结果显示出有希望的结果。
目的:系统地回顾和荟萃分析关于正念干预对 ADHD 及其相关特征、相关临床状况、神经认知障碍、正念技能、整体功能和生活质量的影响的研究。
方法:在五个数据库中进行了搜索,包括针对成人和儿童的对照和观察性研究。审查过程符合系统评价和荟萃分析的首选报告项目(PRISMA)。进行了荟萃分析和荟萃回归模型。
结果:纳入了 31 篇全文。在成人和儿童中,MBI 均显示比等待名单更能有效改善 ADHD 症状和其他一些结果。在成人中,荟萃分析显示 ADHD 症状的中等 pooled 效应量,但在某些情况下检测到发表偏倚。亚组分析和荟萃回归证实了我们的系统评价中检测到的成人研究中无活性对照研究的中等/大效应量与活性对照研究的低/可忽略的效应量之间的差距。在儿童中,没有进行活性对照研究。在成人研究中,正念意识实践(MAP)和正念认知疗法(MBCT)是最常用的方案,而 MBCT 和正念减压(MBSR)的组合更受儿童和青少年患者的青睐。
结论:即使需要进一步具有更好方法学的研究,我们也可以建议正念干预可能是有用的补充,而不是其他活性干预的替代。
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