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儿童和青少年心理健康与精神疾病中的正念:随机对照试验的系统评价与荟萃分析

Mindfulness in Mental Health and Psychiatric Disorders of Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Carneiro Bruno Daniel, Pozza Daniel Humberto, Costa-Pereira José Tiago, Tavares Isaura

机构信息

Department of Biomedicine, Unit of Experimental Biology, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.

Rheumatology Service, Unidade Local de Saúde do Alto Minho, Hospital Conde de Bertiandos, 4990-078 Ponte de Lima, Portugal.

出版信息

Pediatr Rep. 2025 May 14;17(3):59. doi: 10.3390/pediatric17030059.

Abstract

UNLABELLED

Mindfulness-Based Interventions (MBIs) are important tools to address mental health issues in children and adolescents. However, previous studies provided variable results that suggest that the effectiveness of those third-wave Cognitive Behavioral Therapies remains uncertain.

OBJECTIVES

The main objective is to assess the impact of MBIs on anxiety, depression, and stress in children and adolescents. The secondary objective is to examine the modalities of MBIs used, the duration of interventions, and potential confounding factors, such as age.

METHODS

A comprehensive search of multiple databases was conducted to identify randomized clinical trials (RCTs) evaluating the effects of MBIs on mental health outcomes in children and adolescents. The research was registered in PROSPERO, adhered to PRISMA guidelines, employed the Cochrane Risk of Bias 2 tool, and calculated the effect sizes using mean differences.

RESULTS

Thirteen RCTs were included; ten were identified as having some concerns, while three were classified as having a low risk of bias. Mindfulness-Based Stress Reduction (MBSR) demonstrated a small positive effect on depression and anxiety, while non-specific MBIs showed a moderate positive effect both on depression and anxiety. Mindfulness-Based Cognitive Therapy (MBCT) was effective in reducing anxiety, depression (moderate positive effects on both), and stress symptoms. In one study, no significant improvements were seen on both anxiety and depression (for MBCT) and in another study on anxiety (for MBCT/MBSR). The meta-analysis did not identify a significant effect of mindfulness interventions on depression or anxiety. The high heterogeneity suggests varying outcomes, requiring further study of moderating factors.

CONCLUSIONS

While some studies suggest benefits from MBIs, mainly MBCT's ability to improve mental health outcomes in children and adolescents, their overall efficacy remains uncertain due to the high heterogeneity. The findings underscore the importance of considering the intervention type, duration, and moderating factors, such as age, when implementing MBIs.

摘要

未标注

基于正念的干预措施(MBIs)是解决儿童和青少年心理健康问题的重要工具。然而,先前的研究结果不一,这表明这些第三波认知行为疗法的有效性仍不确定。

目的

主要目的是评估MBIs对儿童和青少年焦虑、抑郁和压力的影响。次要目的是研究使用的MBIs模式、干预持续时间以及潜在的混杂因素,如年龄。

方法

对多个数据库进行全面检索,以识别评估MBIs对儿童和青少年心理健康结果影响的随机临床试验(RCTs)。该研究在PROSPERO中注册,遵循PRISMA指南,使用Cochrane偏倚风险2工具,并使用平均差异计算效应量。

结果

纳入了13项RCTs;10项被确定存在一些问题,而3项被归类为低偏倚风险。基于正念的减压疗法(MBSR)对抑郁和焦虑有小的积极影响,而非特异性MBIs对抑郁和焦虑均有中等程度的积极影响。基于正念的认知疗法(MBCT)在减轻焦虑、抑郁(对两者均有中等程度的积极影响)和压力症状方面有效。在一项研究中,(MBCT)对焦虑和抑郁均未观察到显著改善,在另一项研究中(针对MBCT/MBSR)对焦虑也未观察到显著改善。荟萃分析未发现正念干预对抑郁或焦虑有显著影响。高度异质性表明结果各异,需要进一步研究调节因素。

结论

虽然一些研究表明MBIs有好处,主要是MBCT改善儿童和青少年心理健康结果的能力,但由于高度异质性,其总体疗效仍不确定。研究结果强调了在实施MBIs时考虑干预类型、持续时间和调节因素(如年龄)的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29fb/12101429/5704623f0ecc/pediatrrep-17-00059-g001.jpg

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