Kim Hwan-Hee, Jung Nam-Hae
Department of Occupational Therapy, Semyung University, Jecheon-si, Republic of Korea.
Department of Occupational Therapy, Dongseo University, Busan, Republic of Korea.
Medicine (Baltimore). 2025 Sep 12;104(37):e44308. doi: 10.1097/MD.0000000000044308.
Attention-deficit/hyperactivity disorder (ADHD) frequently persists into adulthood and is associated with impairments in attention, emotional regulation, executive functioning, and quality of life. Although mindfulness-based interventions (MBIs) have been proposed as promising non-pharmacological treatments, the evidence regarding their efficacy in adults with ADHD remains inconsistent.
A systematic search was conducted using the MEDLine, CINAHL, and PsycINFO databases to identify controlled trials published up to 2023. Studies were included if they evaluated the effects of MBIs in adults with ADHD using a control group, regardless of randomization. Only studies in which mindfulness was the primary therapeutic modality were included, even if limited psychoeducational or behavioral components were present. Ten studies met the inclusion criteria. Outcomes were categorized into 6 domains: self-reported and observer-rated ADHD symptoms, negative and positive affect, mindfulness skills, and functional outcomes. Meta-analyses were performed using standardized mean differences (SMDs) or mean differences with 95% confidence intervals (CIs). Risk of bias and publication bias were assessed using Cochrane tools and funnel plots, respectively.
Statistically significant improvements were observed in self-reported ADHD symptoms (SMD = 0.48, 95% CI [0.19, 0.76]), observer-rated ADHD symptoms (SMD = 0.32, 95% CI [0.09, 0.56]), and functional outcomes (SMD = 0.56, 95% CI [0.22, 0.90]). However, there were no significant effects on mindfulness skills (SMD = -0.20, 95% CI [-0.47, 0.08]), negative affect (SMD = 0.31, 95% CI [-0.06, 0.67]), or positive affect (SMD = -0.21, 95% CI [-0.58, 0.16]).
MBIs may be effective in improving core ADHD symptoms and overall functioning in adults with ADHD. However, their effects on emotional well-being and mindfulness skills remain inconclusive. These findings support the utility of MBIs as complementary interventions for ADHD while highlighting the need for further high-quality studies to clarify their long-term effects and mechanisms of action.
注意力缺陷多动障碍(ADHD)常常持续至成年期,并与注意力、情绪调节、执行功能及生活质量受损相关。尽管基于正念的干预措施(MBIs)已被视为有前景的非药物治疗方法,但关于其对成年ADHD患者疗效的证据仍不一致。
通过检索MEDLine、CINAHL和PsycINFO数据库进行系统搜索,以识别截至2023年发表的对照试验。如果研究使用对照组评估MBIs对成年ADHD患者的影响,无论是否随机分组,均纳入研究。仅纳入以正念为主要治疗方式的研究,即使存在有限的心理教育或行为成分。十项研究符合纳入标准。结果分为6个领域:自我报告和观察者评定的ADHD症状、消极和积极情绪、正念技能及功能结局。使用标准化均数差(SMD)或95%置信区间(CI)的均数差进行荟萃分析。分别使用Cochrane工具和漏斗图评估偏倚风险和发表偏倚。
在自我报告的ADHD症状(SMD = 0.48,95% CI [0.19, 0.76])、观察者评定的ADHD症状(SMD = 0.32,95% CI [0.09, 0.56])和功能结局(SMD = 0.56,95% CI [0.22, 0.90])方面观察到具有统计学意义的改善。然而,对正念技能(SMD = -0.20,95% CI [-0.47, 0.08])、消极情绪(SMD = 0.31,95% CI [-0.06, 0.67])或积极情绪(SMD = -0.21,95% CI [-0.58, 0.16])没有显著影响。
MBIs可能对改善成年ADHD患者的核心ADHD症状和整体功能有效。然而,它们对情绪健康和正念技能的影响仍不明确。这些发现支持MBIs作为ADHD辅助干预措施的效用,同时强调需要进一步的高质量研究来阐明其长期效果和作用机制。