注意缺陷多动障碍的正念干预:系统回顾与元分析

IF 1.2 Q4 PSYCHIATRY Psychiatry international Pub Date : 2022-12-07 DOI:10.3390/psychiatryint3040031
Clara Kretschmer, Burcu Göz Tebrizcik, E. Dommett
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引用次数: 1

摘要

注意缺陷多动障碍(ADHD)是一种影响儿童和成人的常见神经发育疾病。目前的治疗方法是有限的,人们对正念的使用越来越感兴趣,正念越来越受欢迎。以前的系统评价通常侧重于特定年龄、结果测量或干预措施。目前的审查旨在采取更全面的办法。题目和摘要在五个数据库中检索随机和非随机对照试验或前后研究,参与者诊断为ADHD或在有效的ADHD测量中得分高于临床相关截止值。研究必须测量多动症的症状,全球或社会功能。提取关键信息,包括参与者状态(即诊断、量表评分、合并症、药物使用)、研究设计和结果测量。计算了效应量(Hedge’s g),如果一种测量方法在至少三个具有相同人群的研究中使用,则考虑进行荟萃分析。最初确定了29项研究,其中7项被认为质量较差,并从进一步的分析中删除,剩下22项研究包含来自1237名患有多动症的儿童和成人以及525名家庭成员的数据。数据表明,正念对自我同情、生活质量、幸福感、抑郁和焦虑可能有好处。研究结果还表明,正念也可能改善ADHD症状、执行功能、问题行为和情绪失调,尽管结果因患者年龄和使用的测量方法而异。父母的压力和养育方式受到的关注有限,这突出了在这些领域进行更多研究的必要性。虽然目前的数据表明,正念可能是有益的,但证据基础并不像这种方法那么受欢迎。许多研究缺乏盲法评估、充分的随机化或合适的对照条件。需要进行高质量的对照研究来证实这一点,这些研究考虑了药物治疗、其他社会心理干预、主动和非主动控制的使用、合并症以及更长的随访期。
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Mindfulness Interventions for Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis
Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition impacting children and adults. Current treatments are limited and there is increasing interest in the use of mindfulness, which is growing in popularity. Previous systematic reviews have typically focused on specific ages, outcome measures or interventions. The current review aimed to take a more comprehensive approach. Title and abstract searches were performed in five databases for randomized and non-randomized controlled trials or pre-post studies with participants with an ADHD diagnosis or a score above a clinically relevant cut-off on a validated ADHD measure. Studies had to measure symptoms of ADHD, global or social functioning. Extraction of key information including participant status (i.e., diagnosis, scale scores, comorbidities, medication use), study design, and outcome measures was conducted. Effect sizes (Hedge’s g) were calculated and where a measure had been used in at least three studies with the same population, meta-analyses were considered. Twenty-nine studies were initially identified, with seven deemed poor quality and removed from further analysis leaving, 22 studies containing data from 1237 children and adults with ADHD along with data from 525 family members. The data indicate possible benefits of mindfulness on self-compassion, quality of life, wellbeing, depression, and anxiety. The findings also suggest that mindfulness may also improve ADHD symptoms, executive function, problematic behaviours, and emotional dysregulation, although results vary by age of patient and measures used. Parent stress and parenting style have received limited attention, highlighting the need for more studies in these areas. Whilst the data presented suggest that mindfulness may be beneficial, the evidence base is not as strong as the popularity of the approach. Many of the studies lacked blind assessment, adequate randomization, or suitable control conditions. As such high-quality controlled studies considering medication, other psychosocial interventions, use of active and in active controls and comorbidity as well as longer follow-up periods, are needed to confirm this.
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