Meditation or Medication? Mindfulness Training Versus Medication in the Treatment of Childhood ADHD: a Randomized Controlled Trial

Overview

Journal BMC Psychiatry

Publisher Biomed Central

Specialty Psychiatry

Date 2016 Jul 28

PMID 27460004

Citations 8

Authors

Renee Meppelink

Esther I de Bruin

Susan M Bogels

Affiliations

Soon will be listed here.

Abstract

Background: Attention-Deficit-Hyperactivity-Disorder (ADHD) is, with a prevalence of 5 %, a highly common childhood disorder, and has severe impact on the lives of youngsters and their families. Medication is often the treatment of choice, as it currently is most effective. However, medication has only short-term effects, treatment adherence is often low and most importantly; medication has serious side effects. Therefore, there is a need for other interventions for youngsters with ADHD. Mindfulness training is emerging as a potentially effective training for children and adolescents with ADHD. The aim of this study is to compare the (cost) effectiveness of mindfulness training to the (cost) effectiveness of methylphenidate in children with ADHD on measures of attention and hyperactivity/impulsivity.

Methods/design: A multicenter randomized controlled trial with 2 follow-up measurements will be used to measure the effects of mindfulness training versus the effects of methylphenidate. Participants will be youngsters (aged 9 to 18) of both sexes diagnosed with ADHD, referred to urban and rural mental healthcare centers. We aim to include 120 families. The mindfulness training, using the MYmind protocol, will be conducted in small groups, and consists of 8 weekly 1.5-h sessions. Youngsters learn to focus and enhance their attention, awareness, and self-control by doing mindfulness exercises. Parents will follow a parallel mindful parenting training in which they learn to be fully present in the here and now with their child in a non-judgmental way, to take care of themselves, and to respond rather than react to difficult behavior of their child. Short-acting methylphenidate will be administered individually and monitored by a child psychiatrist. Assessments will take place at pre-test, post-test, and at follow-up 1 and 2 (respectively 4 and 10 months after the start of treatment). Informants are parents, children, teachers, and researchers.

Discussion: This study will inform mental health care professionals and health insurance companies about the clinical and cost effectiveness of mindfulness training for children and adolescents with ADHD and their parents compared to the effectiveness of methylphenidate. Limitations and several types of bias that are anticipated for this study are discussed.

Trial Registration: Dutch Trial Register: NTR4206 . Registered 11 October 2013.

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References

Suveg C, Sood E, Barmish A, Tiwari S, Hudson J, Kendall P . "I'd rather not talk about it": emotion parenting in families of children with an anxiety disorder. J Fam Psychol. 2008; 22(6):875-84. PMC: 2610353. DOI: 10.1037/a0012861. View

Wolraich M, Brown L, Brown R, DuPaul G, Earls M, Feldman H . ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011; 128(5):1007-22. PMC: 4500647. DOI: 10.1542/peds.2011-2654. View

Cohen S, Kamarck T, Mermelstein R . A global measure of perceived stress. J Health Soc Behav. 1983; 24(4):385-96. View

Fabiano G, Pelham Jr W, Coles E, Gnagy E, Chronis-Tuscano A, OConnor B . A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clin Psychol Rev. 2009; 29(2):129-40. DOI: 10.1016/j.cpr.2008.11.001. View

Kooij J, Buitelaar J, van den Oord E, Furer J, Rijnders C, Hodiamont P . Internal and external validity of attention-deficit hyperactivity disorder in a population-based sample of adults. Psychol Med. 2005; 35(6):817-27. DOI: 10.1017/s003329170400337x. View

Graham J, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Dittmann R . European guidelines on managing adverse effects of medication for ADHD. Eur Child Adolesc Psychiatry. 2010; 20(1):17-37. PMC: 3012210. DOI: 10.1007/s00787-010-0140-6. View

Brown R, Borden K, Wynne M, Schleser R, Clingerman S . Methylphenidate and cognitive therapy with ADD children: a methodological reconsideration. J Abnorm Child Psychol. 1986; 14(4):481-97. DOI: 10.1007/BF01260518. View

Brooks R . EuroQol: the current state of play. Health Policy. 1996; 37(1):53-72. DOI: 10.1016/0168-8510(96)00822-6. View

Molina B, Hinshaw S, Swanson J, Eugene Arnold L, Vitiello B, Jensen P . The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry. 2009; 48(5):484-500. PMC: 3063150. DOI: 10.1097/CHI.0b013e31819c23d0. View

10.

Briggs A, Wonderling D, Mooney C . Pulling cost-effectiveness analysis up by its bootstraps: a non-parametric approach to confidence interval estimation. Health Econ. 1997; 6(4):327-40. DOI: 10.1002/(sici)1099-1050(199707)6:4<327::aid-hec282>3.0.co;2-w. View

11.

Murray D, Britton A, Bulstrode C . Loss to follow-up matters. J Bone Joint Surg Br. 1997; 79(2):254-7. DOI: 10.1302/0301-620x.79b2.6975. View

12.

Gu J, Strauss C, Bond R, Cavanagh K . How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clin Psychol Rev. 2015; 37:1-12. DOI: 10.1016/j.cpr.2015.01.006. View

13.

Sonuga-Barke E, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M . Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry. 2013; 170(3):275-89. DOI: 10.1176/appi.ajp.2012.12070991. View

14.

Zylowska L, Ackerman D, Yang M, Futrell J, Horton N, Hale T . Mindfulness meditation training in adults and adolescents with ADHD: a feasibility study. J Atten Disord. 2007; 11(6):737-46. DOI: 10.1177/1087054707308502. View

15.

Goyal M, Singh S, Sibinga E, Gould N, Rowland-Seymour A, Sharma R . Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014; 174(3):357-68. PMC: 4142584. DOI: 10.1001/jamainternmed.2013.13018. View

16.

Chiesa A, Serretti A . Mindfulness-based interventions for chronic pain: a systematic review of the evidence. J Altern Complement Med. 2011; 17(1):83-93. DOI: 10.1089/acm.2009.0546. View

17.

Kabat-Zinn J, Lipworth L, Burney R . The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med. 1985; 8(2):163-90. DOI: 10.1007/BF00845519. View

18.

van de Loo-Neus G, Rommelse N, Buitelaar J . To stop or not to stop? How long should medication treatment of attention-deficit hyperactivity disorder be extended?. Eur Neuropsychopharmacol. 2011; 21(8):584-99. DOI: 10.1016/j.euroneuro.2011.03.008. View

19.

Barkley R . Global issues related to the impact of untreated attention-deficit/hyperactivity disorder from childhood to young adulthood. Postgrad Med. 2008; 120(3):48-59. DOI: 10.3810/pgm.2008.09.1907. View

20.

Preacher K, Hayes A . Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008; 40(3):879-91. DOI: 10.3758/brm.40.3.879. View