The efficacy of mindfulness-based interventions in attention-deficit/hyperactivity disorder beyond core symptoms: A systematic review, meta-analysis, and meta-regression.
Francesco Oliva, Francesca Malandrone, Giulia Di Girolamo, Santina Mirabella, Nicoletta Colombi, Sara Carletto, Luca Ostacoli
Journal of Affective Disorders September 1, 2021 DOI: 10.1016/j.jad.2021.05.068 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Peer reviewed |
|---|---|
| Population | Adults and children with ADHD |
| Interventions | Mindfulness-Based Interventions (MBIs) Mindfulness Awareness Practice (MAP) Mindfulness-Based Cognitive Therapy (MBCT) Mindfulness-Based Stress Reduction (MBSR) |
| Topics | Meditation |
| Keywords | Adolescents Adults Children Mindfulness-based interventions Systematic review |
| Key findings | MBIs improved ADHD symptoms and some other outcomes compared with waiting lists in both adults and children. In adults, the pooled effect size for ADHD symptoms was medium, though publication bias was detected in some cases; effects were medium-to-large versus inactive controls but low-to-negligible versus active controls. No active-controlled studies were identified in children. The authors suggest MBIs may be useful as a complement, not a replacement, for other active interventions. |
Abstract
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. 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. 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. 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. 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.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |
Citations in the library
Cited by 28
- Educating Through Attentional States of Consciousness, an Effective Way to Develop Creative Potential? Frontiers in Education March 17, 2022
- Executive Function Training Through a Mindfulness-Based Neuroeducational Program in Elementary School Students Mindfulness November 1, 2024
- Conduct problems, hyperactivity, and screen time among community youth: can mindfulness help? an exploratory study Frontiers in Psychiatry April 9, 2024
- Efficacy of mindfulness-based interventions for children and adolescents with attention deficit hyperactivity disorder: a systematic review and meta-analysis Frontiers in Psychiatry September 16, 2026
- Cognitive-behavioral and mindfulness-based cognitive therapies for adults with attention-deficit/hyperactivity disorder and cognitive disengagement syndrome: a randomized controlled trial Middle East Current Psychiatry September 7, 2026
and 23 more in the library
Cites 36
- Short-term meditation training improves attention and self-regulation Proceedings of the National Academy of Sciences October 11, 2007
- The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Journal of Child and Family Studies February 1, 2011
- The Effectiveness of Mindfulness Training on Behavioral Problems and Attentional Functioning in Adolescents with ADHD Journal of Child and Family Studies September 21, 2011
- An EEG Investigation of the Attention-Related Impact of Mindfulness Training in Youth With ADHD: Outcomes and Methodological Considerations Journal of Attention Disorders July 27, 2017
- Mindfulness-based cognitive therapy for bipolar disorder: A systematic review and meta-analysis. Psychiatry Research May 25, 2020
and 31 more in the library