Meditation-based therapies for attention-deficit/hyperactivity disorder in children, adolescents and adults: a systematic review and meta-analysis
Open accessAbstract
Background: The efficacy of meditation-based therapies for attention deficit/hyperactivity disorder (ADHD) across the lifespan remains uncertain. Objective: To conduct a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy of meditation-based therapies for ADHD core symptoms and associated neuropsychological dysfunctions in children/adolescents or adults with ADHD. Methods: We searched Pubmed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge with no language, date or type of document restriction, up to 5 May 2018. Random-effects model was used. Heterogeneity was assessed with Cochran’s Q and I 2 statistics. Publication (small studies) bias was assessed with funnel plots and the Egger’s test. Studies were evaluated with the Cochrane risk of bias (RoB) tool. Analyses were conducted using Comprehensive Meta-Analysis. Findings: 13 RCTs (seven in children/adolescents, n=270 and six in adults, n=339) were retained. Only one RCT was double-blind.Meditation-based therapies were significantly more efficacious than the control conditions in decreasing the severity of ADHD core symptoms (inattention+hyperactivity/impulsivity: children/adolescents: Hedge’s g=-0.44, 95% CI −0.69 to −0.19, I 2 0%; adults: Hedge’s g=−0.66, 95% CI –1.21 to −0.11, I 2 81.81%). No significant effects were found on neuropsychological measures of inattention and inhibition in children/adolescents. In adults, significant effects were detected on working memory and inhibition, although these results were based on a small number of studies (n=3). 57% and 43% of the studies in children/adolescents were rated at overall unclear and high risk of bias, respectively. In adults, 33% and 67% of the studies were deemed at overall unclear and high risk of bias, respectively. No evidence of publication bias was found. Conclusions: Despite statistically significant effects on ADHD combined core symptoms, due to paucity of RCTs, heterogeneity across studies and lack of studies at low risk of bias, there is insufficient methodologically sound evidence to support meditation-based therapies for ADHD. Trial registration number: PROSPERO 2018 [CRD42018096156].
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Half of the studies in the meditation-based therapy meta-analysis did not use active controls.
“It found moderate reductions in ADHD symptoms in both children and adolescents (6 RCTs, 240 participants) and adults (6 RCTs, 339 participants), but half the studies did not use active controls.”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Zhang et al., 2018
Meditation-based therapy was associated with moderate reductions in ADHD symptoms in children and adolescents.
“It found moderate reductions in ADHD symptoms in both children and adolescents (6 RCTs, 240 participants) and adults (6 RCTs, 339 participants), but half the studies did not use active controls.”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Zhang et al., 2018
Meditation-based therapy was associated with moderate reductions in ADHD symptoms in adults.
“It found moderate reductions in ADHD symptoms in both children and adolescents (6 RCTs, 240 participants) and adults (6 RCTs, 339 participants), but half the studies did not use active controls.”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Zhang et al., 2018
There is insufficient methodologically sound evidence to support recommending meditation-based therapies for targeting ADHD core symptoms or related neuropsychological dysfunctions in children, adolescents, or adults with ADHD.
“The authors concluded “there is insufficient methodologically sound evidence to support the recommendation of meditation-based therapies as an intervention aimed to target ADHD core symptoms or related neuropsychological dysfunctions in children/adolescents or adults with ADHD” (Zhang et al., 2018).”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Zhang et al., 2018
Removing studies with waiting list controls made the meditation-based therapy results nonsignificant.
“Removing studies with waiting list controls made results nonsignificant.”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Zhang et al., 2018
The Original article reports that results became nonsignificant after removing two studies whose interventions were not exclusively meditation-based, not after removing waiting-list-controlled studies. It reports that restricting analyses to waiting-list controls increased effect sizes, but our copy does not report results for an analysis excluding those studies. (LLM, conf=0.76)
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- Authors
- Zhang, J., Díaz-Román, A., & Cortese, S.
- Affiliations
- Yancheng Teachers University (CN)
- Mind, Brain and Behavior Research Center, University of Granada, Granada, Spain
- University of Nottingham (GB)
- Corresponding author
- Cortese, Samuele
- Venue
- Evidence Based Mental Health
- Publisher
- BMJ
- Published
- 2018-07-10
- Volume
- 21
- Issue
- 3
- Pages
- 87-94
- ISSN
- 1362-0347 (ISSN-L)
- 1468-960X
- PMC
- PMC10270372
- OpenAlex
- W2860528520
- Semantic Scholar
- ce03c43a57bcf6492f58543318f36e112aaaff98
- Cited by
- 55
- References
- 32
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 8 · 2023: 8 · 2022: 7 · 2021: 14 · 2020: 6 · 2019: 1 · 2018: 1
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Evidence-Based Mental Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- attention deficit hyperactivity disorder, inattention, hyperactivity/impulsivity, working memory, inhibition, neuropsychological performance, children and adolescents, adults, treatment efficacy, risk of bias, publication bias, mindfulness, relaxation training, cognitive training, neurofeedback, biofeedback, transcranial magnetic stimulation, transcranial direct current stimulation
- MeSH terms
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Child, Humans, Outcome Assessment, Health Care, Meditation
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