Attention Deficit Disorder With Hyperactivity Clinical Trial
Official title:
Breathing Meditation With Methylphenidate for the Treatment of Attention Deficit Hyperactivity Disorder Children: A Randomized Controlled Trial
In 2004, the Developmental Clinic of the Child Psychiatric Unit at Srinagarind Hospital, had
80 new pediatric cases of attention deficit hyperactivity disorder (ADHD) come for
evaluation and intervention. The children were between 7-12 years of age. Most of them were
treated with stimulant medication, (i.e. methylphenidate) to help reduce hyperactivity;
however, both the parents and children needed special help to develop some techniques for
behavioural management.
Meditation has been used as an attention training method for many thousands of years, and
was mostly involved with religious or spiritual practices in various parts of the world,
especially in the eastern countries. Breathing meditation is a popular method which can be
applied to all people without instructions that are too complicated. If meditation therapy,
by breathing meditation which is specified to treat attention deficit hyperactivity
disorders, benefits this group of patients, it would be very useful, culturally appropriate,
cost-effective and would reduce the drugs used which will save the child from drug side
effects.
Attention Deficit Hyperactivity Disorder (ADHD) is the most common psychiatric disorder in
children, with an estimated prevalence of 3-7% in school children (Diagnostic and
Statistical Manual of Mental Disorders, 4th Edition, Text Revision [DSM-IV-TR]). The major
symptoms of this disorder are developmentally inconsistent and chronic levels of
inattention, impulsiveness, and hyperactivity.
The numbers of patients visiting physicians for ADHD are increasing from year to year. Boys
are diagnosed with ADHD three times more often than girls. Although the studies on
adolescents are few, the data suggest that about half of the children diagnosed with ADHD
will have persistent symptoms into adolescence and some symptoms persist into adulthood.
The symptoms of ADHD, if not adequately managed, will have many life long effects on the
patients, families, friends, peers, teachers and colleagues. For the patients, the disorder
will impact on patient's academic, social and emotional performance, and behavioural
development, leading to poor academic achievement, low occupational status, increased risk
of substance abuse and delinquency. More than 30% of children with ADHD repeat a year in
school and up to 56% require remedial tutoring.
Drug therapy began in the 1930s; since the 1970s, stimulants such as dexamphetamine, and
methylphenidate have increasingly been used as the treatment of choice, but remain
controversial. Currently available psychological treatments for ADHD include behavioural
training for teachers and parents, and parenting skills classes, behavioural therapy for
children with ADHD. Psychosocial treatments are generally combined with medication because
each treatment alone has only a partial effect on the core symptoms of the disorder.
Growing scientific evidence, clinical experience and community attitudes are encouraging a
shift to more natural and holistic forms of therapy as alternatives or adjuncts to
pharmacological approaches in a variety of conditions. Meditation has a wide range of
applications, but it is especially useful in treating stress and related disorders to
promote calmness and enhance the attentional ability. A psychological oriented definition
stated that meditation is a set of attentional practices leading to an altered state or
trait of consciousness characterized by expanded awareness, greater presence, and a more
integrated sense of self.
Breathing Meditation could be classified as both concentrative meditation and mindfulness
meditation. The concentrative ability is first developed at the beginning state and followed
by mindful ability.
The studies which use meditation therapy for ADHD are still scarce. In Thailand, Hassasiri
A, et al (1995) had developed meditation program for children with ADHD based on
Neo-humanist concept which comprised of meditation and imagery . The program was tested in
pre-post test design with purposive sampling and yielded the statistical significant
different at p < 0.05 (unpublished data). There has never been research about the
effectiveness of breathing meditation. We are interested in conducting a randomized
controlled trial to study the effectiveness in patients with attention deficit hyperactivity
disorder.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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