PDF(Pubmed)
Abstract：
In recent years, there has been an increase in the prevalence of the diagnosis of attention-deficit/hyperactivity disorder (ADHD), a cognitive and behavioral disorder in which individuals present with inattention and impulsivity, in the pediatric population. With an increase in diagnoses, there is also increasing concern regarding overdiagnosis and overtreatment with medications for ADHD. The objective of this study was to map out and compile the recent literature pertaining to alternative therapies (e.g., physical activity, diet, mindfulness, and computer-based interventions) for children and adolescents diagnosed with ADHD in an attempt to reduce or replace the use of pharmacological therapy. This scoping review searched articles from multiple databases (PubMed, ScienceDirect, Web of Science, Directory of Open Access Journals, Scopus, and CINAHL). Using search terms \"children with ADHD,\" \"alternative treatment,\" and \"cognitive behavioral therapy,\" articles were identified that were specific to the research question. The inclusion criteria were patients under the age of 18 with a previous diagnosis of ADHD, no other comorbid illnesses, alternative treatments, and was limited to studies published between 2012 and 2022. After removing duplicates, screening for eligibility criteria, and conducting a critical appraisal of the articles, 16 articles were retained for the final review. The main alternative therapeutic domains that emerged were (1) physical activity, (2) diet, (3) mindfulness, (4) computer-based interventions, and (5) miscellaneous interventions. Seven articles assessed the effect of physical activity on executive and cognitive function in children and adolescents with ADHD. Most findings showed improvement with increased physical activity. Two articles explored the effect of diet on the improvement of ADHD symptoms and reported a positive impact. The two articles that evaluated the effects of mindfulness on ADHD symptoms reported a reduction in ADHD symptoms. Two studies evaluated the use of computer-based interventions as an adjunct treatment in children and adolescents with ADHD; improvements in symptoms were reported. One study each evaluated interventions based on music and nerve stimulation. These showed an improvement in attention, memory, and executive function. With the increasing prevalence of ADHD diagnosis in children and adolescents, alternative and/or adjunctive treatments may be a viable and valuable alternative to pharmaceutical interventions. The findings from this review suggest that multiple non-pharmacological interventions effectively reduce symptoms of ADHD in children and adolescents, including diet, exercise, mindfulness, computer-based interventions, music, and nerve stimulation. While there are implications for alternatives to be used in the future, more research is warranted using larger samples with controlled trials.
摘要：
近年来,注意缺陷/多动障碍（ADHD）的诊断患病率有所增加，一种认知和行为障碍，个体表现为注意力不集中和冲动，在儿科人群中。随着诊断的增加，对于多动症的过度诊断和药物过度治疗,人们也越来越担心.这项研究的目的是绘制和汇编有关替代疗法的最新文献(例如，身体活动,饮食，正念,和基于计算机的干预措施），用于诊断为ADHD的儿童和青少年，以减少或替代药物治疗的使用。此范围审查从多个数据库(PubMed、ScienceDirect,WebofScience,开放存取期刊目录，Scopus,和CINAHL）。使用搜索词“患有多动症的儿童，“替代治疗”，“和”认知行为疗法，“确定了特定于研究问题的文章。纳入标准为18岁以下先前诊断为ADHD的患者，没有其他合并症，替代疗法,并且仅限于2012年至2022年之间发表的研究。删除重复项后，筛选资格标准，并对文章进行批判性评估，保留了16篇文章供最后审查。出现的主要替代治疗领域是(1)身体活动，（2）饮食，（3）正念，（4）基于计算机的干预，(5)其他干预措施。七篇文章评估了体育锻炼对ADHD儿童和青少年执行和认知功能的影响。大多数研究结果表明，随着体力活动的增加，情况有所改善。两篇文章探讨了饮食对改善ADHD症状的影响，并报道了积极的影响。评估正念对ADHD症状的影响的两篇文章报道了ADHD症状的减轻。两项研究评估了使用基于计算机的干预措施作为ADHD儿童和青少年的辅助治疗；报告了症状的改善。一项研究均评估了基于音乐和神经刺激的干预措施。这些显示出注意力的改善，记忆,和执行功能。随着儿童和青少年ADHD诊断患病率的增加，替代和/或辅助治疗可能是药物干预的可行和有价值的替代方案。这篇综述的结果表明，多种非药物干预措施可以有效减轻儿童和青少年的ADHD症状。包括饮食,锻炼,正念,基于计算机的干预，音乐,和神经刺激。虽然对未来使用的替代品有影响，更多的研究需要使用更大的样本和对照试验.
