Intervention Review

Acupuncture for Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents

  1. Shasha Li2,
  2. Bo Yu1,*,
  3. Dong Zhou3,
  4. Chengqi He2,
  5. Lin Kang4,
  6. Xiaotong Wang5,
  7. Songhe Jiang6,
  8. Xiang Chen6

Editorial Group: Cochrane Developmental, Psychosocial and Learning Problems Group

Published Online: 13 APR 2011

Assessed as up-to-date: 9 OCT 2010

DOI: 10.1002/14651858.CD007839.pub2

Database Title

Additional Information

How to Cite

Li S, Yu B, Zhou D, He C, Kang L, Wang X, Jiang S, Chen X. Acupuncture for Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents. Cochrane Database of Systematic Reviews 2011, Issue 4. Art. No.: CD007839. DOI: 10.1002/14651858.CD007839.pub2.

Author Information

  1. 1

    Sichuan Provincial Hospital for Women and Children, Department of Paediatrics, Chengdu, China

  2. 2

    West China Hospital, Sichuan University, Department of Rehabilitation Medicine, Chengdu, Sichuan Province, China

  3. 3

    West China Hospital, Sichuan University, Department of Neurology, Chengdu, Sichuan, China

  4. 4

    West China Hospital, Sichuan University, Department of Psychiatry, Chengdu, Sichuan, China

  5. 5

    The 2nd Affiliated Hospital of Wenzhou Medical College, Department of Neurology, Wenzhou, Zhejiang, China

  6. 6

    The 2nd Affiliated Hospital of Wenzhou Medical College, Department of Rehabilitation Medicine, Wenzhou, Zhejiang, China

*Bo Yu, Department of Paediatrics, Sichuan Provincial Hospital for Women and Children, Chengdu, China. dog4317169@hotmail.com.

Publication History

  1. Publication Status: New
  2. Published Online: 13 APR 2011

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. Resumen

Background

Attention Deficit Hyperactivity Disorder (ADHD) is a common childhood psychiatric disorder with features of inattention, hyperactivity and impulsivity. There is increasing interest in complementary and alternative therapies such as acupuncture; however, it remains unclear whether the use of acupuncture in children and adolescents with ADHD is supported by the existing evidence.

Objectives

To assess the efficacy and safety of acupuncture as a treatment for ADHD in children and adolescents.

Search methods

We searched CENTRAL (The Cochrane Library 2010, Issue 2); MEDLINE (21 May 2010); CINAHL (21 May 2010); EMBASE (21 May 2010); ERIC (21 May 2010); PsycINFO (21 May 2010), Chinese Biological Medicine Database (10 May 2010); Chinese Scientific Periodical Database of VIP INFORMATION (10 May 2010); China Periodical in China National Knowledge Infrastructure (10 May 2010); and Chinese Evidence-Based Medicine Database (10 May 2010). We handsearched Chinese language journals and conference proceedings.

Selection criteria

Randomised controlled trials and quasi-randomised controlled trials comparing acupuncture with placebo or sham acupuncture, or conventional treatment. Participants under the age of 18 years with any type of ADHD were included. Papers in any language were included.

Data collection and analysis

Two review authors (S Li, B Yu) independently determined the studies to be included in the review based on inclusion and exclusion criteria and extracted the data using pre-developed extraction forms. The risk of bias within the trials was assessed by the same review authors in relation to allocation concealment, blinding and withdrawals. The measures of ADHD outcomes were extracted from core symptoms rating scales and additional secondary outcomes were considered.

Main results

No studies met the inclusion criteria for this review.

Authors' conclusions

A comprehensive search showed that there is no evidence base of randomised or quasi-randomised controlled trials to support the use of acupuncture as a treatment for ADHD in children and adolescents. Due to the lack of trials, we cannot reach any conclusions about the efficacy and safety of acupuncture for ADHD in children and adolescents. This review highlights the need for further research in this area in the form of high quality, large scale, randomised controlled trials.

 

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. Resumen

Acupuncture for ADHD in children and adolescents

Attention Deficit Hyperactivity Disorder (ADHD) is a common childhood psychiatric disorder with features of inattention, hyperactivity and impulsivity. In general, effective treatment for ADHD relies on comprehensive therapy. Acupuncture is a complementary and alternative medicine (CAM) therapy that seems to have few side effects.

Being considered a relatively simple, inexpensive and safe treatment compared to other conventional interventions, acupuncture is used widely in oriental countries. According to the basic theory of Traditional Chinese Medicine (TCM), ADHD is caused by 'liver yang overactive', 'effulgent gallbladder fire', 'heart-spleen qi deficiency', 'non-interaction of heart and kidney' and 'yin-yang disharmony'. Thus, ADHD in children presents as clinical symptoms of over-activity, restlessness, recklessness, impoliteness and stubbornness. 'Yin-yang' and 'Qi-xue' are very important concepts in TCM. In a meridian system, the main interpretation of 'yin' and 'yang' is symmetry and balance. Acupuncture could help keep internal yin and yang in balance. It is also believed in TCM theory that acupuncture can strengthen the vital essence of the human body, which is called 'Qi' in China, and remove the blockage of channels. Qi could move between yin and yang to coordinate them in harmony so as to make an amiable, stable and peaceful internal environment.

Acupuncture is increasingly practiced as a therapeutic intervention in Western countries. However, it remains uncertain whether the existing evidence is strong enough to justify the use of acupuncture as a treatment for ADHD.

No trials were included in this review. The review authors concluded that there is inadequate evidence to draw any conclusions about the efficacy or safety of acupuncture for ADHD in children and adolescents. There is an urgent need for further large scale, multicenter, randomised, controlled, double-blinded studies of acupuncture with standardized evaluation of outcomes for ADHD in children and adolescents.

 

Resumen

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. Resumen

Antecedentes

Acupuntura para el trastorno de hiperactividad y déficit de atención (THDA) en niños y adolescentes

El trastorno de hiperactividad y déficit de atención (THDA) es un trastorno psiquiátrico habitual de la niñez con características de desatención, hiperactividad e impulsividad. Existe un mayor interés en los tratamientos complementarios y alternativos como la acupuntura; sin embargo, aún es incierto si las pruebas existentes apoyan el uso de la acupuntura en niños y adolescentes con THDA.

Objetivos

Evaluar la eficacia y la seguridad de la acupuntura como tratamiento del THDA en niños y adolescentes.

Estrategia de búsqueda

Se hicieron búsquedas en CENTRAL (Cochrane Library 2010, número 2); MEDLINE (21 mayo 2010); CINAHL (21 mayo 2010); EMBASE (21 mayo 2010); ERIC (21 mayo 2010); PsycINFO (21 mayo 2010), Chinese Biological Medicine Database (10 mayo 2010); Chinese Scientific Periodical Database of VIP INFORMATION (10 mayo 2010); China Periodical in China National Knowledge Infrastructure (10 mayo 2010); y en la Chinese EvidenceBased Medicine Database (10 mayo 2010). Se hicieron búsquedas manuales en revistas en chino y en actas de congresos.

Criterios de selección

Ensayos controlados con asignación aleatoria y cuasialeatoria que compararon la acupuntura con placebo o acupuntura simulada, o tratamiento convencional. Se incluyeron pacientes menores de 18 años de edad con cualquier tipo de THDA. Se incluyeron artículos en cualquier idioma.

Obtención y análisis de los datos

Dos revisores (S Li, B Yu) determinaron de forma independiente los estudios a incluir en la revisión según los criterios de inclusión y exclusión y extrajeron los datos mediante formularios de extracción desarrollados previamente. Los mismos revisores evaluaron el riesgo de sesgo de los ensayos con respecto a la ocultación de la asignación, el cegamiento y los retiros. Las medidas de resultados del THDA se extrajeron de las escalas de calificación de los síntomas principales y se consideraron las medidas de resultado secundarias adicionales.

Resultados principales

Ningún estudio cumplió los criterios de inclusión para esta revisión.

Conclusiones de los autores

Una búsqueda exhaustiva mostró que no hay una base de pruebas de ensayos controlados con asignación aleatoria o cuasialeatoria para apoyar el uso de la acupuntura como tratamiento para el THDA en niños y adolescentes. Debido a la falta de ensayos no se estableció una conclusión acerca de la eficacia y la seguridad de la acupuntura para el THDA en niños y adolescentes. Esta revisión destaca la necesidad de más estudios de investigación en esta área en forma de ensayos controlados con asignación aleatoria a gran escala y de alta calidad.

Traducción

Traducción realizada por el Centro Cochrane Iberoamericano

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