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Acupuncture points for the treatment of post-traumatic stress disorder Primary patterns (standard points for all subjects)
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Background
Post-traumatic stress disorder (PTSD) is a significant public health problem, affecting approximately 7% of the general population and 13–18% of the combat Veteran population. The first study using acupuncture for PTSD in a civilian population showed large pre- to post-treatment effects for an empirically developed verum protocol, which...
Context in source publication
Context 1
... group: verum acupuncture (ACU): Table 2 Individual treatment sessions are 1 h twice per week for 12 weeks and reflect clinical practice with an interview (10 min), pulse and tongue observation (5 min), standard needling, and needle retention (30 min). Subjects receive a standard acupuncture point prescription defined in our previous study and chosen for the most likely TCM diagnostic patterns for PTSD. ...Similar publications
In this study we focus on anxiety and stress resulting from exposure to media covering COVID-19. The objectives were: to prepare a subjects' psychological map; describe stress-producing elements of real media reports (RMR) about pandemic and their correlation with participants' psychological profiles. We conducted an experiment to identify latent,...
Citations
... No extant data were available for a priori sample size/power estimates on the secondary hypotheses about anxiety, depression, and insomnia. A description of study methods has been published [17]. ...
... The exclusion criteria included characteristics that are known PTSD treatment confounds, might affect biological assessment, indicate past non-adherence or treatment resistance, or indicate a risk of harm [17]. The study was approved by the local VA IRB and written informed consent was obtained. ...
... Each of the 20 items are rated from 0 (absent) to 4 (severe), summed into a single severity score. The more complete CAPS-5 scoring rules applied in this study have been published [17]. Twenty assessments were co-rated from audio-tape recordings, with an inter-rater reliability (Pearson's r) on symptom severity of 0.91, p < 0.001. ...
Objective: Current interventions for anxiety, depression, and insomnia are efficacious, yet effectiveness may be limited by side effects and/or high withdrawal rates. Other desirable treatment options are needed. Many veterans and civilians are turning to acupuncture as an emerging therapy. Our objective was to conduct a more definitive study comparing verum with sham acupuncture (minimal needling). Methods: A two-arm, single-blinded randomized controlled trial (RCT) hypothesizing that both verum and sham acupuncture are effective and the effects of verum are superior to those of sham acupuncture. We recruited subjects from a single outpatient-based site, the Tibor Rubin VA Medical Center, Long Beach, CA, USA. A total of 93 treatment-seeking combat Veterans with posttraumatic stress disorder (PTSD), aged 18–55, were allocated to groups by adaptive randomization, and 71 participants completed the intervention protocols. Verum and sham were both offered as 1 h sessions, twice a week, and participants were allowed 15-weeks to complete up to 24 sessions. This was a secondary analysis from a larger study about the efficacy of acupuncture for PTSD. Outcomes for the current study were pre- to post-intervention change in the Hamilton Anxiety Rating Scale, Beck Depression Inventory, and Pittsburgh Sleep Quality Index. Outcomes were assessed pre-, mid-, and post-treatment. General Linear Models comparing within- and between-group results were analyzed in both intention-to-treat (ITT) and treatment completer models. Results: In total, 85 males and 8 females, with a mean age of 39.2 (median = 37.0), were randomized. For anxiety, the verum acupuncture showed a large treatment effect (d = 1.3), whereas sham acupuncture showed a moderate effect (d = 0.9). There was no statistical difference between the verum and sham acupuncture groups. Similar effects were found for depression and insomnia symptoms. Withdrawal rates were low. Conclusions: Both verum and sham acupuncture were efficacious in the treatment of anxiety, depression, and insomnia in a population of veterans with PTSD. However, there was no clinical difference between the verum and sham acupuncture groups. These data build on extant literature and suggest that further research on the clinical implementation and durability of acupuncture for anxiety, depression, and insomnia is warranted.
... Stress is a state of worry or mental or emotional tension caused by a difficult situation [21]; Anxiety can be described as a normal reaction to stress while anxiety disorder can be defined as a state of mind that is typified by feelings of concern, fear, or uneasiness, frequently related to uncertain or future occurrences [22]; Depression is characterized by enduring melancholy, hopelessness, and a loss of interest or enjoyment in activities, persistent sadness, inability to carry out daily activities, low concentration and decreased energy [23,24]; Post-traumatic stress disorder (PTSD) is a mental health condition triggered by experiencing or witnessing a traumatic event, such as violence, accidents, or natural disasters. Symptoms may also include hyper arousal, unfavorable changes in mood and thought processes, numbing and avoiding reminders of trauma [25]; Burnout is a condition of physical, emotional, and mental fatigue brought on by ongoing stress, and is frequently associated with a job or providing care. It reflects a psychological syndrome stemming from chronic emotional and interpersonal stressors in professional or caregiving contexts [26,27]; The symptoms of insomnia include trouble getting asleep, remaining asleep, or waking up too early and not being able to go back to sleep [28]. ...
Introduction
The Coronavirus pandemic (COVID-19) was first identified in December 2019 in Wuhan, China, and later caused a severe health crisis, causing massive disruptions to most healthcare systems worldwide. During this pandemic period, the structure of the Intensive Care Unit (ICU) activities changed fast. It was observed that the mental health of ICU nurses reached levels of extreme clinical and psychological concern. This paper aims to shed light on how COVID-19 affected ICU nurses’ mental health.
Methods
A literature review of articles published on this topic from January 2020 to December 2024. English-language, peer-reviewed, mixed-methods, qualitative, and quantitative research on the mental health outcomes of ICU nurses were included while studies without primary data, non-ICU nurses, and non-peer-reviewed publications were excluded. To identify relevant literature, we searched five databases, including PubMed, MEDLINE, CINAHL, Web of Science, and Embase. Additionally, grey literature sources, including Google Scholar and Research Gate, were also searched. Narrative synthesis was used to evaluate both quantitative and qualitative data.
Results
A total of 23 articles were reviewed. The most prevalent mental health issues were depression, anxiety, fear, and post-traumatic stress disorder (PTSD). The effects of burnout, illness, exhaustion, physical strain, sleep disturbances, and ongoing job stress were equally detrimental to the health of ICU nurses. The nurses’ health declined as a result of the new procedures and working environment, the enormous workload, the continued exhaustion, the concerns for their families and themselves being infected by COVID-19, the social reaction, and seeing the death toll rise.
Conclusion
The COVID-19 pandemic had a negative impact on nurses’ mental health well-being such as stress, depression, post-traumatic stress disorder, insomnia, anxiety, and fear. Sustainable support systems, networks and plans ought to be made available. Due to unique working conditions of ICU nurses and in readiness for similar pandemics in future, legislators should focus on the mental health of ICU nurses because they play a critical role in managing public health crises as frontline health solders.
... A description of study methods has been published. 33 Written informed consent was obtained. ...
... Differences by group, also discussed below, are previously described. 33 Experimental Group: Verum Acupuncture Individual sessions were offered twice weekly, aiming for 24 sessions in a 15-week period, and reflected clinical practice with an interview (10 minutes), pulse and tongue observation (5 minutes), standard needling to elicit deqi (fullness, heaviness, aching, tingling but not sharp pain; 10 minutes), needle retention (30 minutes), and removal and conclusion (5 minutes). Participants received a standard point prescription designed in our previous work translating PTSD symptoms into traditional Chinese medicine diagnostic patterns. ...
Importance
Current interventions for posttraumatic stress disorder (PTSD) are efficacious, yet effectiveness may be limited by adverse effects and high withdrawal rates. Acupuncture is an emerging intervention with positive preliminary data for PTSD.
Objective
To compare verum acupuncture with sham acupuncture (minimal needling) on clinical and physiological outcomes.
Design, Setting, and Participants
This was a 2-arm, parallel-group, prospective blinded randomized clinical trial hypothesizing superiority of verum to sham acupuncture. The study was conducted at a single outpatient-based site, the Tibor Rubin VA Medical Center in Long Beach, California, with recruitment from April 2018 to May 2022, followed by a 15-week treatment period. Following exclusion for characteristics that are known PTSD treatment confounds, might affect biological assessment, indicate past nonadherence or treatment resistance, or indicate risk of harm, 93 treatment-seeking combat veterans with PTSD aged 18 to 55 years were allocated to group by adaptive randomization and 71 participants completed the intervention protocols.
Interventions
Verum and sham were provided as 1-hour sessions, twice weekly, and participants were given 15 weeks to complete up to 24 sessions.
Main Outcomes and Measures
The primary outcome was pretreatment to posttreatment change in PTSD symptom severity on the Clinician-Administered PTSD Scale-5 (CAPS-5). The secondary outcome was pretreatment to posttreatment change in fear-conditioned extinction, assessed by fear-potentiated startle response. Outcomes were assessed at pretreatment, midtreatment, and posttreatment. General linear models comparing within- and between-group were analyzed in both intention-to-treat (ITT) and treatment-completed models.
Results
A total of 85 male and 8 female veterans (mean [SD] age, 39.2 [8.5] years) were randomized. There was a large treatment effect of verum (Cohen d , 1.17), a moderate effect of sham ( d , 0.67), and a moderate between-group effect favoring verum (mean [SD] Δ, 7.1 [11.8]; t 90 = 2.87, d , 0.63; P = .005) in the intention-to-treat analysis. The effect pattern was similar in the treatment-completed analysis: verum d , 1.53; sham d , 0.86; between-group mean (SD) Δ, 7.4 (11.7); t 69 = 2.64; d , 0.63; P = .01). There was a significant pretreatment to posttreatment reduction of fear-potentiated startle during extinction (ie, better fear extinction) in the verum but not the sham group and a significant correlation ( r = 0.31) between symptom reduction and fear extinction. Withdrawal rates were low.
Conclusions and Relevance
The acupuncture intervention used in this study was clinically efficacious and favorably affected the psychobiology of PTSD in combat veterans. These data build on extant literature and suggest that clinical implementation of acupuncture for PTSD, along with further research about comparative efficacy, durability, and mechanisms of effects, is warranted.
Trial Registration
ClinicalTrials.gov Identifier: NCT02869646
... A total of 56 studies were included, with 19 clinical studies and 37 animal studies. Two studies (Prisco et al., 2013;King Heather et al., 2015) used ear acupuncture, one study (Wu et al., 2013) used scalp acupuncture, one study (Yang et al., 2022) used CO 2 laser stimulation, one study (Feng et al., 2019) used TEAS, and other studies (Fang et al., 2012;Li, 2012Li, , 2014Li, , 2018Li, , 2020Wang et al., 2012Wang et al., , 2015Hou et al., 2013aHou et al., ,b, 2021Wang, 2013Wang, , 2019Engel et al., 2014;Li and Zhao, 2014;Zhao et al., 2014Zhao et al., , 2019Zhao et al., , 2020Xie et al., 2015;Zheng, 2015;Zheng et al., 2015;Zhou et al., 2015Zhou et al., , 2019Lu et al., 2016;Zhu et al., 2016Zhu et al., , 2022Han, 2017;Li et al., 2017Li et al., , 2020aDing, 2018;Oh et al., 2018;Chen et al., 2019Chen et al., , 2020Chen et al., , 2021Liu et al., 2019Liu et al., , 2020Moiraghi et al., 2019;Wei et al., 2019;Xue et al., 2019;Yu et al., 2019;Zhang et al., 2019;Zhu and Lu, 2019;Alvear, 2021;Hollifield et al., 2021;Abanes et al., 2022;Lee and Pan, 2022;Song et al., 2022;Zhou C. et al., 2022) used filiform needle (detail in Supplementary Tables 3, 4). ...
... With the increasing availability of acupuncture worldwide, patients with PTSD are increasingly seeking and accepting acupuncture. Many studies have confirmed the effectiveness of acupuncture for PTSD (Yang and Zhang, 2012;Zhang, 2013;Jin et al., 2014Jin et al., , 2015Zheng et al., 2014;Zhao et al., 2015;Han et al., 2016Han et al., , 2017Grant et al., 2018;Ding et al., 2020;Song et al., 2020Song et al., , 2021Hollifield et al., 2021;Kwon et al., 2021;Li et al., 2021). Because the number of studies in the last 10 years accounts for the vast majority and is limited by research technology, there are some differences in outcomes between the long-term research and the current research, so we searched various databases from 1 January 2012 to 27 November 2022. ...
As a major public health problem, posttraumatic stress disorder (PTSD) has a substantial impact on individuals and society. The total excess economic burden of PTSD in the US is estimated to be more than $232.2 billion a year. Acupuncture is widely used in patients with PTSD, and an increasing number of studies have been undertaken to assess the efficacy and underlying mechanisms of acupuncture for the treatment of individuals with PTSD. However, there has not yet been a review that simultaneously elucidates the therapeutic efficacy and biological mechanisms of acupuncture. We wished to examine the efficacy and underlying mechanisms of acupuncture for the treatment of individuals with PTSD. We conducted this review in three sections as follows: a meta-analysis, an acupoint analysis, and mechanism research. PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI), WanFang Database, China Biology Medicine Database (CBM), Chinese Science and Technology Journals Database (VIP), and other databases were searched from 1 January 2012 to 27 November 2022. Based on the included studies, we first determined whether acupuncture is more effective than psychological treatment or pharmacological treatment for treating and improving the quality of life of individuals with PTSD by meta-analysis. Second, the most commonly used acupoints and parameters of acupuncture were summarized based on animal and clinical studies. Third, we attempt to summarize the current mechanisms of acupuncture in the treatment of PTSD. Finally, 56 acupoint analyses, eight meta-analyses, and 33 mechanistic studies were included. Acupuncture outperformed pharmacotherapy treatment in improving symptom scores by CAPS, HAMA, HAMD, PCL-C, and SCL-90 somatization for PTSD and outperformed psychotherapy treatment in improving symptom scores by CAPS PCL-C and HAMD, according to the meta-analysis. GV20 was the most frequently used acupuncture point in clinical studies and animal studies, with a 78.6% application rate. Acupuncture may be effective in treating PTSD by regulating the structure and components of several brain areas, regulating the neuroendocrine system, and involving signaling pathways. In conclusion, this finding indicates that acupuncture has promising potential for treating PTSD.
... Beside the GWAS study that conducted in the human beings, there are abundant studies that focus on neurobiological study of PTSD animal models and resilient. Stress resilience is the opposite with PTSD and it negatively correlated, which provides us a precise view of the mechanism in PTSD development [11]. ...
In recent years, with the continuous spread of the COVID-19, the post-traumatic stress disorder (PTSD) has gradually become the major mental disorder which puzzles the people's psychological problems. PTSD has a high incidence rate in people who have experienced one or more trauma, but not all people who have experienced trauma will suffer from PTSD. Research shows that most patients with post-traumatic stress disorder often have one or more other mental diseases, including major depression and substance abuse or others (like bipolar, anxiety and so on). As a mental disorder with high risk and high suicide rate, PTSD is easy to be comorbid with depression, anxiety, sleep disorders and other symptoms, which not only makes patients more painful, but also greatly increases the difficulty of treatment. Although traumatic events are a necessary condition for diagnosis of the PTSD, they are not the sufficient condition for occurrence of the PTSD. At present, a lot of research has been done on PTSD, but its pathogenesis is still not completely clear. The causes may include genetic susceptibility factors, childhood psychological trauma, and other negative life events before and after traumatic events.Psychotherapy and drug treatment are the main treatment schemes for PTSD at present, but in the epidemic environment, these treatments have certain inconveniences, which reflects the advantages of telemedicine. In the future, people should obtain more and more evidence-based evidence from multiple perspectives in order to obtain the best curative effect.
Purpose
This open-trial pilot study evaluated the feasibility and effectiveness of acupuncture with brief therapy (ABT) for individuals with posttraumatic stress disorder (PTSD).
Method
Participants included 27 individuals with PTSD diagnoses confirmed using the Clinician-Administered PTSD Scale for DSM-5. Before ABT, 22 participants completed eight acupuncture sessions and three telehealth sessions of a brief treatment program for PTSD (Brief Relaxation, Education, and Trauma Healing [BREATHE]).
Results
ABT significantly reduced PTSD symptoms, depression symptoms, anxiety, and improved trauma-related cognition.
Conclusion
Acupuncture can play an important role in mental health recovery, and combining acupuncture with a brief, telehealth-based treatment (BREATHE) may assist recovery among individuals with PTSD. [ Journal of Psychosocial Nursing and Mental Health Services, xx (xx), xx–xx.]
