The Effects of Tai Chi on Sleep Quality in Chinese American Patients With Major Depressive Disorder: A Pilot Study.

OBJECTIVE: This pilot study evaluated the effects of Tai Chi training on sleep quality (primary outcomes), and depression and social functioning levels (secondary outcomes) among patients with depression. PARTICIPANTS: Sixteen depressed Chinese patients. METHODS: Participants received 1-hr Tai Chi training sessions 2 times per week for 10 weeks. Patients' subjective sleep quality ratings, objective sleep quality measurements, and depression and social functioning levels were measured before, during, and after the intervention. RESULTS: Sleep quality and depression outcomes improved significantly. Patients reported improved Pittsburgh Sleep Quality Index (PSQI) scores (9.6 ± 3.3 to 6.6 ± 5.2, p = 0.016), and cardiopulmonary coupling (CPC) analysis of electrocardiogram (ECG) showed decreased stable sleep onset latency (75.7 ± 100.6 to 20.9 ± 18.0, p = 0.014), increased stable sleep percentages (31.5 ± 18.7 to 46.3 ± 16.9, p = 0.016), and decreased unstable sleep percentages (45.3 ± 20.1 to 30.6 ± 16.5, p = 0.003). Patients also reported decreased Hamilton Rating Scale for Depression (HAM-D-17; 20.1 ± 3.7 to 7.8 ± 5.9, p < 0.001) and Beck Depression Inventory (BDI) scores (22.3 ± 9.1 to 11.1 ± 10.6, p = 0.006). Significant correlations were found between the changes in subjective sleep assessments ΔPSQI and ΔHAM-D-17 (r = 0.6, p = 0.014), and ΔPSQI and ΔBDI (r = 0.62, p = 0.010). Correlations between changes in objective sleep measurements and changes in depression symptoms were low and not significant. CONCLUSIONS: Tai Chi training improved sleep quality and mood symptoms among depressed patients.

Depressed Chinese Americans present predominantly psychological symptoms: A new trend or different outcomes due to methodological differences?

People of Asian cultural origin have been reported to emphasize somatic rather than psychological symptoms when they are depressed. However, a recent study investigated 190 Chinese immigrants with depression in a primary care clinic and reported that they were more likely to report depressed mood, rather than physical symptoms. We performed a qualitative analysis of the chief complaint narratives of 57 Chinese immigrants with major depressive disorder who were referred to a behavioral health clinic. These patients' chief complaints included insomnia, sadness, anxiety, cognition issues, being irritated/annoyed, having low energy/motivation, and stress. Among this population, 70.18 % presented psychological symptoms, 5.26 % presented somatic symptoms, and the remaining 15.8 % presented only neutral symptoms (e.g. 'low energy', 'loss of appetite', and 'insomnia'). Our findings show that depressed Chinese Americans at outpatient clinics present predominantly psychological and not somatic symptoms. This may reflect a new trend of symptoms reporting among Asian Americans with depression.