The relationship between liver function and neurophysiological factors in depressed individuals: a cross-sectional study using an integrated "East meets West" medicine approach.

Introduction: Depression is a common mental disorder worldwide. The pathology of depression may involve the dysregulation of neurotransmitters and immunity and produce genetic and environmental effects. Traditional Chinese Medicine (TCM) has been practiced for several thousand years and has a different understanding of depression compared to Western medicine. However, this approach has not been widely accepted by scientific communities as TCM mainly focuses on clinical practice. Methods: In this study, we conducted a cross-sectional study among 100 participants in a rehabilitation hospital to analyze the plausible pathways linking TCM-based liver function and depression, which we hypothesized in a prior theoretical review. Results: A significant relationship between adrenocorticotropic hormone and TCM-based liver function was found (r = 0.211, p = 0.041). Cortisol was significantly associated with norepinephrine (r = 0.243, p = 0.015) and adrenocorticotropic hormone (r = 0.302, p < 0.001). A positive significant relationship was also found between norepinephrine and adrenocorticotropic hormone (r = 0.272, p < 0.001). There was no significant relationship between the ratio from low frequency to high frequency and TCM-based liver function (p = 0.690). Discussion: These results suggest that TCM-based liver function can be interpreted using the hypothalamic-pituitary-adrenal axis. This is a pioneering study to examine the mechanisms of depression in relation to liver function by integrating Eastern and Western medical approaches. The findings of this study are valuable for a deeper understanding of depression and public education.

Enhancing Subjective Well-Being Through Qigong: A Randomized Controlled Trial in Older Adults in Hong Kong With Chronic Physical Illness.

Context: Eight-section Brocades, a qigong protocol, has been shown to reduce depressive symptoms in older adults with chronic physical illness, but its positive effects on quality of life, such as subjective well-being, aren't known. Objective: This study intended to evaluate the efficacy of qigong for increasing subjective well-being in older adults with chronic physical illness. Design: A randomized controlled trial was conducted. Setting: A governmental family clinic in Hong Kong. Participants: Participants were 47 older adults, 19 males and 28 females, with chronic physical illness. Intervention: Participants were randomly assigned to an Eight-section Brocades group (n = 25) or a cognitive training group (n = 22). The groups received 12 weeks of the Eight-section Brocades intervention or of cognitive training, respectively. Outcome Measures: The primary outcome-subjective well-being-and the secondary outcomes-functional independence, sleep quality, mobility, and hand grip strength-were assessed at baseline, postintervention, and at a one-month follow-up. Results: No significant between-group differences were observed in improvements in subjective well-being or any of the secondary outcomes. Significant improvements in subjective sleep quality and decreases in daytime dysfunction over time were reported by participants in both groups. Conclusions: The findings didn't support 12 weeks of Eight-section Brocades qigong as an effective treatment to enhance the subjective well-being of older adults with chronic physical illness. These null findings may be due to the possibilities that: (1) the treatment may have minimal effects on positive psychology outcomes; (2) the primary outcome measure showed possible ceiling effects for the groups; (3) the current study used an active control condition that may have had more benefits than the control conditions used in previous studies; (4) the current study may have been underpowered; (5) more than 12 weeks (24 sessions) of qigong may be required to impact well-being; or (6) some combination of these factors may have affected the results.

Comparing Mindful and Non-Mindful Exercises on Alleviating Anxiety Symptoms: A Systematic Review and Meta-Analysis.

BACKGROUND: In recent years, studies and reviews have reported the therapeutic benefits of both mindful and non-mindful exercises in reducing anxiety. However, there have not been any systematic reviews to compare their relative effectiveness for therapeutic application, especially among the non-clinical population. Thus, the aim of this review is to compare the effectiveness between mindful and non-mindful exercise on treating anxiety among non-clinical samples. METHODS: Potential articles were retrieved from PubMed, Embase, Academic Search Premier, and PsycInfo. Randomized controlled trials, which involved both mindful and non-mindful exercises as intervention, and the use of anxiety outcome measures were included. RESULTS: Twenty-four studies fulfilled the inclusion criteria and were included in our systematic review. In addition, 14 studies provided sufficient data to be included in the meta-analysis. For studies that reported significant group differences at post-assessment, results showed that mindful exercise was more beneficial in reducing anxiety than non-mindful exercise. The meta-analysis reported that yoga was more effective in reducing anxiety than non-mindful exercise. CONCLUSIONS: Compared to non-mindful exercise, yoga is shown to be more effective in alleviating anxiety symptoms. It is recommended that yoga could be used as a primary healthcare intervention to help the public reduce anxiety.

Qigong for the treatment of depressive symptoms: Preliminary evidence of neurobiological mechanisms.

OBJECTIVES: Qigong has been shown to effectively reduce depressive symptoms in older adults with chronic physical illness. Here, we sought to evaluate the effects of qigong on serotonin, cortisol, and Brain-derived Neurotropic Factors (BDNF) levels and test their roles as potential mediators of the effects of qigong on depressive symptoms. METHODS: Thirty older adults with chronic physical illness participated in a randomized clinical trial. They were randomly assigned to a qigong group (n = 14) or a control group for cognitive training of executive function and memory (n = 16). The participants provided blood and saliva samples at baseline and post-intervention. Levels of cortisol were measured from the salvia samples, and serotonin and BDNF were measured from the blood samples. RESULTS: Consistent with the study findings presented in the primary outcome paper, a significant Group × Time interaction effect emerged on depressive symptoms, explained by greater reductions in the qigong group than the control group. Qigong participants had significantly larger increases in serotonin and BDNF, and decreases in cortisol levels, compared with control group participants. Moreover, treatment-related changes in cortisol levels (but not serotonin or BDNF) fully mediated the beneficial effects of qigong on depressive symptoms. CONCLUSION: The findings provide preliminary evidence that treatment-related changes in cortisol may mediate the benefits of qigong on depressive symptoms. Given the limitation of small sample size of the present study, future studies with larger sample sizes and more extended follow-up assessment are warranted to determine the reliability of these findings.

The Neuroscience of Nonpharmacological Traditional Chinese Therapy (NTCT) for Major Depressive Disorder: A Systematic Review and Meta-Analysis.

BACKGROUND: Depression is a common disease affecting a large number of people across the world. Many researchers have focused on treatment for depression based on Western scientific approaches, but research based on traditional Chinese medicine (TCM) interventions, studying its clinical effectiveness and the underlying mechanisms involved, has been limited. The aim of this review is to conduct a pioneering systematic review with meta-analysis of existing studies that investigate the neuroscience basis of nonpharmacological traditional Chinese therapy (NTCT). METHODS: Both English (Pubmed, Embase, Scopus, SPORTDiscus, PsycINFO) and Chinese (China National Knowledge Infrastructure (CNKI)) databases were searched from inception to October 2018. The effects of NTCT on major depressive disorder, brain activity, and neurophysiological biomarker related outcomes were extracted. Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. The effect size of each study was reported by the mean difference of change scores. RESULTS: Six of twelve eligible studies showed that there was a significant improvement in favor of acupuncture in depressive symptoms (SMD -0.69, 95% CI -1.09 to -0.28, p=0.002, I 2 = 73%, p< 0.0008). Based on the available evidence, NTCT including acupuncture, Qigong, and Tai Chi was found to possibly improve brain metabolites, brain activity, and immune and endocrine systems in patients with major depressive disorder. CONCLUSIONS: Acupuncture could effectively relieve depressive syndromes. The clinical effects of acupuncture might be attributable to their influence on three proposed pathways, namely, the hypothalamic-pituitary-adrenal (HPA) axis, the locus coeruleus (LC)-immunity pathway, and the negative feedback loop of the hippocampus. Nevertheless, conclusions are limited due to the small number of studies included and the low-quality of the study designs. In the future, a cross-sectional study is needed to test the proposed plausible pathways. PROSPERO registration number is CRD42017080937.

An East Meets West Approach to the Understanding of Emotion Dysregulation in Depression: From Perspective to Scientific Evidence.

Depression, an emotion regulation disorder, is a prevalent mental illness in the world. Meanwhile, traditional Chinese medicine (TCM) has been increasingly regarded as a promising and effective alternative therapy approach for patients with depression. Despite many years of research on depression, the current understanding of the pathological mechanism of depression based on TCM theories is still in its infancy. Due to the lack of scientific evidence in the past, TCM is not fully recognized by researchers around the world. This review firstly summarizes the pathogenesis and etiology of depression in terms of both Eastern and Western medical systems. Secondly, it adopts an integrated Eastern and Western approach to propose some plausible neurophysiological pathways linking the liver, spleen, and heart functions explicated in TCM theory. The aim of this theoretical review is to bridge the knowledge gap between Eastern and Western medicine, which may better explain the pathology of depression.

Effects of yoga on stress management in healthy adults: A systematic review.

OBJECTIVE: This article reports a systematic review and critical appraisal of the effect of yoga on stress management in healthy adults. METHODS: A systematic literature search was performed to identify randomized controlled trials (RCTs) and clinical controlled trials (CCTs) that assessed the effects of yoga on stress management in healthy adults. Selected studies were classified according to the types of intervention, duration, outcome measures, and results. They were also qualitatively assessed based on Public Health Research, Education and Development standards. RESULTS: The systematic review was based on eight RCTs and CCTs that indicated a positive effect of yoga in reducing stress levels or stress symptoms. However, most of the studies had methodological problems in that the intervention duration was short and limited follow-up data was available. CONCLUSION: This review revealed positive effects of yoga on stress reduction in healthy adult populations. However, the result should be interpreted with caution due to the small number of studies and the associated methodological problems. Further studies to ascertain yoga's long-term effects and the underlying biological mechanisms leading to its stress reduction effect should be conducted.