Effectiveness of mindfulness and Qigong training for self-healing in patients with Hwabyung and depressive disorder: a protocol for a randomized controlled trial.

Background: Hwabyung is a Korean culture-bound syndrome characterized by anger-related physical and psychological symptoms. Depressive disorder is a common mental illness occurring worldwide, and has been reported to have a high comorbidity rate with Hwabyung. For patients with depressive disorders, differential diagnosis and combined treatment for Hwabyung should be considered. Mindfulness and Qigong may be effective alternatives for regulating emotions such as depression, anxiety, and anger. This study aims to investigate whether Mindfulness and Qigong Training for Self-Healing (MQT-SH) would improve emotional problems in patients with Hwabyung and depressive disorder. Methods: This study will be a two-arm block randomized controlled trial. A total of 64 participants will be recruited and randomly assigned to either experimental or control group. While the experimental group will perform MQT-SH for the first six weeks, the control group will receive no treatment. During the next six weeks, the control group will perform MQT-SH for ethical equity. Assessments will be conducted at baseline, post-intervention (6 weeks) and follow-up (12 weeks). The primary outcomes would be Hwabyung and depression, while the secondary outcomes would include anxiety, anger, and vitality. Discussion: This study will provide a basis for assessing the effectiveness of mindfulness and Qigong training in patients with Hwabyung and depressive disorder. Ethics and dissemination: This study was approved by the Institutional Review Board of Kyung-Hee University Oriental Medicine Hospital in Gangdong (KHNMCOH 2023-09-003). The results will be disseminated through peer-reviewed publications. Trial registration: This trial was registered with the Clinical Research Information Service (CRIS), Republic of Korea, No. KCT0008937 and was registered on November 10, 2023.

Systematic review and meta-analysis of cardiac neurosis for development of clinical practice guidelines of Korean medicine.

Background: The development of clinical practice guidelines in traditional medicine requires evidence that sufficiently reflects the medical field. Cardiac neurosis is a disease that occurs because of problems in the autonomic nervous system and is characterized by symptoms of the circulatory system that are representative of autonomic dysfunction. In traditional medicine, the heart is considered to be involved in mental health problems, and cardiac neurosis is accompanied by a variety of mental symptoms. Furthermore, there is a categorized diagnosis for cardiac neurosis, and active empirical research is being conducted in China. Objective: This study aimed to systematically review and quantitatively synthesize the effects of Korean medicine treatments in patients with cardiac neurosis to develop evidence-based clinical practice guidelines for the treatment of autonomic dysfunction. Methods: Nine databases were searched for articles published before September 13, 2022. The methodological quality of the studies was assessed using the RoB tool. The primary outcomes were somatization, depression, anxiety, and effectiveness rate. The secondary outcome was the rate of adverse effects. Results: Based on a systematic literature review, 151 randomized controlled trials were selected and analyzed. For patients with cardiac neurosis, herbal medicine, combined treatment of herbal medicine and Western medicine, combined treatment of herbal medicine and acupuncture, acupuncture, and combined treatment of acupuncture and Western medicine showed better overall effects than Western medicine alone. Furthermore, the combined treatment of herbal medicine and psychotherapy and that of herbal medicine, psychotherapy, and Western medicine showed an overall better effect than the combined treatment of Western medicine and psychotherapy. Conclusion: A meta-analysis of articles revealed the effectiveness of Korean medicine treatments and verified the effectiveness of a Korean medicine treatment alone, Korean medicine combined treatment, and combined treatment of Korean medicine and Western medicine on cardiac neurosis. Limitations included the inability to verify the cause of high heterogeneity between studies and the poor quality of the included studies. Nevertheless, this systematic review and meta-analysis of cardiac neurosis showed that the disease concept of traditional medicine can also be organized based on the latest research. Future research related to traditional diseases such as these should be conducted. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022347992, identifier CRD42022347992.

How do children with Tourette's syndrome and their caregivers live with the disorder? A systematic review of qualitative evidence.

Background: Tourette's syndrome (TS) is a childhood neurodevelopmental disorder characterized by sudden, repetitive, involuntary, and irregular muscle movement and vocalization. Recently, non-pharmaceutical methods, such as behavioral therapy, psychotherapy, and deep brain stimulation, have been introduced as alternatives to pharmacological treatment for TS. This study aimed to systematically review and synthesize qualitative evidence on the experiences of children with TS and their caregivers. A meta-synthesis of qualitative evidence could help provide a comprehensive understanding of the challenges experienced by children with TS and their caregivers with the aim of providing more effective treatment and services for them. Materials and methods: A systematic search was conducted using MEDLINE/PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycARTICLES, and three Korean databases (Korean Medical Database, Research Information Sharing Service, and ScienceON) in July 2021. Studies were included if they collected and analyzed qualitative data from children with tic disorder or TS, or their caregivers. Qualitative research findings on the experiences and perspectives of children with TS and their caregivers were critically appraised and synthesized using the Joanna Briggs Institute methodology. Results: Eight eligible studies were included. The findings from these studies (i.e., themes or subthemes of qualitative research) were aggregated into categories (a group of similar findings) and synthesized findings (a group of categorized findings). Ultimately, the 60 findings were aggregated into 15 categories. Finally, four synthesized findings were derived from the 15 categories: (i) continuation of challenging daily life, (ii) denying that TS causes emotional distress, (iii) accepting and understanding TS as part of oneself, and (iv) looking to the future. Conclusion: Children with TS and their caregivers experience physical and psychological distress and social deprivation. Avoiding and suppressing TS causes secondary distress such as guilt. However, seeking social support and accepting the disorder reduce the distress caused by symptoms and lays the foundation for later growth. Even in the face of adversity, children with TS and their caregivers find personal value and acquire a more open and optimistic attitude toward life. This review shows that acceptance-based therapy and social support should be provided for the treatment and management of TS.

Effects of mobile mindfulness training on mental health of employees: A CONSORT-compliant pilot randomized controlled trial.

BACKGROUND: Employee stress and well-being affect organizational efficiency and productivity, as well as physical and psychological health of employees. Mindfulness is believed to reduce stress, prevent diseases, and promote well-being. Mindfulness has been used as the main component of various smartphone-based healthcare applications. Previous studies have suggested that mindfulness applications have a positive effect on employee stress and mental health. However, relatively few randomized controlled trials have examined the effectiveness of mindfulness applications on employees. This study aims to evaluate whether mobile mindfulness training (MMT) as a stress self-management tool improves employees' perceived stress, subjective well-being, and Mibyeong, a condition that is not a disease but shows obvious health abnormalities. METHODS: Participants were recruited through advertisements displayed at 3 workplaces, including a patent attorney's office, a construction company, and a public relations firm. A total of 45 employees were randomly assigned to 1 of 2 groups: the MMT group (Group A) receiving smartphone application-based mindfulness training, and a wait-list control (WLC) group (Group B), who received no intervention. Group A employees conducted MMT following daily and event guidelines for 4 weeks. In contrast, Group B employees did not receive any intervention in that time. The outcome variables were perceived stress, subjective well-being, and Mibyeong. Surveys were conducted at baseline, post-intervention, and follow-up (fourth week post-intervention). RESULTS: Demographic characteristics and baseline assessments were not significantly different between the 2 groups. The results of this study revealed that subjective well-being and Mibyeong were significantly improved in the MMT group compared with the WLC group. Moreover, this improvement was maintained up to at least 4 weeks later. However, perceived stress was not significantly reduced in the MMT group compared to the WLC group. CONCLUSION: Four weeks of MMT improved the subjective well-being and Mibyeong of employees. However, further studies are required to investigate the effect of MMT on other areas of mental health.

Erratum: Withdrawal notice to: Electroacupuncture plus moxibustion for major depressive disorder: A randomized, sham-controlled, pilot clinical trial.

[This corrects the article DOI: 10.1016/j.imr.2021.100802.].

Meditation-based intervention for obsessive-compulsive disorder: A PRISMA-compliant systematic review and meta-analysis.

BACKGROUND: The purpose of this study was to investigate the effects of the meditation-based intervention on obsessive-compulsive disorder (OCD). METHODS: The following databases were searched up to April 2021: the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Medline (via PubMed), PsycARTICLES, 4 Korean databases (Korean Medical Database [KMbase], Koreanstudies Information Service System [KISS], National Digital Science Library [NDSL], and Oriental Medicine Advanced Searching Integrated System [OASIS]), and China National Knowledge Infrastructure (CNKI). The search terms related to meditation-based intervention and OCD were used. This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The selected articles were evaluated using the Cochrane risk of bias tool. The Review Manager (RevMan) 5.4 was used to perform the meta-analysis. RESULTS: In all, 16 randomized controlled trials were selected. The meta-analysis showed that the group receiving the treatment combining medication and meditation-based intervention for OCD showed a more significant post-treatment improvement in Yale-Brown obsessive compulsive scale than the group receiving medication only. Compared with other non-medication interventions that are known to be effective in treating OCD, the Yale-Brown obsessive compulsive scale showed a significant improvement immediately after the meditation-based intervention. However, no significant difference was found in the follow-up monitoring data across all examined cases. CONCLUSION: This study was conducted to verify the effects of meditation-based intervention on OCD. The results suggested that combined treatment with medication and meditation-based intervention was more effective in treating OCD than medication alone; the positive effects of meditation-based intervention may be greater than the effects of other non-medication interventions. However, the lack of significant difference in the follow-up indicates that long-term effect of meditation-based interventions is unclear. TRIAL REGISTRATION NUMBER: PROSPERO CRD42021244408.

Efficacy and safety of Gyejibokryeong-hwan (GBH) in major depressive disorder: study protocol for multicentre randomised controlled trial.

BACKGROUND: Gyejibokryeong-hwan (GBH) is an herbal medicine composed of five herbs. It has been widely used to treat gynaecological diseases in traditional East Asian medicine. Recent animal studies suggest antidepressant effects of GBH. In this trial, we explore the efficacy and safety of GBH in patients with major depressive disorder and to identify the optimal dose for the next phase III trial. METHODS: This trial will enrol 126 patients diagnosed with major depressive disorder and not treated with antidepressants. Participants will be randomised to receive a high or a low dose of GBH or placebo granules. The study drugs will be administered three times a day, for 8 weeks. The 17-item Hamilton Depression Rating Scale (HDRS) will be used to measure the severity of depressive symptoms at weeks 2, 4, 6, 8, and 12. The primary efficacy endpoint is the change from baseline in HDRS-17 total score post-treatment at week 8. Analysis of covariance will be based on the baseline HDRS-17 total score and site as the covariates. Safety assessment will be based on the frequency of adverse events. The severity and causality of the study drug will be assessed. DISCUSSION: This study is designed to evaluate the efficacy and safety of GBH granules compared with placebo in patients with major depressive disorder. TRIAL REGISTRATION: Clinical Research Information Service KCT0004417 . Registered on November 1, 2019 (prospective registration).

Anti-anger Effects of Herbal Medicine: A Mini-Review of Rat Studies.

OBJECTIVE: To analyze the available data on the anti-anger effects of herbal medicines (HMs) as well as their underlying mechanisms in rat models. METHODS: From 6 electronic databases [PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang, Oriental Medicine Advanced Searching Integrated System (OASIS), and Research Information Sharing Service (RISS)], relevant animal experiments were searched by using "anger," "rats," and "animal" as search keywords. The last search was conducted on November 22, 2019, and all experiments involving rat models of anger and treatment using HMs published until the date of the search were considered. RESULTS: A total of 24 studies with 16 kinds of HMs were included. Most studies have used the "tail irritating method" and "social isolation and resident intruder" method to establish anger models. According to the included studies, the therapeutic mechanisms of HMs for anger regulation and important herbs by their frequency and/or preclinical evidence mainly incladed regulation of hemorheology (Bupleuri Radix, Paeoniae Radix Alba, and Glycyrrhizae Radix), regulation of sex hormones (Bupleuri Radix, Cyperi Rhizoma, and Paeoniae Radix Alba), regulation of neurotransmitters (Cyperi Rhizoma), regulation of anger-related genes (Bupleuri Radix, Glycyrrhizae Radix, and Paeoniae Radix Alba), and other effects. Overall, Liver (Gan) qi-smoothing herbs including Bupleuri Radix and Cyperi Rhizoma were the most frequently used. CONCLUSIONS: This review found the frequent methods to establish an anger model, and major mechanisms of anti-anger effects of HMs. Interestingly, some Liver qi-smoothing herbs have been frequently used to investigate the anti-anger effects of HM. These findings provide insight into the role and relevance of HMs in the field of anger management.

Electroacupuncture plus moxibustion for major depressive disorder: A randomized, sham-controlled, pilot clinical trial.

BACKGROUND: The first treatment option for major depressive disorder (MDD) is antidepressants, however, there is substantial demand for alternative therapies due to its low compliance and remission rates. This study was aimed to explore the effectiveness, safety, and feasibility of electroacupuncture plus moxibustion therapy for MDD. METHODS: Thirty adults with MDD were randomly assigned to the treatment group (TG) or control group (CG). The TG was treated with electroacupuncture plus moxibustion, and the CG received sham interventions at non-acupoints for 8 weeks. The primary outcome measure was the intergroup difference of the mean change of total score of the Hamilton rating scale for depression (HRSD) between baseline and week 9. Secondary outcome measures were Beck's depression inventory, insomnia severity index, the state-trait anxiety inventory, the EuroQol-5 dimension index, the measure yourself medical outcome profile version 2, and frontal alpha asymmetry measured by electroencephalography. Adverse events (AEs) were monitored for safety assessment. RESULTS: The primary outcome measure was not significantly different between the two groups (p=0.2641), although the scores of HRSD in both groups improved significantly after treatment. No significant difference was identified between groups in secondary outcome measures. The incidence of AE was not significantly different between the two groups (p=0.1067). CONCLUSION: A clinical trial using electroacupuncture plus moxibustion for MDD seems feasible. However, further studies with the larger size, adopting ideal controls are warranted to provide a confirmative conclusion to the efficacy and safety of electroacupuncture plus moxibustion for MDD. TRIAL REGISTRATION: The protocol was registered at Korean Clinical Trial Registry (CRIS-KCT0001810).

A multicenter registry of neuropsychiatric outpatients in Korean medicine hospitals (KMental): Protocol of a prospective, multicenter, registry study.

INTRODUCTION: Mental health is an important global health concern. In Korea, many people visit Korean medicine clinics due to Stagnation syndrome and Hwabyung (cultural idioms of distress). METHODS AND ANALYSIS: We established a research collaboration comprising of professionals from 8 Korean medicine hospitals and planned a prospective, multicenter registry study. Demographic, socioeconomic, and clinical data will be collected from patients with mental disorders visiting the Korean medicine neuropsychiatric department of Korean medicine hospitals. We will include major psychiatric diagnoses related to neurosis and Korean traditional mental disorders such as Stagnation syndrome and Hwabyung.We expect to identify comprehensive characteristics of participants, measure the severity of their symptoms or distress, and investigate patterns of Korean medicine interventions and treatment responses for both the short-term and long-term (at least 4 years). Additionally, this study will include Health Insurance Review & Assessment Service data to analyze the medical use of registered patients before and after registration, in case the participant submits the consent form for personal information collection and use.To analyze the effectiveness of Korean medicine treatment for the participants, stratified or corrected analyses of age, sex, and diagnosis will be performed. The difference in the change in the psychometric measurements, quality of life measured by short form 36, and quality-adjusted life years will be calculated to evaluate the effectiveness of Korean medicine treatment.

Effectiveness and Safety of the Korean Medicine Senior Health Promotion Program Using Herbal Medicine and Acupuncture for Mild Cognitive Impairment: A Retrospective Study of 500 Patients in Seoul, Korea.

BACKGROUND: The management of mild cognitive impairment (MCI) is becoming increasingly important. The Korean Medicine Senior Health Promotion Program (KSHPP) was developed in 2016, and it has been in use to date. This study aimed to assess the effectiveness of KSHPP using herbal medicine and acupuncture for treating MCI and the safety of herbal medicine using liver and renal function tests. METHODS: We retrospectively reviewed the medical records of the participants with MCI. We assessed the Korean version of the Montreal Cognitive Assessment (MoCA-K), the Mini-Mental State Examination-Dementia Screening (MMSE-DS), and the Geriatric Depression Scale Short Form-Korea version (GDSSF-K) scores before and after KSHPP to determine its effectiveness. To evaluate its safety, the liver and renal function tests were conducted before and after herbal treatment. RESULTS: We enrolled 1002 participants, and 500 participants satisfied the inclusion criteria. Of 500 patients, 364 (72.8%) were depressed and 136 (27.2%) were not. The mean MoCA-K score significantly increased by 2.77 for the entire sample and 3.22 for the depressed sample (all P < 0.0001). The mean MMSE-DS score significantly increased by 2.19 for the entire sample and 2.51 for the depressed sample (all P < 0.0001); the mean GDSSF-K score significantly decreased by 1.73 for the entire sample and 2.68 for the depressed sample (all P < 0.0001). CONCLUSIONS: Our findings suggest that Korean medicine interventions can improve cognitive function and depression symptoms in patients with MCI. In addition, the results of the liver and renal function tests were analyzed as surrogate outcomes to assess the safety of herbal medicine. Based on these results, we expect that Korean medicine interventions can promote the cognitive and mental health of seniors. However, as there were several study limitations, particularly study design, practice effect, and short follow-up, these results must be interpreted with caution. We need a further long-term study with a rigorous design to retain confidence in the effectiveness and safety of KSHPP.

Electroacupuncture plus moxibustion for major depressive disorder: A randomized, sham-controlled, pilot clinical trial.

BACKGROUND: The first treatment option for major depressive disorder (MDD) is antidepressants, however, there is substantial demand for alternative therapies due to its low compliance and remission rates. This study was aimed to explore the effectiveness, safety, and feasibility of electroacupuncture plus moxibustion therapy for MDD. METHODS: Thirty adults with MDD were randomly assigned to the treatment group (TG) or control group (CG). The TG was treated with electroacupuncture plus moxibustion, and the CG received sham interventions at non-acupoints for 8 weeks. The primary outcome measure was the intergroup difference of the mean change of total score of the Hamilton rating scale for depression (HRSD) between baseline and week 9. Secondary outcome measures were Beck's depression inventory, insomnia severity index, the state-trait anxiety inventory, the EuroQol-5 dimension index, the measure yourself medical outcome profile version 2, and frontal alpha asymmetry measured by electroencephalography. Adverse events (AEs) were monitored for safety assessment. RESULTS: The primary outcome measure was not significantly different between the two groups (p=0.2641), although the scores of HRSD in both groups improved significantly after treatment. No significant difference was identified between groups in secondary outcome measures. The incidence of AE was not significantly different between the two groups (p=0.1067). CONCLUSION: A clinical trial using electroacupuncture plus moxibustion for MDD seems feasible. However, further studies with the larger size, adopting ideal controls are warranted to provide a confirmative conclusion to the efficacy and safety of electroacupuncture plus moxibustion for MDD.

How Suppressed Anger Can Become an Illness: A Qualitative Systematic Review of the Experiences and Perspectives of Hwabyung Patients in Korea.

Background: In the clinical field, anger has generally been studied in terms of aggressive behavior. However, in Asians, anger suppression is more common than anger expression. Hwabyung is a culture-related anger syndrome in Korea and is known to occur due to the continued repression of anger. Investigating Hwabyung should lead to a better understanding of the multiple dimensions of anger. To explore Hwabyung patients' experiences and perspectives, a meta-aggregation approach was used to conduct a systematic review and a qualitative synthesis. Methods: A systematic search was conducted in MEDLINE/PubMed, EMBASE, Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycARTICLES, and four Korean databases [Korean Medical Database (KMbase), Korean Studies Information Service System (KISS), National Digital Science Library (NDSL), and Oriental Medicine Advanced Searching Integrated System (OASIS)] in September 2020. Studies were included if they collected and analyzed qualitative data from Hwabyung patients. Qualitative research findings on the experiences and perspectives of Hwabyung patients in Korea were critically appraised and synthesized using the Joanna Briggs Institute methodology. Results: Seven eligible studies were included. The findings from those studies (i.e., theme or subtheme of qualitative research) were aggregated into categories (a group of similar findings) and synthesized findings (a group of categorized findings). Ultimately, 116 findings were aggregated into 15 categories. Finally, four synthesized findings were derived from the 15 categories: (i) anger arousal, (ii) blame, (iii) uncontrollable physical and emotional symptoms, and (iv) compromise and temporary coping. Conclusions: Patients with Hwabyung experience chronic anger through the complex cognitive processes involved in blame. Hwabyung negatively affects patients' physical, psychological, and social functions. Because Hwabyung patients feel as if they are losing control, due to emotional dysregulation and physical symptoms, professional support should be provided to facilitate their coping strategies. Further studies on Hwabyung can serve as a new model of pathological anger.

Nonpharmacological treatments for Tourette syndrome and tic disorders: A protocol for systematic review and network meta-analysis.

BACKGROUND: A tic is a sudden, rapid, recurrent, nonrhythmic motor movement, or vocalization. Tic disorders are diagnosed based on the presence of motor or vocal tics, duration of tic symptoms, and age at onset. Current clinical practice guidelines strongly recommend behavioral therapies because they are more effective and safer than medications. To determine the most effective nonpharmacological intervention for tic disorders and Tourette syndrome, we will conduct a systematic review and network meta-analysis. METHODS: We will search the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycARTICLES, AMED, 3 Chinese databases (China National Knowledge Infrastructure, Chongqing VIP, and Wanfang Data), 3 Korean databases (Korean Medical Database, Korean studies Information Service System, and ScienceON), and a Japanese database (CiNii). There will be no language or date restrictions. The primary outcome will be the tic severity scale, the Yale Global Tic Severity Scale. The secondary outcomes will include the effective rate defined by the trial authors, dropout rate, and adverse events. Methodological quality will be assessed using the Cochrane risk of bias tool. RESULTS: Results of this review and network meta-analysis will be published in a peer-reviewed journal. CONCLUSIONS: This systematic review will assess the effectiveness of nonpharmacological interventions for treating tic disorders. A systematic review or meta-analysis will provide an unbiased overview of the existing evidence.

The mindfulness-based stress reduction program for improving sleep quality in cancer survivors: A systematic review and meta-analysis.

INTRODUCTION: This study aims to evaluate the efficacy and effectiveness of a mindfulness-based stress reduction (MBSR) program in improving sleep in cancer survivors. METHODS: Four electronic databases (Cochrane Library, EMBASE, PubMed, and PsycARTICLES) were searched for randomized controlled trials evaluating the effects of MBSR on the sleep of cancer survivors from their inception to May 2020. The primary outcome was sleep quality measured by validated questionnaires such as the Insomnia Severity Index and Pittsburgh Sleep Quality Index. The secondary outcomes were sleep parameters obtained from a sleep diary, polysomnography, and actigraphy. The included studies were critically appraised by the Cochrane risk of bias tool and meta-analyzed. RESULTS: Ten studies were included, and nine studies were analyzed quantitatively. MBSR significantly improved sleep quality compared to usual care (standardized mean difference -0.29, 95 % confidence interval -0.55 to -0.04, I2 = 58 %). However, there were no favorable results with sleep parameters. Compared to active controls, MBSR presented mixed results with sleep quality according to the outcomes and negative results with sleep parameters. CONCLUSION: This review suggests that MBSR helps cancer survivors improve sleep quality. Our results support the possibility of using MBSR for cancer survivors. However, its efficacy and effectiveness in improving sleep quality and sleep parameters are inconclusive because the number of included studies was few with inconsistent results. Further studies with high methodological quality are required to establish conclusive evidence about the efficacy and effectiveness of MBSR in improving sleep quality and sleep parameters in cancer survivors.

Mindfulness meditation program for the elderly in Korea: A preliminary review for planning the program.

BACKGROUND: The significance of mindfulness meditation (MM) has increased in recent years in both clinical settings and public health. However, ways to implement MM as a disease prevention or treatment method in the elderly is still a major challenge. A comprehensive analysis of previous studies on MM programs for the elderly in Korea will help build future integrated care programs that incorporate MM. METHODS: Seven international and Korean domestic electronic databases were searched to collect relevant clinical studies until May 30, 2020. RESULTS: Sixteen articles with twelve clinical studies were included in this review. The MM program was generally offered once a week over eight weeks with a duration of between 60 and 90 min per session. The main reason for participants' drop out was poor program compliance attributed to conflicting schedules, physical illness, or a change of mind. The program results were either positive or mixed, but the mindfulness level of the participants was improved. CONCLUSIONS: This review summarizes information obtained from previously published studies in Korea, on the design considerations, characteristics, and preliminary effectiveness of the MM program for the elderly. The findings can be used as preliminary data by future practitioners and/or researchers to design MM programs targeted toward the elderly; it could also help policymakers integrate MM-based strategies into integrated care programs to promote their mental health and well-being.

One-year visiting care service treatment with Korean medicine for a solitary elderly woman in a public health setting: A case report.

In public health, the plight of the solitary elderly is associated with serious social and medical burden. In this vulnerable population, neuropsychiatric complications such as senile depression and dementia as well as chronic pain conditions often co-occur. In this case report, we present a case of an 81-year-old solitary woman who received one year of visiting care service with Korean medicine treatments in a public health setting. During the one year, her pain severity (measured using numeric rating scale) remained moderate after her initial decline and her depressive symptoms and cognitive function scales (Geriatric Depression Scale-Short Form Korean and the Korean version of the Mini-Mental State Examination for Dementia Screening) remained almost unchanged; however, another cognitive function scale (Korean version of the Montreal Cognitive Assessment) showed noticeable improvements. This case report suggests that providing visiting care services with Korean medicine may be a viable strategy for addressing the issues of the solitary elderly.

Do Cochrane reviews reflect the latest evidence on meditation and mindfulness-based interventions? A snapshot of the current evidence.

Growing evidence emphasizes the importance of meditation and mindfulness-based interventions (MBIs) in clinical settings. Here, we attempted to determine the clinical issues targeted by Cochrane reviews of meditation and MBIs and whether the judgements about quality/certainty as expressed by the Cochrane authors differed from that of non-Cochrane reviews and guidelines. The search database was the Cochrane Database of Systematic Reviews and the search date was December 31, 2019. Screening and selection of reviews was carried out by two independent authors. Overall, 20 reviews and four protocols were selected for this study. The effects of meditation and/or MBIs on various conditions described in the Cochrane reviews seemed ambiguous, with the exception of mindfulness-based stress reduction in breast cancer patients. However, we found some international clinical practice guidelines and latest non-Cochrane reviews describing meditation and MBIs to be more comprehensive and favorable. This gap is likely due to the priority-setting issues, which resulted in a lack of latest up-to-date evidence, as well as gaps in interventions of interest between Cochrane and non-Cochrane reviews.

Effect of herbal medicine (Huanglian-jie-du granule) for somatic symptoms and insomnia in patients with Hwa-byung: A randomized controlled trial.

BACKGROUND: Huanglian-jie-du (HJD) granule, which is composed of representative "heat-clearing" herbs has been used for Hwa-byung. Hwa-byung is a culture-bound syndrome in Korea, characterized by distinct somatic symptoms such as chest congestion and heat sensation resulting from suppressed anger. We investigated the effect of HJD in patients with Hwa-byung. METHODS: Forty-four patients with Hwa-byung were recruited, and HJD or placebo granules were administered orally three times daily for seven days. The two primary outcomes were somatic symptoms, which were measured by Patient Health Questionnaire of physical symptoms (PHQ-15), and insomnia, which was measured by Insomnia Severity Index (ISI) at post-treatment. RESULTS: Between July 10 and October 31, 2017, 44 patients with Hwa-byung (mean age 36.68 years; and 38 female) were randomly assigned to HJD (n = 22) or placebo (n = 22) group. After administration of HJD or placebo granule for seven days, ISI score was lower in the HJD group compared to placebo group at post-treatment (adjusted mean difference -2.56 [95% CI -4.72 to -0.39], p = 0.0208). Meanwhile, there was no difference in PHQ-15 score between HJD group and placebo group at post-treatment (adjusted mean difference -0.50 [95% CI: -3.02-4.02], p = 0.7812). CONCLUSIONS: Our results suggest that the administration of HJD granule has a potential to improve insomnia in Hwa-byung patients. Effect of HJD granule for general somatic symptoms in Hwa-byung patients is unclear, and further researches are needed. TRIAL REGISTRATION: Clinical Research Information Service, KCT0002379.

Analysis of the bio-psychological characteristics of Sasang typology in Korean preschool children using the ponderal index and the temperament and character inventory.

OBJECTIVES: The aim of this study was to identify different physical and mental characteristics among three common Sasang types, Tae-eum, So-yang, and So-eum (except scarce type, Tae-Yang) in preschoolers, to improve constitutional diagnoses. METHODS: Our study included 65 boys and 67 girls from six kindergartens in South Korea. The number of children who were categorized as Tae-Yang, Tae-Eum, So-Yang, and So-Eum types were 1, 56, 40, and 35, respectively. We measured height, weight, mid-parental height, predicted adult height, ponderal index (PI), and findings from the junior temperament and character inventory 3 to 6. RESULTS: The Tae-eum type exhibited higher weight percentiles and PIs than the other types (p < 0.001), and the So-eum type displayed higher harm avoidance (HA) scores than the Tae-eum type (p = 0.033). CONCLUSIONS: Children with high PIs and low HA scores have a higher probability of being classified as the Tae-eum type than as the So-eum type.