Differences in Symptoms Following Acupuncture Treatment in Three Case Presentations of Bipolar Disorder: Type 2, Comorbid Anxiety Disorder, and Rapid Cycling Type.

Background: This study reports the effects of acupuncture treatment on depression and anxiety symptoms for 3 different bipolar disorder (BD) pathologies. Case: Case 1: A 35-year-old man was diagnosed with BD type 2. His depressive symptoms appeared 17 years ago. He did not meet the diagnostic criteria for anxiety disorder (AD) in the Mini International Neuropsychiatric Interview (MINI). Case 2: A 32-year-old woman was diagnosed with BD type 2 with AD. Her depressive symptoms appeared 5 years ago. MINI indicated panic-, social anxiety-, and generalized AD. Case 3: A 42-year-old woman was diagnosed with rapid cycling BD. She developed depressive and hypomanic symptoms and visited our hospital 18 years ago. Acupuncture treatment was performed weekly for 12 weeks. Depression and anxiety symptoms were evaluated using the Himorogi Self-Rating Depression Scale (HSDS) and Himorogi Self-Rating Anxiety Scale (HSAS), respectively. Results: Case 1: The HSAS score did not improve significantly, but the HSDS score decreased from 22 points at baseline to 9 points at the 12th visit. Case 2: The HSDS score did not improve, and the HSAS score remained high from 26 points at baseline to 25 points at the 12th visit. Case 3: During the acupuncture period, both HSDS and HSAS scores fluctuated greatly, and the patient experienced repeated episodes of depression and hypomania. Conclusions: The response to acupuncture treatment may differ according to the classification and pathology of BD, and it may be desirable to perform the acupuncture treatment after evaluating the pathology and estimating the prognosis.

Effect of Acupuncture on Physical Symptoms and Quality of Life in Treatment-Resistant Major Depressive Disorder and Bipolar Disorder: a Single-Arm Longitudinal Study.

Background: Acupuncture is a non-pharmacological therapy used clinically for mood disorders. Relief of physical symptoms with acupuncture treatment may lead to relief of depressive symptoms and improvement of quality of life (QoL). Few studies have examined the effect of acupuncture on the physical symptoms and QoL of patients with mood disorders. Objectives: To examine the effect of acupuncture on physical symptoms and QoL of patients with treatment-resistant major depressive disorder (MDD) and bipolar disorder (BD). Methods: This prospective, single-arm, longitudinal study included patients with MDD and BD from an outpatient psychiatric clinic. Acupuncture was performed weekly for 12 weeks in combination with regular treatment, with fixed acupoints and individualized treatment for each patient. Psychiatric symptoms were evaluated using the Himorogi Self-Rating Depression Scale (HSDS) and Himorogi Self-Rating Anxiety Scale (HSAS). Physical symptoms such as physical pain, gastrointestinal symptoms, and sleep disorders were evaluated using the Japanese version of the Somatic Symptom Scale-8 (SSS-8) and Visual Analog Scale (VAS). QoL was evaluated using the 8-item Short-Form (SF-8) Health Survey. Results: A total of 36 patients (15 MDD and 21 BD patients) were analyzed. After 12 weeks of acupuncture, HSDS and HSAS scores significantly decreased (p < 0.05). Physical symptoms evaluated using SSS-8 and VAS scores also significantly improved (p < 0.05). In particular, neck pain and insomnia improved at an early stage. Among the SF-8 subscales, scores of bodily pain, general health perception, role limitations due to emotional problems, and mental health significantly increased (p < 0.05). Conclusion: Acupuncture may improve not only psychiatric symptoms but also physical symptoms and QoL in patients with treatment-resistant mood disorders. Further studies are required for confirmation of the preliminary data collected thus far.

Acupuncture for the Treatment of Depression and Physical Symptoms in Chronic Bipolar Disorder: A Case Report.

INTRODUCTION: Bipolar disorder (BD) is typically treated by pharmacotherapy. However, pharmacotherapy alone is often not adequate to cope with the variety of symptoms associated with BD. The present case report describes the therapeutic effects of manual acupuncture on a patient with chronic BD, and multiple concurrent physical symptoms, that did not improve with standard pharmacotherapy. CASE: A 41-year-old woman with type II BD presented with depression, anxiety, and multiple physical symptoms. Her symptoms had first appeared 12 years prior, and she was diagnosed with type II BD 3 years after symptom onset. Although she received standard treatment, including medication and psychotherapy, her symptoms did not improve. Acupuncture treatment aimed at improving psychiatric and physical symptoms was performed weekly for 12 weeks. Depression and anxiety symptoms were evaluated using the Himorogi Self-Rating Depression Scale (HSDS) and Himorogi Self-Rating Anxiety Scale (HSAS) respectively. A visual analog scale (VAS) was used to evaluate physical symptoms including diarrhea, insomnia, and general malaise. Outcome measures were evaluated before each treatment. RESULTS: Throughout the course of the acupuncture intervention, no changes were made to the patient's psychotropic medication regimen. HSDS and HSAS scores decreased after 12 weeks of acupuncture treatment and improvements in all physical symptoms, as measured by the VAS, were observed. Furthermore, psychiatric symptoms with hypomanic or mixed features were not exacerbated. CONCLUSIONS: In this patient, acupuncture was effective in improving psychiatric and physical symptoms of type II BD. This non-pharmacological intervention may be a viable option for the treatment of BD-associated symptoms.

Clinical trial registration, and publication in acupuncture studies: A systematic review.

BACKGROUND: To research 1) how many acupuncture clinical trials are registered with the WHO International Clinical Trial Registry Platform (ICTRP) and what patterns they demonstrate, 2) publication of the articles of acupuncture clinical trials which were registered with ICTRP. METHODS: The search strategy using the ICTRP: Intervention: acupuncture; Recruitment status: All; Date of registration; from 1 Jan 1990 to 31 Dec 2018. We searched the indexed articles in PubMed using trial IDs on 25 Feb 2019. When the paper was published, we indicated the number of weeks from the date of registration with ICTRP to the date of publication in order to define time till the publication. We divided the whole period we analyzed into 6 periods of every 3 years and measured the proportion of publication and the time from the date of registration of each trial till its publication in each period by the Kaplan-Meier method. RESULTS: Forty-three countries/areas conducted at least one acupuncture clinical trial. The total number of registrations was 1758. China, the USA, and the Republic of Korea accounted for 61% of those registrations. The proportion of publication was 178/1758 10% for the fully published papers and 141/1758 8% for the protocol papers. CONCLUSIONS: The substantial increase of registrations by China, the Republic of Korea, Iran, Brazil, Japan was observed which may be attributed to improved awareness of the CONSORT statement. However, the fully published papers rate is low at 10%. The publication of results of acupuncture clinical trials should also be rigorously mandated.