Transcutaneous electrical acupoint stimulation as an adjunct therapy for obsessive-compulsive disorder: A randomized controlled study.

BACKGROUND: Transcutaneous electrical acupoint stimulation (TEAS) is thought to have potential to treat obsessive-compulsive disorder (OCD). OBJECTIVE: The purpose of this study was to determine whether adding TEAS to cognitive behavioral therapy (CBT) and clomipramine would improve the efficacy of these conventional treatments in OCD. METHODS: In this randomized controlled trial, 360 OCD patients were assigned to receive TEAS combined with CBT plus clomipramine (Group A, n = 120), TEAS combined with CBT plus placebo (Group B, n = 120), and simulated (placebo) TEAS combined with CBT plus clomipramine (Group C, n = 120) for 12 weeks. The primary outcome was measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). RESULTS: OCD symptoms in all patients reduced over time, however Groups A and B had a significantly greater reduction in Y-BOCS total score and the subscale for obsession and compulsion between week 2 and week 12 compared to Group C. Groups A and B had similar scores on these measures. Both groups had significantly higher rates of clinical response than Group C (88.3% and 81.7% vs. 67.5%, respectively, p < 0.001); and higher rates of remission (30.0% and 22.5% vs. 9.2%, respectively, p < 0.001). Group B experienced fewer adverse events than the other two groups. CONCLUSIONS: TEAS enhances the efficacy of conventional OCD interventions and avoids the adverse effects associated with conventional pharmacological treatment. It can be considered as an effective adjunct intervention for OCD.

Clinical study on treatment of the earthquake-caused post-traumatic stress disorder by cognitive-behavior therapy and acupoint stimulation.

OBJECTIVE: To study the curative effect of acupoint stimulation on the earthquake-caused post-traumatic stress disorder (PTSD). METHODS: The 91 PTSD patients in Wenchuan hit by a strong earthquake were randomly divided into a control group of 24 cases treated by the cognitive-behavior therapy, and a treatment group of 67 cases treated by both cognitive-behavior therapy and acupoint stimulation. The scores were evaluated according to Chinese version of the incident effect scale revised (IES-R) and the self-compiled questionnaire for the major post-traumatic psychological condition, and the curative effect was compared between the two groups. RESULTS: The total scores of IES-R, the scores of all factors and the total scores of the questionnaire in the two groups after treatment were much lower than those before treatment (P < 0.01). The comparison of reduction in the factor scores between the two groups showed that the curative effect in the treatment group was better that of in the control group. CONCLUSION: The acupoint stimulation is effective for the PTSD patients, with better results than that of cognitive-behavior therapy used alone.

[A multilevel analysis on the association between socioeconomic status and psychiatric disorders].

OBJECTIVE: To explore the association between psychiatric disorders and socioeconomic status such as education, income, employment and area of community settings in Zhejiang province. METHODS: Data were from the epidemiological survey of mental illnesses aged 15 and older in 2001 (n = 14 632). Psychiatric disorders were measured by GHQ-12 with a cut-point 4. Logistic multilevel analysis was the main statistical method being used. RESULTS: The overall prevalence of psychiatric disorders was 18.5%(95% confidence intervals, 17.9% to 19.1%), higher than the data from Hebei province (u = 4.39, P < 0.001). Annual household income and employment were strongly associated with psychiatric disorders especially for those with low income (odds ratio 3.45, 95%CI: 1.72 - 6.67) and unemployment (odds ratio 2.03, 95%CI: 1.73 - 2.40). Factors as regional effect and education level showed weak or inconsistent association with psychiatric disorders after controlling on other indicators. CONCLUSION: Inverse gradient relation between psychiatric disorders and SES seemed as the main result of low SES individual characteristics and some minor effects at the county level.

[A multilevel cross-sectional study of mental disorder in community settings in Zhejiang Province].

OBJECTIVE: To investigate the prevalence of mental disorder through the 12-item general health questionnaire (GHQ-12) survey and its related factors in community settings in Zhejiang Province. METHODS: A muti-level model was analyzed using data of 14,632 respondents nested in counties (cities), townships (urban districts), villages (urban neighborhoods) from the epidemiological survey of mental illnesses above 15 years old. RESULTS: The mean score measured by GHQ-12 was (1.54 +/- 2.15), which was lower than that of samples from four cities of Guangzhou, Chongqing, Taiyuan and Hangzhou (U = 11.08, P < 0.01). The mental disorder clustered within county (city) level, which represented 4.3% (chi(2) = 3.94, P < 0.05) of the total variance including four levels. After controlling for the county level, the mental disorder was associated with age, marital status, residency patterns, education, occupation and household incoming. In particular, it was reported that higher household incoming was significantly associated with better mental disorder among population in community settings. CONCLUSION: The prevalence of mental disorder clustered at the county (city) level is relatively lower with vulnerable groups including divorced, widowed, unemployed, retired, lower-income ones in community settings in Zhejiang Province.

[Clinical study on treatment of obsessive compulsive neurosis by acupoint stimulating control].

OBJECTIVE: To study the clinical effect of acupoint stimulating control (ASC) in treating obsessive compulsive neurosis. METHODS: The comparative study was conducted in 65 patients with obsessive compulsive neurosis, they were divided into two groups, the 33 patients in the control group treated with chlorimipramine and the 32 in the tested group treated with ASC. The therapeutic efficacy and adverse reaction were assessed according to the standard for clinical efficacy evaluation by Yale-Brown scale for obsession (Y-BOCS)and adverse reaction scale. RESULTS: The curative rate and markedly effective rate in the control group was 24.2% (8/33) and 27.3% (19/33), which in the tested group was 37.5% (12/32) and 34.4% (11/32) respectively. Significant difference was shown in comparison of Y-BOCS score between the two groups from the end of the 4th week of treatment (P < 0.05), indicating the efficacy in the tested group was better than that in the control group. Moreover, the occurrence of adverse reaction was higher in the control group than that in the tested group. CONCLUSION: ASC is a treatment with good effect, less adverse reaction and favourable safety superior to the treatment by chlorimipramine.

[Epidemiological survey of mental illnesses in the people aged 15 and older in Zhejiang Province, China].

OBJECTIVE: To describe the current prevalence and distribution of all types of mental disorders in Zhejiang Province and use this data to develop a provincial mental health plan. METHODS: Stratified multi-stage cluster randomization was used to identify 14 counties (cities), 70 townships (urban districts), 140 villages (urban neighborhoods) and 15,000 subjects > or = 15 years of age. Psychiatric nurses used an expanded version of the General Health Questionnaire (GHQ) to identify subgroups of subjects at high, moderate and low risk of having a mental disorder, then psychiatrists determined their diagnoses by administering a structured psychiatric examination (SCID) that employs American diagnostic criteria for mental disorders (DSM-IV) to 100% of high-risk, 40% of moderate-risk and 10% of low-risk subjects. RESULTS: 14 639 subjects completed the screening and 4,788 completed the psychiatric examination. The adjusted overall current rate of mental disorders was 17.3% (95% CI = 16.0%-18.7%), which dropped to 13.4% (12.2%-14.7%) if the non-specific (NOS) disorders were excluded. The most common diagnostic groups were affective disorders (8.6%, 7.9%-9.5%), anxiety disorders (4.3%, 3.6%-5.1%), and substance use disorders (3.0%, 2.4%-3.8%). The most common specific disorders were major depressive disorder (4.3%, 3.7%-4.9%), alcohol use disorder (2.9%, 2.3%-3.7%), dysthymia (1.6%, 1.3%-1.9%) and specific phobias (1.2%, 0.8%-1.8%). The overall prevalence was higher in rural than in urban areas (RR = 1.23, 95% CI = 1.11-1.37) and slightly higher in women than in men (RR = 1.11, 1.00-1.22). CONCLUSIONS: Mental disorders seriously affect the social and economic development of Zhejiang Province; they are a major public health problem that urgently needs to be addressed. To do this, it is necessary to develop and implement a comprehensive province-wide mental health plan and regularly evaluate its effectiveness.