RESUMO
OBJECTIVE: To investigate the effectiveness of acupuncture in the treatment of chronic schizophrenia and co-morbid sleep disorders. METHODS: A 42-year-old German male outpatient, suffering from long-term schizophrenia and sleep disorders, entered the study. Acupuncture was used as a non-pharmacological intervention. In addition to his ongoing Western Medicine (pharmacological) treatment, the patient received 12 weekly (non-standardized) acupuncture treatments in the clinic. The Traditional Chinese Medicine (TCM) diagnosis, the psychological assessment and the actiwatch data were compared before and after the acupuncture treatment. RESULTS: The TCM diagnosis revealed a Liver Fire pattern before the acupuncture treatment, which was still present, although to a lesser degree, after the treatment. The psychological assessment revealed no change in the positive symptoms, but a small decrease in the negative symptoms and the general psychopathology of the patient. This was further illustrated by the small decrease in the number of depressive symptoms. The subjective sleep disorders improved markedly after acupuncture treatment, but the daytime sleepiness did not. The actiwatch results showed that after acupuncture treatment, the patient was moving less during sleep, but no significant results were found for the other sleep parameters. CONCLUSION: Acupuncture was found to be an effective non-pharmacological add-on method for treating subjective sleep disorders, and, to a lesser degree, objective sleep disorders and the negative symptoms of chronic schizophrenia. Future larger clinical trials with follow-up measurements are needed in order to replicate the present preliminary beneficial acupuncture findings and in order to determine whether the observed effects can be sustained.
RESUMO
<p><b>BACKGROUND</b>In patients with depression, as well as in patients with schizophrenia, both mood and working memory performance are often impaired. Both issues can only be addressed and improved with medication to some extent.</p><p><b>OBJECTIVE</b>This study investigates the mood and the working memory performance in patients with depression or schizophrenia and whether acupuncture can improve these.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>A pragmatic clinical trial design was used. The study was conducted in a psychiatric clinic. Fifty patients with depression and 50 with schizophrenia were randomly divided into an experimental and a waiting-list group. Additionally, 25 healthy control participants were included. Twelve weeks of individualized acupuncture treatment was used as the clinical intervention.</p><p><b>MAIN OUTCOME MEASURES</b>All patients were tested before (T1) and after (T2) acupuncture treatment on a mood scale (Beck Depression Inventory-II, BDI-II), a simple working memory task (digit span), and a complex working memory task (letter-number sequencing); the healthy controls were tested at T1 only.</p><p><b>RESULTS</b>Patients with depression scored worse than the others on the BDI-II, and patients with schizophrenia scored worse than the healthy controls. On the digit span, patients with schizophrenia did not differ from healthy controls whereas they scored worse of all on the letter-number sequencing. With respect to the acupuncture findings, first, the present study showed that the use of acupuncture to treat patients with schizophrenia was both practical and safe. Moreover, acupuncture had a positive effect on the BDI-II for the depression group, but acupuncture had no effect on the digit span and on the letter-number sequencing performance for the two clinical groups.</p><p><b>CONCLUSION</b>The clinical improvement in patients with depression after acupuncture treatment was not accompanied by any significant change in a simple working memory task or in a more complex working memory task; the same was true for the patients with schizophrenia.</p><p><b>TRIAL REGISTRATION</b>Dutch Trial Register NTR3132.</p>
