Randomized Effectiveness Trial of a Brief Course of Acupuncture for Posttraumatic Stress Disorder

随机对照试验 针灸科 医学 萧条(经济学) 焦虑 物理疗法 检查表 创伤后应激 心理健康 精神科 心理学 内科学 替代医学 认知心理学 经济 病理 宏观经济学
作者
Charles C. Engel,Elizabeth Harper Cordova,David M. Benedek,Xian Liu,Kristie L. Gore,Christine Goertz,Michael Freed,Cindy Crawford,Wayne B. Jonas,Robert J. Ursano
出处
期刊:Medical Care [Lippincott Williams & Wilkins]
卷期号:52 (Supplement 5): S57-S64 被引量:54
标识
DOI:10.1097/mlr.0000000000000237
摘要

Initial posttraumatic stress disorder (PTSD) care is often delayed and many with PTSD go untreated. Acupuncture appears to be a safe, potentially nonstigmatizing treatment that reduces symptoms of anxiety, depression, and chronic pain, but little is known about its effect on PTSD.Fifty-five service members meeting research diagnostic criteria for PTSD were randomized to usual PTSD care (UPC) plus eight 60-minute sessions of acupuncture conducted twice weekly or to UPC alone. Outcomes were assessed at baseline and 4, 8, and 12 weeks postrandomization. The primary study outcomes were difference in PTSD symptom improvement on the PTSD Checklist (PCL) and the Clinician-administered PTSD Scale (CAPS) from baseline to 12-week follow-up between the 2 treatment groups. Secondary outcomes were depression, pain severity, and mental and physical health functioning. Mixed model regression and t test analyses were applied to the data.Mean improvement in PTSD severity was significantly greater among those receiving acupuncture than in those receiving UPC (PCLΔ=19.8±13.3 vs. 9.7±12.9, P<0.001; CAPSΔ=35.0±20.26 vs. 10.9±20.8, P<0.0001). Acupuncture was also associated with significantly greater improvements in depression, pain, and physical and mental health functioning. Pre-post effect-sizes for these outcomes were large and robust.Acupuncture was effective for reducing PTSD symptoms. Limitations included small sample size and inability to parse specific treatment mechanisms. Larger multisite trials with longer follow-up, comparisons to standard PTSD treatments, and assessments of treatment acceptability are needed. Acupuncture is a novel therapeutic option that may help to improve population reach of PTSD treatment.
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