ACUPUNCTURE IN THE TREATMENT OF DEPRESSION

描述（申请人摘要）： 不幸的是，抑郁症是一种常见的疾病， 替代（非西方）治疗，也许是因为传统的 治疗并不总是提供持久的缓解。一项试点研究 （艾伦，Schnyer和Hitt，1996年）建议，针灸，一种流行的，但 研究不足的替代疗法来自中医，持有 足够的承诺作为治疗抑郁症，以保证更大规模的 临床试验我们建议测试针灸设计的功效 通过与针灸治疗相比较来治疗抑郁症 用于治疗不属于抑郁症状的症状 图片和等待列表控制组。因为复发和复发的 严重抑郁症很常见，我们还建议评估临床 治疗结束后18个月的参与者状态，以检查 治疗剂量是否可预测复发的可能性， 复发在这项双盲随机临床试验的第一阶段， 在一项试验中，150名符合DSM-IV标准的男性和女性将 被随机分配到三个条件之一：（a）八周的 专门针对抑郁症设计的针灸;（B）八周的 非特异性针灸治疗，旨在治疗有效的症状模式 抑郁症;（c）或等待列表控制条件。结束时 在第一阶段，将使用盲法评估来比较治疗 从西方精神病学和中国精神病学的角度来看， 药在这一阶段之后，所有参与者都将获得具体的 治疗因此，该实验设计将解决以下问题 具体目的：（1）评价针灸治疗的疗效 重度抑郁症与等待名单对照和非特异性 针灸治疗所需的治疗症状，不属于 （2）探讨针刺治疗抑郁症的临床意义。 通过评估针灸的影响来治疗抑郁症， 不仅对抑郁症，而且对社会和工作领域的功能也有影响; (3)检查是否存在剂量-反应关系， 具体针灸治疗的数量与以下可能性有关： 治疗期间缓解，或复发或复发的可能性 治疗后。次要目的是：（1）评估 针灸治疗使用的结果的措施来自原则 （2）研究西方医学与 基于中医药的结局指标的临床意义; (3)以确定能量模式的变化是否介导了 西方定义的抑郁症严重程度;（4）探讨患者和 历史变量预测针灸治疗的反应。

DESCRIPTION (Applicant's Abstract): Depression is an unfortunately common condition for which people often seek alternative (non-western) treatments, perhaps because conventional treatments do not consistently provide lasting relief. A pilot study (Allen, Schnyer, & Hitt, 1996) suggests that acupuncture, a popular but under-researched alternative treatment derived from Chinese medicine, holds sufficient promise as a treatment for depression to warrant a larger-scale clinical trial. We propose to test the efficacy acupuncture designed specifically to treat depression by comparing it to acupuncture treatment designed to treat symptoms that are not part of the depressive symptom picture and to a wait list control group. Because relapse and recurrence of Major Depression are quite common, we also propose to assess the clinical status of participants for 18 months after treatment concludes, to examine whether the dose of treatment predicts the likelihood of relapse or recurrence. In the first phase of this double-blind randomized clinical trial, 150 men and women meeting DSM-IV criteria for Major Depression will be randomly assigned to one of three conditions: (a) eight weeks of acupuncture designed specifically to address depression; (b) eight weeks of nonspecific acupuncture treatments designed to treat valid symptom pattens other than depression; (c) or a waitlist control condition. At the end of this first phase, blind assessments will be used to compare treatment effects from the perspectives of both western psychiatry and Chinese medicine. After this phase, all participants will receive specific treatment. This experimental design will thus address the following specific aims: (1) to evaluate the efficacy of acupuncture treatments for Major Depression relative to both a waitlist control and to nonspecific acupuncture treatments desired to treat symptoms that are not part of depression; (2) to evaluate the clinical significance of acupuncture as a treatment for Major Depression by assessing the impact of acupuncture not only on depression but also on functioning in social and work arenas; and (3) to examine whether a dose-response relationship exists, such that the number of specific acupuncture treatments is related to the likelihood of remission during treatment, or the likelihood of recurrence or relapse following treatment. Secondary aims are: (1) to assess the efficacy of acupuncture treatments using measures of outcome derived from the principles of Chinese medicine; (2) to examine the convergence of western-based and Chinese-medicine-based outcome measures in terms of clinical significance; (3) to determine whether changes in energetic pattern mediate changes in western defined depression severity; and (4) to explore whether patient and history variables predict response to acupuncture treatments.