Evidence

Acupuncture

There are numerous challenges in treating Substance Abuse and Mental Health (SAMH) disorders. Many of these difficulties revolve around already difficult conditions to treat from a general practitioner facility which include chronic pain, mental health challenges resulting from stress, and preventing and/or addressing addictions.

The effectiveness of acupuncture in addressing these problems have been studied extensively by researchers and clinicians from all over the world, including leading institutions such as Harvard University and University of York. In these studies, acupuncture has been found to be effective in addressing various problems, including chronic pain, mental stress, anxiety, depression, non-medication pain relief, and substance abuse. [1-24, 29, 36].

Among these studies, some have shown the cost effectiveness of acupuncture, when offered in addition to the conventional treatment, in treating patients with depression [19, 20]. 

Dietary Therapy

Existing evidence of the beneficial effect of using magnesium as a therapeutic supplementation on patients with depression or anxiety could be found in various studies as well as systematic reviews [37-40].

Another recent systematic review and meta-analysis results showed that vitamin B supplementation (including B6, B8 and B12) significantly reduced psychiatric symptoms [41].

A recent systematic review also suggested that magnesium and vitamin B6 in combination may be effective in reducing premenstrual stress, and vitamin B6 alone may reduce anxiety effectively in older women [42].

It is well-known that proper nutrition has a positive impact on the prevention or decline of depressive symptoms among elderly people; B vitamin supplementation may particularly benefit populations who are at risk due to poor nutrient status and/or poor mental health [43, 44].

Exercise

Baduanjin Qigong, one of the oldest mindfulness-based exercise for health and wellbeing developed in China about 1000 years ago, has been well established as a safe, easy to learn, yet highly effective adjunct intervention.

Systematic reviews and meta-analyses of evidences from published randomized controlled trials (RCTs) have shown significant health benefits of Baduanjin Qigong practice, especially when combined with conventional therapy [45-58].  

More specifically, Baduanjin Qiong has been found to be beneficial on improving quality of life, sleep quality, balance, handgrip strength, trunk flexibility, diastolic blood pressure [45], alleviate musculoskeletal pain and improving overall sleep quality for people with chronic illness [46], improve clinical outcomes for knee osteoarthritis patients [47], improve cognitive and memory function for patients with mild cognitive impairment [48], improve exercise capability and pulmonary function of COPD patients as well as quality of life [49], improve blood pressure for hypertension patients [50], improve the quality of life, anxiety, depression, distress, and fatigue of cancer patients [51], and improving global cognition in adults with cognitive impairment [52].

Noticeably, Baduanjin Qigong has been found to significantly improve mental health for youth, college students, and elderly [53-57].

References:

1.     Acupuncture for chronic pain and depression in primary care: a programme of research. Programme Grants for Applied Research. pp. 1-342. ISSN 2050-4322.

2.     Effects of Acupuncture on Anxiety Levels and Prefrontal Cortex Activity Measured by Near-Infrared Spectroscopy: A Pilot Study.

3.     Auricular Acupuncture to Relieve Health Care Worker’s Stress and Anxiety: Impact on Caring.

4.     The Use of Auricular Acupuncture to Reduce Preoperative Anxiety.

5.     Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research.

6.     Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review.

7.     Reduction of Opioid Use by Acupuncture in Patients Undergoing Hematopoietic Stem Cell Transplantation: Secondary Analysis of a Randomized, Sham-Controlled Trial.

8.     Acupuncture on the Stress-Related Drug Relapse to Seeking.

9.     Opioid Alternatives for Athletes.

10.  Acupuncture versus titrated morphine in acute renal colic: a randomized controlled trial.

11.  Acupuncture to Reduce Opioid Consumption in Patients with Pain: Getting to the Right Points.

12.  Study of acupuncture for low back pain in recent 20 years: a bibliometric analysis via CiteSpace.

13.  Osher Center For Integrative Medicine – Harvard Medical School and Brigham and women’s Hospital

14.  Health Center – University of Maryland

15.  Pain Management Clinic – Walter Reed National Military Medical Center

16.  Acupuncture – Mayo Clinic

17.  Acupuncture – Johns Hopkins Medicine

18. Acupuncture for Addictions Service – Toronto Western Hospital

19.  Spackman et al. (2014) Cost-Effectiveness Analysis of Acupuncture, Counselling and Usual Care in Treating Patients with Depression: The Results of the ACUDep Trial. PLoS ONE 9(11): e113726.

20.  Camacho et al. (2016) Long-term cost-effectiveness of collaborative care (vs usual care) for people with depression and comorbid diabetes or cardiovascular disease: a Markov model informed by the COINCIDE randomised controlled trial. BMJ Open 6(10):e012514.

21.  Hopton AK, Curnoe S, Kanaan M, Macpherson H (2012) Acupuncture in practice: mapping the providers, the patients and the settings in a national cross-sectional survey. BMJ Open. 2:e000456.

22.  Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, et al. (2012) Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 172:1444–1453.

23.  Smith CA, Hay PP, Macpherson H (2010) Acupuncture for depression. Cochrane Database Syst Rev: CD004046.

24.  MacPherson H, Richmond S, Bland M, Brealey S, Gabe R, et al. (2013) Acupuncture and counselling for depression in primary care: a randomised controlled trial. PLoS Med. 10:e1001518.

25. Fancourt D & Ali H. (2019). Differential use of emotion regulation strategies when engaging in artistic creative activities amongst those with and without depression. Scientific Reports, 9, 9897.

26. Noone D, Stott J, Aguirre E, Llanfear K & Spector A. (2019). Meta-analysis of psychosocial interventions for people with dementia and anxiety or depression. Aging & Mental Health, 23, 1282-1291.

27. de Bruin EI, Valentin S, Baartmans JMD, Blok M & Bogels SM. (2020). Mindful2Work the next steps: Effectiveness of a program combining physical exercise, yoga and mindfulness, adding a wait-list period, measurements up to one year later and qualitative interviews. Complementary Therapies in Clinical Practice, 39, 101137.

28. Griffin KH, Johnson JR, Kitzmann JP, Kolste AK & Dusek JA. (2015). Outcomes of a Multimodal Resilience Training Program in an Outpatient Integrative Medicine Clinic. Journal of Alternative & Complementary Medicine, 21, 628-37.

29. Elwy AR, Taylor SL, Zhao S, McGowan M, Plumb DN, Westleigh W, et al. (2020). Participating in Complementary and Integrative Health Approaches Is Associated With Veterans’ Patient-reported Outcomes Over Time. Medical Care, 58 Suppl 2 9S, S125-S132.

30. Griffith JM, Hasley JP, Liu H, Severn DG, Conner LH & Adler LE. (2008). Qigong stress reduction in hospital staff. Journal of Alternative & Complementary Medicine, 14, 939-45.

31. Harbottle L. (2019). Potential of emotional freedom techniques to improve mood and quality of life in older adults. British Journal of Community Nursing, 24, 432-435.

32. Amorim D, Amado J, Brito I, Costeira C, Amorim N & Machado J. (2018). Integrative medicine in anxiety disorders. Complementary Therapies in Clinical Practice, 31, 215-219.

33. Poznysh VA, Vdovenko VY, Kolpakov IE & Stepanova EI. (2019). APPLICATION OF ART THERAPY FOR CORRECTION OF PERSONAL DISORDERS OF PSYCHOEMOTIONAL STATE OF CHILDREN – INHABITANTS OF RADIATION POLLUTED TERRITORIES AND CHILDREN DISPLACED FROM THE ARMED CONFLICT ON THE SOUTHERN EAST OF UKRAINE. Problemi Radiacijnoi Medicini Ta Radiobiologii, 24, 439-448.

34. Konsgen N, Polus S, Rombey T & Pieper D. (2019). Clowning in children undergoing potentially anxiety-provoking procedures: a systematic review and meta-analysis. Systematic Reviews, 8, 178.

35. Gonzalez-Valero G, Zurita-Ortega F, Ubago-Jimenez JL & Puertas-Molero P. (2019). Use of Meditation and Cognitive Behavioral Therapies for the Treatment of Stress, Depression and Anxiety in Students. A Systematic Review and Meta-Analysis. International Journal of Environmental Research & Public Health

36. Leung B, Takeda W & Holec V. (2018). Pilot study of acupuncture to treat anxiety in children and adolescents. Journal of Paediatrics & Child Health, 54, 881-888.

37. Botturi A, Ciappolino V, Delvecchio G, Boscutti A, Viscardi B, Brambilla P. The Role and the Effect of Magnesium in Mental Disorders: A Systematic Review. Nutrients. 2020 Jun 3;12(6):1661.

38. Boyle NB, Lawton C, Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review. Nutrients. 2017 Apr 26;9(5):429. doi: 10.3390/nu9050429. PMID: 28445426; PMCID: PMC5452159.

39. Lakhan SE, Vieira KF. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutr J. 2010 Oct 7;9:42.

40. Tarleton EK, Littenberg B, MacLean CD, Kennedy AG, Daley C. Role of magnesium supplementation in the treatment of depression: A randomized clinical trial. PLoS One. 2017 Jun 27;12(6):e0180067.

41. Firth J, Stubbs B, Sarris J, Rosenbaum S, Teasdale S, Berk M, Yung AR. The effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis. Psychol Med. 2017 Jul;47(9):1515-1527.

42. McCabe D, Lisy K, Lockwood C, Colbeck M. The impact of essential fatty acid, B vitamins, vitamin C, magnesium and zinc supplementation on stress levels in women: a systematic review. JBI Database System Rev Implement Rep. 2017 Feb;15(2):402-453.

43. Klimova B, Novotny M, Valis M. The Impact of Nutrition and Intestinal Microbiome on Elderly Depression-A Systematic Review. Nutrients. 2020 Mar 7;12(3):710.

44. Young LM, Pipingas A, White DJ, Gauci S, Scholey A. A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and ‘At-Risk’ Individuals. Nutrients. 2019 Sep 16;11(9):2232. doi: 10.3390/nu11092232. PMID: 31527485; PMCID: PMC6770181.

45. Zou L, SasaKi JE, Wang H, Xiao Z, Fang Q, Zhang M. A Systematic Review and Meta-Analysis Baduanjin Qigong for Health Benefits: Randomized Controlled Trials. Evid Based Complement Alternat Med. 2017;2017:4548706.

46. Zou L, Yeung A, Quan X, Boyden SD, Wang H. A Systematic Review and Meta-Analysis of Mindfulness-Based (Baduanjin) Exercise for Alleviating Musculoskeletal Pain and Improving Sleep Quality in People with Chronic Diseases. Int J Environ Res Public Health. 2018 Jan 25;15(2):206.

47. Zeng ZP, Liu YB, Fang J, Liu Y, Luo J, Yang M. Effects of Baduanjin exercise for knee osteoarthritis: A systematic review and meta-analysis. Complement Ther Med. 2020 Jan;48:102279.

48. Yu L, Liu F, Nie P, Shen C, Chen J, Yao L. Systematic review and meta-analysis of randomized controlled trials assessing the impact of Baduanjin exercise on cognition and memory in patients with mild cognitive impairment. Clin Rehabil. 2020 Nov 4:269215520969661.

49. Liu SJ, Ren Z, Wang L, Wei GX, Zou L. Mind⁻Body (Baduanjin) Exercise Prescription for Chronic Obstructive Pulmonary Disease: A Systematic Review with Meta-Analysis. Int J Environ Res Public Health. 2018 Aug 24;15(9):1830.

50. Shao BY, Zhang XT, Vernooij RWM, Lv QY, Hou YY, Bao Q, Lao LX, Liu JP, Zhang Y, Guyatt GH. The effectiveness of Baduanjin exercise for hypertension: a systematic review and meta-analysis of randomized controlled trials. BMC Complement Med Ther. 2020 Oct 8;20(1):304.

51. Zhang Y, Yao F, Kuang X, Li L, Huang L, Zhou Q, Peng J, Chang Q. How Can Alternative Exercise Traditions Help Against the Background of the COVID-19 in Cancer Care? An Overview of Systematic Reviews. Cancer Manag Res. 2020 Dec 17;12:12927-12944.

52. Li C, Zheng D, Luo J. Effects of traditional Chinese exercise on patients with cognitive impairment: A systematic review and Bayesian network meta-analysis. Nurs Open. 2021 Feb 19.

53. Mansfield L, Kay T, Meads C, Grigsby-Duffy L, Lane J, John A, Daykin N, Dolan P, Testoni S, Julier G, Payne A, Tomlinson A, Victor C. Sport and dance interventions for healthy young people (15-24 years) to promote subjective well-being: a systematic review. BMJ Open. 2018 Jul 15;8(7):e020959.

54. Jing L, Jin Y, Zhang X, Wang F, Song Y, Xing F. The effect of Baduanjin qigong combined with CBT on physical fitness and psychological health of elderly housebound. Medicine (Baltimore). 2018 Dec;97(51):e13654.

55. Chan SHW, Tsang HWH. The beneficial effects of Qigong on elderly depression. Int Rev Neurobiol. 2019;147:155-188.

56. Cheng FK. Effects of Baduanjin on mental health: a comprehensive review. J Bodyw Mov Ther. 2015 Jan;19(1):138-49.

57. Ye J, Zheng Q, Zou L, Yu Q, Veronese N, Grabovac I, Stefanac S, Tzeng HM, Yu JJ. Mindful Exercise (Baduanjin) as an Adjuvant Treatment for Older Adults (60 Years Old and Over) of Knee Osteoarthritis: A Randomized Controlled Trial. Evid Based Complement Alternat Med. 2020 Jun 14;2020:9869161.

58. Fang J, Zhang L, Wu F, Ye J, Cai S, Lian X. The Safety of Baduanjin Exercise: A Systematic Review. Evid Based Complement Alternat Med. 2021 Jan 21;2021:8867098.

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