Search JIM Advanced Search

Journal of Integrative Medicine ›› 2015, Vol. 13 ›› Issue (6): 380-390.doi: 10.1016/S2095-4964(15)60204-7

• Research Article • Previous Articles     Next Articles

The effect of acupuncture on mood and working memory in patients with depression and schizophrenia

Bosch Peggya,b,c, van den Noort Mauritsc,d, Yeo Sujunge, Lim Sabinac, Coenen Antona, van Luijtelaar Gillesa   

  1. a Donders Centre for Cognition, Radboud University Nijmegen, 6525 HR Nijmegen, The Netherlands
    b Psychiatric Research Institute, LVR-Klinik Bedburg-Hau, 47551 Bedburg-Hau, Germany
    c Division of Acupuncture & Meridian, WHO Collaborating Center for Traditional Medicine, East-West Medical Research Institute and School of Korean Medicine, Kyung Hee University, Seoul 130-701, Korea
    d Brussels Institute for Applied Linguistics, Free University of Brussels, 1050 Brussels, Belgium
    e Department of Acupuncture & Meridian of Oriental Medicine, Sang Ji University, Wonju, Korea
  • Received:2015-05-27 Accepted:2015-07-09 Online:2015-11-10 Published:2015-11-15

Background
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.

Objective
This study investigates the mood and the working memory performance in patients with depression or schizophrenia and whether acupuncture can improve these.

Design, setting, participants and interventions

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.


Main outcome measures

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.


Results

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.


Conclusion

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.


Trial registration
Dutch Trial Register NTR3132.

Key words: Acupuncture therapy, Schizophrenia, Depression disorder, Affect, Working memory

[1] Samuels N, Gropp C, Singer SR, Oberbaum M . Acupuncture for psychiatric illness: a literature review. Behav Med, 2008,34(2):55-64
doi: 10.3200/BMED.34.2.55-64 pmid: 18682338
[2] Wang H, Qi H, Wang BS, Cui YY, Zhu L, Rong ZX, Chen HZ . Is acupuncture beneficial in depression: a meta-analysis of 8 randomized controlled trials?[J] Affect Disord. 2008; 111(2-3):125-134.
doi: 10.1016/j.jad.2008.04.020 pmid: 18550177
[3] Bosch P, van Luijtelaar G, van den Noort M, Lim S, Egger J, Coenen A . Sleep ameliorating effects of acupuncture in a psychiatric population. Evid Based Complement Alternat Med, 2013,2013: 969032
doi: 10.1155/2013/969032 pmid: 23781273
[4] Reshev A, Bloch B, Vadas L, Ravid S, Kremer I, Haimov I . The effects of acupuncture treatment on sleep quality and on emotional measures among individuals living with schizophrenia: a pilot study. Sleep Disord, 2013,2013: 327820
[5] Kim H, Park HJ, Han SM, Hahm DH, Lee HJ, Kim KS, Shim I . The effects of acupuncture stimulation at PC6(Neiguan) on chronic mild stress-induced biochemical and behavioral responses. Neurosci Lett, 2009,460(1):56-60
doi: 10.1016/j.neulet.2009.05.008
[6] Kim H, Park HJ, Shim HS, Han SM, Hahm DH, Lee H, Shim I . The effects of acupuncture(PC6) on chronic mild stress-induced memory loss. Neurosci Lett, 2011,488(3):225-228
doi: 10.1016/j.neulet.2010.09.080 pmid: 20946936
[7] Soliman N . Auricular acupuncture microsystem approach to attention-deficit/hyperactivity disorder. Med Acupunct, 2008,20(2):103-108
doi: 10.1089/acu.2008.0619
[8] Zhong XY, Su XX, Liu J, Zhu GQ . Clinical effects of acupuncture combined with nimodipine for treatment of vascular dementia in 30 cases. J Tradit Chin Med, 2009,29(3):174-176
doi: 10.1016/S0254-6272(09)60058-3
[9] Bowles RP, Salthouse TA . Assessing the age-related effects of proactive interference on working memory tasks using the Rasch model. Psychol Aging, 2003,18(3):608-615
doi: 10.1037/0882-7974.18.3.608
[10] Kyllonen PC, Christal RE . Reasoning ability is (little more than) working memory capacity?! Intelligence. 1990; 14(4):389-433.
doi: 10.1016/S0160-2896(05)80012-1
[11] Salthouse TA, Babcock RL, Mitchell DRD, Palmon R, Skovronek E . Sources of individual differences in spatial visualization ability. Intelligence, 1990,14(2):187-230
doi: 10.1016/0160-2896(90)90004-D
[12] Baddeley AD, Hitch G. Working memory. In: Brower GH. The psychology of learning and motivation: advances in research and theory. Vol 8. New York: Academic Press, 1974,8: 47-89
[13] Baddeley AD . The episodic buffer: a new component of working memory? Trends Cogn Sci. 2000; 4(11):417-423.
doi: 10.1016/S1364-6613(00)01538-2 pmid: 11058819
[14] Bussell J . The effect of acupuncture on working memory and anxiety. J Acupunct Meridian Stud, 2013,6(5):241-246
doi: 10.1016/j.jams.2012.12.006 pmid: 24139461
[15] Mayer JS, Fukada K, Vogel EK, Park S . Impaired contingent attentional capture predicts reduced working memory capacity in schizophrenia. PLoS One, 2012,7(11):e48586
doi: 10.1371/journal.pone.0048586
[16] Christopher G, MacDonald J .The impact of clinical depression on working memory. Cogn Neuropsychiatry, 2005,10(5):379-399
doi: 10.1080/13546800444000128 pmid: 16571468
[17] World Health Organization. The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization Press. 1992.
[18] MacPherson H . Pragmatic clinical trials. Complement Ther Med, 2004,12(2-3):136-140
doi: 10.1016/j.ctim.2004.07.043
[19] Godwin M, Ruhland L, Casson I, MacDonald S, Delva D, Birtwhistle R, Lam M, Seguin R . Pragmatic controlled clinical trials in primary care: the struggle between external and internal validity. BMC Med Res Methodol, 2003,3(): 28
[20] MacPherson H, White A, Cummings M, Jobst KA, Rose K, Niemtzow RC ; STRICTA Group. Standards for Reporting Interventions in Controlled Trials of Acupuncture: the STRICTA recommendations. J Altern Complement Med, 2002,8(1):85-89
doi: 10.1089/107555302753507212
[21] Beck AT, Steer RA, Brown GK . Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation. 1996.
[22] Berna C, Lang TJ, Goodwin GM, Holmes EA . Developing a measure of interpretation bias for depressed mood: an ambiguous scenarios test. Pers Individ Dif, 2011,51(3):349-354
doi: 10.1016/j.paid.2011.04.005
[23] Peirson AR, Heuchert JW . The relationship between personality and mood: comparison of the BDI and the TCI. Pers Individ Dif, 2001,30(3):391-399
doi: 10.1016/S0191-8869(00)00031-3
[24] Sprinkle SD, Lurie D, Insko SL, Atkinson G, Jones GL, Logan AR, Bissada NN . Criterion validity, severity cut scores, and test-retest reliability of the Beck Depression Inventory-II in a university counseling center sample. J Couns Psychol, 2002,49(3):381-385
doi: 10.1037/0022-0167.49.3.381
[25] Wechsler D . WAIS-III Nederlandstalige bewerking: Afname- en scoringshandleiding [WAIS-III Dutch version: User manual]. Lisse: Swets & Zeitlinger. 2000.
[26] Groth-Marnat G . Handbook of Psychological Assessment. New York: John Wiley & Son. 1997.
[27] Redick TS, Broadway JM, Meier ME, Kuriakose PS, Unsworth N, Kane MJ, Engle RW . Measuring working memory capacity with automated complex span tasks. Eur J Psychol Assess, 2012,28(3):164-171
doi: 10.1027/1015-5759/a000123
[28] van den Noort M, Bosch P, Hugdahl K . Foreign language proficiency and working memory capacity. Eur Psychol, 2006,11(4):289-296
doi: 10.1027/1016-9040.11.4.289
[29] Bosch P, Staudte H, van den Noort M, Lim S . A case study on acupuncture in the treatment of schizophrenia. Acupunct Med, 2014,32(3):286-289
doi: 10.1136/acupmed-2014-010547 pmid: 24614531
[30] Kay SR, Fiszbein A, Opler LA . The Positive and Negative Syndrome Scale(PANSS) for schizophrenia. Schizophr Bull, 1987,13(2):261-276
doi: 10.1093/schbul/13.2.261
[31] Bosch P, Van Luijtelaar G, Van den Noort M, Schenkwald J, Kueppenbender N, Lim S, Egger J, Coenen A . The MMPI-2 in chronic psychiatric illness. Scand J Psychol, 2014,55(5):513-519
doi: 10.1111/sjop.12152 pmid: 25059636
[32] World Medical Organization. Declaration of Helsinki.[ 2015-01-10]. .
[33] Joe S, Woolley ME, Brown GK, Ghahramanlou-Holloway M, Beck AT . Psychometric properties of the Beck Depression Inventory-II in low-income, African American suicide attempters. J Pers Assess, 2008,90(5):521-523
[34] Lyons Z, van der Watt G, Shen Z, Janca A . Acupuncture and Chinese herbs as treatments for depression: an Australian pilot study. Complement Ther Clin Pract, 2012,18(4):216-220
doi: 10.1016/j.ctcp.2012.06.003 pmid: 23059435
[35] Corigliano V, De Carolis A, Trovini G, Dehning J, Di Pietro S, Curto M, Donato N, De Pisa E, Girardi P, Comparelli A . Neurocognition in schizophrenia: from prodrome to multi-episode illness. Psychiatry Res, 2014,220(1-2):129-134
doi: 10.1016/j.psychres.2014.07.067 pmid: 25149131
[36] Lett TA, Voineskos AN, Kennedy JL, Levine B, Daskalakis ZJ . Treating working memory deficits in schizophrenia: a review of the neurobiology. Biol Psychiatry, 2014,75(5):361-370
doi: 10.1016/j.biopsych.2013.07.026 pmid: 24011822
[37] Herold CJ, L?sser MM, Schmid LA, Seidl U, Kong L, Fellhauer I, Thomann PA, Essig M, Schrder J . Neuropsychology, autobiographical memory, and hippocampal volume in “younger” and “older” patients with chronic schizophrenia. Front Psychiatry, 2015,6: 53
[38] Van den Noort M, Bosch P, Haverkort M, Hugdahl K . A standard computerized version of the reading span test in different languages. Eur J Psychol Assess, 2008,24(1):35-42
doi: 10.1027/1015-5759.24.1.35
[39] Nutt DJ . The role of dopamine and norepinephrine in depression and antidepressant treatment. J Clin Psychiatry, 2006,67(suppl 6):3-8
doi: 10.4088/JCP.0706e03
[40] Dunlop BW, Nemeroff CB . The role of dopamine in the pathophysiology of depression. Arch Gen Psychiatry, 2007,64(3):327-337
doi: 10.1001/archpsyc.64.3.327 pmid: 17339521
[41] Young SN . How to increase serotonin in the human brain without drugs. J Psychiatry Neurosci, 2007,32(6):394-399
[42] Lee SH, Chung SH, Lee JS, Kim SS, Shin HD, Lim BV, Jang MH, Kim H, Kim EH, Kim CJ . Effects of acupuncture on 5-hydroxytryptamine synthesis and tryptophan hydrozylase expression in the dorsal raphe of exercised rats. Neurosci Lett, 2002,332(1):17-20
doi: 10.1016/S0304-3940(02)00900-X
[43] Chang YH, Hsieh MT, Cheng JT . Increase of locomotor activity by acupuncture on Bai-Hui point in rats. Neurosci Lett, 1996,211(2):121-124
doi: 10.1016/0304-3940(96)12737-3 pmid: 8830859
[44] Han JS . Electroacupuncture: an alternative to antidepressants for treating affective diseases? Int[J] Neurosci. 1986; 29(1-2):79-92.
doi: 10.3109/00207458608985638 pmid: 3516903
[45] Bosch P, Van den Noort M, Staudte H, Lim S . Schizophrenia and depression: a systematic review of the effectiveness and the working mechanisms behind acupuncture. Explore, 2015,11(4):281-291
doi: 10.1016/j.explore.2015.04.004
[46] Zhang ZJ, Chen HY, Yip KC, NG R, Wong VT . The effectiveness and safety of acupuncture therapy in depressive disorders: systematic review and meta-analysis. J Affect Disord, 2010,124(1-2):9-21
[47] Bosch P, van Luijtelaar G, Groetelaers L, Van den Noort M, Lim S, Egger J, Coenen A . The Munich parasomnia screening in psychiatry. Somn Sleep Res Sleep Med, 2012,16(4):257-262
doi: 10.1007/s11818-012-0587-4
[48] Seeman P . Atypical antipsychotics: mechanism of action. Can J Psychiatry, 2002,47(1):27-38
doi: 10.1192/bjp.180.2.190 pmid: 11873706
[49] Carlsson C . Acupuncture mechanisms for clinically relevant long-term effects: reconsideration and a hypothesis. Acupunct Med, 2002,20(2-3):82-99
doi: 10.1136/aim.20.2-3.82
[50] Fulford KW, Howse K . Ethics of research with psychiatric patients: principles, problems and the primary responsibilities of researchers. J Med Ethics, 1993,19(2):85-91
doi: 10.1136/jme.19.2.85
[51] Streiner DL . Sample size and power in psychiatric research. Can J Psychiatry, 1990,35(7):616-620
doi: 10.1177/070674379003500712
[52] Patel MX, Doku V, Tennakoon L . Challenges in recruitment of research participants. Adv Psychiatr Treat, 2003,9(3):229-238
doi: 10.1192/apt.9.3.229
[1] Chia-Chun Hung, Pin-Kuei Fu, Hsyn-Yi Wang, Chin-Hong Chan, Tsuo-Hung Lan. Treatment effects of traditional Chinese medicines Suoquan Pill and Wuling Powder on clozapine-induced hypersalivation in patients with schizophrenia: Study protocol of a randomized, placebo-controlled trial. Journal of Chinese Integrative Medicine, 2011, 9(5): 495-502.
[2] Patricia Ronan, Nicola Robinson, Dominic Harbinson, Douglas Maclnnes. A case study exploration of the value of acupuncture as an adjunct treatment for patients diagnosed with schizophrenia: Results and future study design. Journal of Chinese Integrative Medicine, 2011, 9(5): 503-514.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] Zhao-guo Li. Discussion on English translation of commonly used sentences in traditional Chinese medicine: part one. Journal of Chinese Integrative Medicine, 2008, 6(1): 107-110
[2] Jin-zhou Tian, Jing Shi, Xin-qing Zhang, Qi Bi, Xin Ma, Zhi-liang Wang, Xiao-bin Li, Shu-li Shen, Lin Li, Zhen-yun Wu, Li-yan Fang, Xiao-dong Zhao, Ying-chun Miao, Peng-wen Wang, Ying Ren, Jun-xiang Yin, Yong-yan Wang, Beijing United Study Group on MCI of the Capital Foundation of Medical Developments. An explanation on "guiding principles of clinical research on mild cognitive impairment (protocol)". Journal of Chinese Integrative Medicine, 2008, 6(1): 15-21
[3] Jun Hu, Jian-ping Liu. Non-invasive physical treatments for chronic/recurrent headache. Journal of Chinese Integrative Medicine, 2008, 6(1): 31
[4] Jun Cai, Hua Wang, Sheng Zhou, Bin Wu, Hua-rong Song, Zheng-rong Xuan. Effect of Sijunzi Decoction and enteral nutrition on T-cell subsets and nutritional status in patients with gastric cancer after operation: A randomized controlled trial. Journal of Chinese Integrative Medicine, 2008, 6(1): 37-40
[5] Dong Yang, Yong-ping Du, Qing Shen, Wei Chen, Yan Yu, Guang-lei Chen. Expression of alpha-smooth muscle actin in renal tubulointerstitium in patients with kidney collateral stasis. Journal of Chinese Integrative Medicine, 2008, 6(1): 41-44
[6] Xue-mei Liu, Qi-fu Huang, Yun-ling Zhang, Jin-li Lou, Hong-sheng Liu, Hong Zheng. Effects of Tribulus terrestris L. saponion on apoptosis of cortical neurons induced by hypoxia-reoxygenation in rats. Journal of Chinese Integrative Medicine, 2008, 6(1): 45-50
[7] Zhi-chun Jin. Problems in establishing clinical guideline for integrated traditional Chinese and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 5-8
[8] Hai-feng Wei, Bai-liu Ya, Ling Zhao, Cui-fei Ye, Li Zhang, Lin Li. Evaluation of tongue manifestation of blood stasis syndrome and its relationship with blood rheological disorder in a rat model of transient brain ischemia. Journal of Chinese Integrative Medicine, 2008, 6(1): 73-76
[9] Xi Lin, Jian-ping Liu. Herbal medicines for viral myocarditis. Journal of Chinese Integrative Medicine, 2008, 6(1): 76
[10] A-gao Zhou, Yong Zhang, Gang Kui, De-Yun Kong, Hai-liang Ge, Qiu-hua Ren, Jia-rong Dong, Sheng Hong, Xu-ming Mao, Yin Wang, Hui-zheng Zhang, Shu-jun Wang. Influence of traditional Chinese compound recipes with different efficacy on body weight, tumor weight and immune function in H22 cancer-bearing mice. Journal of Chinese Integrative Medicine, 2008, 6(1): 77-82