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--- acupuncture:evaluation:neuro-psychiatrie:14. anxiete [26 Sep 2019 07:53]
Nguyen Johan [2. Revues de revues systématiques]
+++ acupuncture:evaluation:neuro-psychiatrie:14. anxiete [24 Oct 2025 14:45] (Version actuelle)
Nguyen Johan
@@ Ligne 1: / Ligne 1: @@
+/*English:Anxiety Disorders*/
+====== Anxiety Disorders ======
 ====== Anxiété : évaluation de l'acupuncture ======
@@ Ligne 5: / Ligne 9: @@
-===== Revues systématiques et méta-analyses  =====
+===== Systematic Reviews and Meta-Analysis =====
+==== Generic Acupuncture ====
+=== Byrne 2023 ===
+Byrne GJ. Interventions for generalized anxiety disorder. Curr Opin Psychiatry. 2023 Mar 1;36(2):134-139.  https://doi.org/10.1097/YCO.0000000000000840
+^Purpose of review| To provide an overview of recently published work on anxiety, focusing on generalized anxiety disorder (GAD) and its treatment.|
+^Recent findings|Self-reported anxiety symptoms were highly prevalent during the COVID-19 global pandemic in both the general population and in selected groups. There remains divided opinion about whether internet-based cognitive behavioural therapy (CBT) is noninferior to face-to-face CBT for GAD. A systematic review of drug treatment for GAD showed efficacy for selective serotonin reuptake inhibitors (SNRIs), agomelatine, and quetiapine. There may be a place for repetitive transcranial magnetic stimulation in the treatment of GAD. There was some evidence of efficacy for complementary therapies, including physical exercise, yoga, **acupuncture**, and Withania somnifera (ashwagandha). However, a systematic review of cannabidiol and tetrahydrocannabinol found insufficient evidence of efficacy in anxiety disorders.|
+^Summary|Antidepressants and quetiapine show efficacy in the treatment of GAD. Internet-based psychological interventions have a place in the treatment of GAD when face-to-face treatment is inaccessible. There is increasing evidence for the use of physical exercise in the management of GAD. Some other complementary therapies, including cannabinoids, require further, methodologically sound, research.|
+=== Li 2022 ===
+Li M, Liu X, Ye X, Zhuang L. Efficacy of acupuncture for generalized anxiety disorder: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2022 Dec 9;101(49):e30076.  https://doi.org/10.1097/MD.0000000000030076.
+^Background|Generalized anxiety disorder (GAD) tightly traps modern people. Its incidence shows an increased peak during the 2019 novel coronavirus (COVID-19) epidemic. Acupuncture is regarded as an effective way to relieve anxiety symptoms. However, there are still controversies. This study aimed to systematically evaluate the clinical efficacy of acupuncture in patients with GAD. |
+^Methods|Four English and 3 Chinese databases were searched from their inception to January 2022. Only randomized controlled trials (RCTs) in which acupuncture was the main intervention were included. The literature was independently screened and extracted by two investigators. The Cochrane Bias Risk Assessment Tool was used for quality evaluation. Analyses were conducted by RevMan 5.3.0 and STATA 15.0 software. The primary outcome was the Hamilton Anxiety Scale (HAMA). The secondary indicators were the total effective rate, the Self-Rating Anxiety Scale (SAS), and the Treatment Emergent Symptom Scale (TESS). |
+^Results|**Twenty-seven studies** were included with a total of **1782 participants**. The risk of performance bias or reporting bias for most of the included trials was unclear. Combined results showed the acupuncture group had better outcomes in the HAMA score [MD = -0.78, 95%CI (-1.09, -0.46)], the total effective rate [RR = 1.14, 95%CI (1.09, 1.19)], the SAS score [MD = -2.55, 95%CI (-3.31, -1.80)] compared with the control group. Regarding the number of adverse events, the acupuncture group was safer than the control group and scored less grade in the TESS score [MD = -1.54, 95%CI (-1.92, -1.17)]. |
+^Conclusions|Acupuncture can effectively relieve the anxiety symptoms of generalized anxiety disorder patients with fewer side effects, but randomized controlled trials with large sample size and high quality are also required to support the result. |
+=== Yang 2021 ===
+Yang XY, Yang NB, Huang FF, Ren S, Li ZJ. Effectiveness of acupuncture on anxiety disorder: a systematic review and meta-analysis of randomised controlled trials. Ann Gen Psychiatry. 2021;20(1):9.   [216808]. [[https://doi.org/10.1186/s12991-021-00327-5|doi]]
-==== Acupuncture générique ====
+^ Background| A number of studies have shown the positive effects of acupuncture on state anxiety. However, the efficacy of acupuncture in treating anxiety disorder remains unclear. This review and meta-analysis aimed to explore whether acupuncture has a positive effect on anxiety disorder. |
+^Methods| Randomised controlled trials (RCTs) published in English and Chinese were found through various electronic databases, including PubMed, Scopus, the Cochrane Central Register of Controlled Trials, Embase, and the Chinese databases WanFang data, VIP Chinese Sci tech periodical database, and China National Knowledge Infrastructure. The primary outcome variable was extent of anxiety symptoms. The secondary outcomes included side effects and dropout rate. Effect sizes were pooled by random-effects modelling using Rev Man 5.3. |
+^Results| **Twenty RCTs ** were included in this systematic review and meta-analysis. All included studies were designed for patients with generalised anxiety disorder (GAD), and 18 studies were published in Chinese. Egger's test showed that the asymmetry of the funnel plot in all studies was not significant (t = - 0.34, p = 0.74). The meta-analysis of anxiety symptoms showed that acupuncture was more effective than the control condition, with a standard mean effect size of - 0.41 (95% CI - 0.50 to - 0.31; p < 0.001), and that acupuncture intervention showed good tolerance and safety in the treatment of anxiety disorder. |
+^Conclusion| Our findings suggest that acupuncture therapy aimed at reducing anxiety in patients with GAD has certain beneficial effects compared to controls. More RCTs with high quality should be conducted to fully understand the role of acupuncture in the treatment of various types of anxiety disorder. The protocol of this review was registered at the Prospero International Prospective Register of Systematic Reviews (Registration ID: PROSPERO 2020CRD42020148536). |
 === Amorin 2018 ===
@@ Ligne 80: / Ligne 115: @@
 ^ Conclusions|**Positive findings are reported for acupuncture in the treatment of generalised anxiety disorder or anxiety neurosis** but there is currently insufficient research evidence for firm conclusions to be drawn. No trials of acupuncture for other anxiety disorders were located. **There is some limited evidence in favour of auricular acupuncture in perioperative anxiety**. Overall, the promising findings indicate that further research is warranted in the form of well designed, adequately powered studies.|
-==== Techniques particulières ====
+==== Special Acupuncture Techniques ====
-=== Kwon 2018 (¤yintang) ===
+=== Kwon 2018 (¤Yintang Acupoint) ===
@@ Ligne 96: / Ligne 131: @@
-=== Au 2015 (acupression) ☆===
-Au DW, Tsang HW, Ling PP, Leung CH, Ip PK, Cheung WM.  Effects of acupressure on anxiety: a systematic review and meta-analysis. Acupunct Med. 2015. 33(5):353-9. {{:medias securises:acupuncture:evaluation:neuro-psychiatrie:au-182989.pdf|[182989].}}
+====Acupression====
+=== Au 2015 ===
+Au DW, Tsang HW, Ling PP, Leung CH, Ip PK, Cheung WM.  Effects of acupressure on anxiety: a systematic review and meta-analysis. Acupunct Med. 2015. 33(5):353-9. {{:medias securises:acupuncture:evaluation:neuro-psychiatrie:au-182989.pdf|[182989].}}
 ^Objective|To evaluate the evidence from randomised controlled trials (RCTs) and quantify the effects of acupressure on anxiety among adults. |
 ^Methodology|RCTs published between January 1997 and February 2014, comparing acupressure with sham control, were identified from the databases Science Citation Index/Social Sciences Citation Index, Scopus, PubMed and PsycINFO. Meta-analysis of eligible studies was performed and the magnitude of the overall effect size was calculated for the anxiety outcome. Revised STRICTA (the Standards for Reporting Interventions in Clinical Trials of Acupuncture) criteria were used to appraise the acupressure procedures, and the Cochrane risk of bias tool was used to assess the methodological quality of the studies. |
@@ Ligne 105: / Ligne 144: @@
 ^Conclusions| **Acupressure seems to be effective in providing immediate relief of pretreatment anxiety among adults, and has a medium effect size**. However, conflicting results were found for the improvements on physiological indicators. More rigorous reporting, including allocation concealment procedure, is needed to strengthen the results. |
+==== Auricular acupuncture ====
-==== Formes cliniques particulières ====
+=== Choi 2025 ===
-=== Syndrome anxio-dépressif de la grossesse ===
+Choi S, Kim B. Effect of Auriculotherapy on Stress: A Systematic Review and Meta-Analysis. J Holist Nurs. 2025 Dec;43(4):336-353. https://doi.org/10.1177/08980101241257138
+^Background| Auriculotherapy, a form of therapy that involves stimulating specific points on the ear auricle, has garnered attention for its potential in holistic stress management in adults, aligning with broader patient-centered therapeutic approaches.|
+^Objective| The aim of this study was to evaluate the effectiveness of auriculotherapy for stress relief in adults.|
+^Methods| A comprehensive search of nine databases (PubMed, Scopus, CINAHL, Web of Science, Ovid Medline, Cochrane Library, RISS, KMbase, and KISS) was performed, yielding 553 studies. Of these, 12 were selected for meta-analysis based on the inclusion criteria, which considered demographic data, types of auriculotherapy, intervention characteristics, auricular points, and stress-related outcomes. The risk of bias was also evaluated for each selected study.|
+^Results| The meta-analysis results (n = 12) indicated that auriculotherapy was significantly superior to the control group in terms of subjective stress index, blood pressure, heart rate variability, and pulse rate, as well as improving low-frequency (LF) and high-frequency (HF) heart rate components and their ratio (LF/HF) in adults. Additionally, the subgroup analysis indicated a trend where the effect size of acupressure may be larger than that of acupuncture.|
+^Conclusion| Our findings underscore auriculotherapy's efficacy in reducing stress in adults, advocating for its integration into nursing curriculums as a viable clinical intervention for stress management. Promoting its application in clinical environments could complement holistic, patient-centric care paradigms.|
-| Voir l' [[acupuncture:evaluation:gyneco-obstetrique:10. depression de la grossesse et du post-partum|article correspondant]] |
+=== Hu 2024 ===
-=== Anxiété pré-opératoire ===
-|Voir l' [[acupuncture:evaluation:soins peri-operatoires:anxiete peri-operatoire|article correspondant]] |
+Hu N, Soh KL, Japar S, Li T. Ear-Marking Relief: A Meta-Analysis on the Efficacy of Auricular Acupressure in Alleviating Anxiety Disorders. Complement Med Res. 2024;31(3):266-277. https://doi.org/10.1159/000537734
-=== Anxiété des soins dentaires ===
+^Background|The increasing worldwide mental health crisis, notably anxiety, emphasizes the urgency for available and effective interventions. Traditional therapies, although beneficial, pose limitations due to their considerable costs and possible adverse effects, thereby inviting alternative treatments such as auricular acupressure (AA). This non-pharmacological, integrative method, underpinned by Eastern and Western medical principles, presents a significant prospect for managing anxiety.|¶
+^Objective|This study aims to evaluate the existing evidence on the efficacy of AA in reducing anxiety, as elucidated through a systematic review.|¶
+^Methods|A comprehensive search of randomized controlled trials was conducted across various databases: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), Wan Fang, and Database for Chinese Technical Periodicals (VIP). Two reviewers retrieved the pertinent studies and assessed their methodological quality. A meta-analysis was then conducted, incorporating data from all relevant time points.|¶
+^Results|Upon examining 25 studies encompassing 1,909 participants, it was discerned that AA significantly diminished anxiety (SMD = -1.1074; 95% confidence interval, -1.348 to -0.801; z = 7.70, p < 0.01). Subgroup analyses indicated that neither an increased number of auricular points nor extended intervention augmented effects. Larger effect sizes were associated with probing and avoidance of sham acupressure. Notably, 23 of the 25 studies exhibited some bias, suggesting further research is necessary.|¶
+^Conclusions|The extant evidence advocates for AA as an effective supplementary intervention that reduces patient anxiety. The results hint at a potential placebo effect elicited by sham acupressure, necessitating rigorous control group definitions in future inquiries. The study findings suggest that fewer acupressure points and shorter intervention durations could effectively alleviate anxiety symptoms. Nonetheless, the significant heterogeneity across the studies underscores the requirement for more stringent research methodologies to substantiate these conclusions.|
+==== Special Clinical Forms ====
-| Voir [[acupuncture:evaluation:stomatologie:02. anxiete des soins dentaires|l'article correspondant]] |
+=== Anxiety and Depression in Pregnancy ===
-===== Revues de revues systématiques =====
+| see [[acupuncture:evaluation:gyneco-obstetrique:10. depression de la grossesse et du post-partum|corresponding item]] |
+=== Anxiety and/or depression during IVF ===
+| see [[acupuncture:evaluation:gyneco-obstetrique:09. fecondation in vitro#Anxiety and/or depression during IVF#|corresponding item]]|
+=== Medical Procedures Anxiety ===
+== Weisfeld 2021 ==
+Weisfeld CC, Turner JA, Bowen JI, Eissa R, Roelk B, Ko A, Dunleavy K, Robertson K, Benfield E. Dealing with Anxious Patients: An Integrative Review of the Literature on Nonpharmaceutical Interventions to Reduce Anxiety in Patients Undergoing Medical or Dental Procedures. Journal of Alternative and Complementary Medicine. 2021;27(9):727-737.   [223071].https://doi.org/10.1089/acm.2020.0505
+^Objectives|A previous systematic literature review (SLR) evaluated 501 experiments on reducing patient anxiety across medical and dental environments. This integrative review examines those interventions and explores possible mechanisms leading to relative success or failure within those environments, in the interest of interprofessional education and communication. |
+^Methods|Reviewers evaluated 501 experiments testing interventions for reducing patient anxiety in a variety of medical and dental health care settings. Methodology for the SLR, largely following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, is briefly reviewed. |
+^Results|A total of 501 experiments (from 408 articles) met review criteria. One hundred and forty-three Music experiments were included, and Music interventions were largely effective, except in the case of colonoscopy. Education is the only intervention that occasionally (5 times of 130 experiments) raised patient anxiety in the face of a procedure; the discussion focuses on the wisdom of assessing patient need for information. Thirty-seven Cognitive Behavioral Therapy (CBT) experiments of various types are included, with a success rate of 89%, with a particularly high rate of success (12 of 12 experiments) in dentistry. Massage has a success rate that is similar to that of CBT, but Massage has been tested in far fewer specialty areas. Relaxation has been tested in every specialty area, except mechanical ventilation, with promising results. **Acupuncture and Acupressure have not been widely tested, but their effectiveness rate is 100% when it comes to reducing patient anxiety in various procedural settings**. Similarly, experiments show Hypnosis to be successful in 90% of trials. In contrast, Distraction was successful in only 40% of the experiments summarized, although it was more effective in dentistry. A variety of Nature-based Interventions (Aromatherapy, Nature Sounds, and Visual Stimuli) were highly successful across a variety of settings. |
+^Discussion|Possible mechanisms are discussed, along with commentary on feasibility. Limitations include publication bias, small sample sizes, and the lack of placebo controls. Future areas of research are pointed out.|
+=== Preoperative Anxiety ===
+|See [[acupuncture:evaluation:soins peri-operatoires:02. anxiete peri-operatoire|corresponding item]] |
+=== Dental Anxiety ===
+| See [[acupuncture:evaluation:stomatologie:02. anxiete des soins dentaires|corresponding item]]  |
+=== Cardiac Neurosis / Névrose cardiaque ===
+== Li 2020 ==
+Li TL, Li B, Pu FL, Zhao GZ, Yang HX, Gong XH, Wang X. [Clinical effect and safety of acupuncture in treatment of cardiac neurosis:a systematic review and meta-analysis]. Acupuncture Research. 2020;45(5):419-25.   [209616].
+^Objective|To systematically evaluate the clinical effect and safety of acupuncture in the treatment of cardiac neurosis. |
+^Methods|Chinese databases (including SinoMed, VIP, CNKI, and Wanfang Data) and English databases (including PubMed and The Cochrane Library) were searched for randomized controlled trials (RCTs) on acupuncture in the treatment of cardiac neurosis published up to March 2019. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of included studies, and then RevMan 5.3 was used to perform a meta-analysis. |
+^Results|A total of 7 RCTs were included, with 491 patients with cardiac neurosis. The results of the meta-analysis showed that compared with the conventional western medicine group, the acupuncture group had a significantly higher total effective rate (risk ratio ［RR］=1.16, 95% CI［1.05,1.28］, P=0.005) and had significantly greater improvements in Hamilton Anxiety Scale score (mean difference ［MD］=-3.22, 95% CI［-6.05, -0.39］, P=0.03). There were no significant differences between the two groups in Hamilton Depression Scale score (MD=-1.92, 95% CI［-4.76, -0.91］, P=0.18)，traditional Chinese medicine symptom score (MD=-5.49, 95% CI［-11.55, 0.56］, P=0.08), somatization symptom score (MD=-0.91, 95% CI［-3.28, 1.46］, P=0.45), and adverse reactions (RR=0.67, 95% CI［0.26,1.78］, P=0.42). |
+^Conclusion|Acupuncture can alleviate the symptoms and is safe in the treatment of cardiac neurosis. |
+=== Anxiety and depression in functional dyspepsia ===
+== Xu 2024 ==
+Xu Z, Zhang X, Shi H, Liang M, Ning F, Wang Q, Jia H. Efficacy of acupuncture for anxiety and depression in functional dyspepsia: A systematic review and meta-analysis. PLoS One. 2024 Mar 7;19(3):e0298438.  https://doi.org/10.1371/journal.pone.0298438
+^Objective| To assess the effectiveness of acupuncture for treating depression and anxiety in patients diagnosed with functional dyspepsia (FD).|
+^Methods| PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, Sinomed, and VIP Database were searched until April 30, 2023 for Randomized Controlled Trials (RCTs) comparing acupuncture to placebo or drugs for symptom alleviation. Two independent reviewers conducted the study search, data extraction, and bias risk assessment using the Cochrane Risk of Bias tool. Mean difference (MD), risk ratio (RR), and corresponding 95% confidence intervals (CI) were computed. Subgroup and sensitivity analyses were also performed. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was employed to evaluate the evidence level.|
+^Results| A total of **16 RCTs involving 1315 participants **were included. Acupuncture demonstrated marked superiority over placebo (MD = -7.07, 95%CI: -11.03 to -3.10, very low quality evidence) in mitigating Self-Rating Anxiety Scale (SAS) scores and was found to be more effective in reducing Self-Rating Depression Scale (SDS) scores than either placebo (MD = -4.63, 95%CI: -6.28 to -2.98, low quality evidence) or first-line drugs (MD = -2.71, 95%CI: -5.19 to -0.23, very low quality evidence). In terms of attenuating Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) scores, acupuncture consistently outperformed both placebo (HAMA: MD = -2.58, 95%CI: -4.33 to -0.83, very low quality evidence; HAMD: MD = -1.89, 95%CI: -3.11 to -0.67, low quality evidence) and first-line drugs (HAMA: MD = -5.76, 95%CI: -10.18 to -1.35, very low quality evidence; HAMD: MD = -5.59, 95%CI: -7.59 to -3.59, very low quality evidence). However, no significant difference was observed between acupuncture and placebo in terms of improvement in Hospital Anxiety and Depression Scale (HADS) scores.|
+^Conclusions| Based on current clinical evidence, acupuncture might have a positive effect on depression and anxiety in patients with FD. Further large-sample, multi-center, high-quality RCTs validation are required, as the conclusion is limited by the quantity and quality of the included studies.|
+===== Overviews of Systematic Reviews =====
 ==== Li 2019 ====
@@ Ligne 138: / Ligne 245: @@
 </wrap>
-===== Recommandations de bonne pratique =====
+===== Clinical Practice Guidelines =====
-| ⊕ recommandation positive (quel que soit le niveau de preuve annoncé) \\ Ø recommandation négative (ou absence de preuve) |
+| ⊕ positive recommendation (regardless of the level of evidence reported) \\ Ø negative recommendation (or lack of evidence) |
@@ Ligne 155: / Ligne 262: @@
 Dara S. Effectiveness of acupuncture in selected mental health conditions , Accident Compensation Corporation (ACC, New-Zealand). 2014.   {{:medias securises:acupuncture:evaluation:neuro-psychiatrie:dara-182119.pdf|[182119].}}
 |There is limited good quality evidence to conclusively determine acupuncture’s efficacy in treatment of mental health conditions such as Major Depressive Disorder, Dysthymia, **Anxiety Disorder**, Borderline Personality Disorder and Post Traumatic Stress Disorder.|
+==== National Collaborating Centre for Mental Health (NCCMH, UK) 2011  Ø ====
+National Collaborating Centre for Mental Health. National Institute for Health and Clinical Excellence: Guidance . Generalised anxiety disorder in adults: management in Primary, secondary and community care. Leicester (UK): British Psychological Society. 2011. https://www.nice.org.uk/guidance/cg113/evidence/anxiety-full-guidance-pdf-136340461
+| The results indicate that acupuncture may be of equivalent effectiveness to medication in the treatment of GAD or ‘anxiety neurosis’. It is important to note, however, that these trials use a range of medications as comparison conditions, many of which have uncertain effectiveness in the treatment of GAD. In addition, there are differences between the CCMD diagnoses of GAD and ‘anxiety neuroses’ and the DSM or ICD classification systems, for example, in duration of symptoms required to meet diagnostic criteria. Therefore this is an important limitation of the review. Furthermore, the trials are only medium sized and also of low to moderate quality, which makes it difficult to arrive at a confident conclusion.\\ From evidence to recommendations Due to the limited evidence base for most interventions reviewed in this section, the GDG concluded that it was not yet possible to generate recommendations on the use of any of these interventions for the treatment of GAD.|

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