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--- acupuncture:evaluation:neuro-psychiatrie:14. anxiete [07 Mar 2022 16:49]
Nguyen Johan [1.3.2. Anxiety in Patients Undergoing Medical or Dental Procedures]
+++ acupuncture:evaluation:neuro-psychiatrie:14. anxiete [24 Oct 2025 14:45] (Version actuelle)
Nguyen Johan
@@ Ligne 10: / Ligne 10: @@
 ===== 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 ===
@@ Ligne 110: / 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 119: / 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 ====
+=== Choi 2025 ===
+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.|
+=== Hu 2024 ===
+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
+^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 ====
@@ Ligne 127: / Ligne 172: @@
 | 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 ===
@@ Ligne 146: / Ligne 196: @@
 === Dental Anxiety ===
-| See [[acupuncture:evaluation:stomatologie:02. anxiete des soins dentaires|l'corresponding item]] |
+| See [[acupuncture:evaluation:stomatologie:02. anxiete des soins dentaires|corresponding item]]  |
 === Cardiac Neurosis / Névrose cardiaque ===
@@ Ligne 160: / Ligne 211: @@
 ^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 =====
@@ Ligne 196: / 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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