Randomized effectiveness trial of a brief course of acupuncture for posttraumatic stress disorder

Engel, C.C.

Cordova, E.H.

Benedek, D.M.

Liu, X.

Gore, K.L.

Goertz, C.

Freed, M.C.

Crawford, C.

Jonas, W.B.

Ursano, R.J.

Med Care

2014

52(12 Suppl 5)

S57-S64

RCT

Mental Disorders

Stress Disorders, Post-Traumatic

Post-Traumatic Stress Disorder

Stress, Psychological

Ptsd

Rct

Acu + Usual Care Versus Usual Care

Acupuncture

Five Element Acupuncture Style

Semi-Individualized Acupuncture Protocol

Individualized Acupuncture Protocol

Traditional Diagnosis Based Point Selection

Restricted Modalities, Acupuncture Only

Usual Care Control, Multimodality

BACKGROUND: Initial posttraumatic stress disorder (PTSD) care is often delayed and many with PTSD go untreated. Acupuncture appears to be a safe, potentially nonstigmatizing treatment that reduces symptoms of anxiety, depression, and chronic pain, but little is known about its effect on PTSD. METHODS: Fifty-five service members meeting research diagnostic criteria for PTSD were randomized to usual PTSD care (UPC) plus eight 60-minute sessions of acupuncture conducted twice weekly or to UPC alone. Outcomes were assessed at baseline and 4, 8, and 12 weeks postrandomization. The primary study outcomes were difference in PTSD symptom improvement on the PTSD Checklist (PCL) and the Clinician-administered PTSD Scale (CAPS) from baseline to 12-week follow-up between the 2 treatment groups. Secondary outcomes were depression, pain severity, and mental and physical health functioning. Mixed model regression and t test analyses were applied to the data. RESULTS: Mean improvement in PTSD severity was significantly greater among those receiving acupuncture than in those receiving UPC (PCLDelta=19.8+/-13.3 vs. 9.7+/-12.9, P<0.001; CAPSDelta=35.0+/-20.26 vs. 10.9+/-20.8, P<0.0001). Acupuncture was also associated with significantly greater improvements in depression, pain, and physical and mental health functioning. Pre-post effect-sizes for these outcomes were large and robust. CONCLUSIONS: Acupuncture was effective for reducing PTSD symptoms. Limitations included small sample size and inability to parse specific treatment mechanisms. Larger multisite trials with longer follow-up, comparisons to standard PTSD treatments, and assessments of treatment acceptability are needed. Acupuncture is a novel therapeutic option that may help to improve population reach of PTSD treatment.

10.1097/MLR.0000000000000237

Date of Input: 4/7/2015; Date Modified: 5/28/2015; Availability: --In File--; Priority: Normal; Stress Disorders, Post-Traumatic; Deployment Health Clinical Center, Walter Reed National Military Medical Center, USA; eng; Web: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=25397825

Mental Disorders

>1/WK

55

4 Weeks