title: Electroacupuncture for residual insomnia associated with major depressive disorder: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of electroacupuncture as an additional treatment for residual insomnia associated with major depressive disorder (MDD).
  
  
  METHODS
  Randomized, placebo-controlled.
  
  
  METHODS
  A psychiatric outpatient clinic.
  
  
  METHODS
  78 Chinese patients with DSM-IV-diagnosed MDD, insomnia complaint, a Hamilton Rating Scale for Depression (HDRS(17)) score ≤ 18, and fixed antidepressant dosage.
  
  
  METHODS
  Electroacupuncture, minimal acupuncture (superficial needling at non-acupuncture points), or noninvasive placebo acupuncture 3 sessions weekly for 3 weeks.
  
  
  RESULTS
  Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), HDRS(17), 1 week sleep diaries, and 3 day actigraphy were administered at baseline, 1 week post-treatment, and 4 week post-treatment. There was significant group by time interaction in ISI, PSQI, and sleep diary-derived sleep efficiency (mixed-effects models, P = 0.04, P = 0.03, and P = 0.01, respectively). Post hoc pairwise comparisons revealed that electroacupuncture and minimal acupuncture were more efficacious than placebo acupuncture in ISI and PSQI at 1 week and 4 week post-treatment. Minimal acupuncture resulted in greater improvement in sleep diary-derived sleep efficiency than placebo acupuncture at 1 week post-treatment. There was no significant between-group difference in actigraphy measures, depressive symptoms, daily functioning, and hypnotic consumption, and no difference in any measures between electroacupuncture and minimal acupuncture.
  
  
  CONCLUSIONS
  Compared with placebo acupuncture, electroacupuncture and minimal acupuncture resulted in greater improvement in subjective sleep measures at 1 week and 4 week post-treatment. No significant difference was found between electroacupuncture and minimal acupuncture, suggesting that the observed differences could be due to nonspecific effects of needling, regardless of whether it is done according to traditional Chinese medicine theory.
authors.affiliation: Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China.
authors.forename: Wing-Fai
authors.initials: WF
authors.lastname: Yeung
authors.forename: Ka-Fai
authors.initials: KF
authors.lastname: Chung
authors.forename: Kwok-Chu
authors.initials: KC
authors.lastname: Tso
authors.forename: Shi-Ping
authors.initials: SP
authors.lastname: Zhang
authors.forename: Zhang-Jin
authors.initials: ZJ
authors.lastname: Zhang
authors.forename: Lai-Ming
authors.initials: LM
authors.lastname: Ho
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D015671:Electroacupuncture; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology* / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents