The role of acupuncture in the management of insomnia as a major or residual symptom among patients with active or previous depression : a systematic review and meta-analysis
- Zhao, Fei-Yi, Kennedy, Gerard, Spencer, Sarah, Conduit, Russell, Zhang, Wen-Jing, Fu, Qiang-Qiang, Zheng, Zhen
- Authors: Zhao, Fei-Yi , Kennedy, Gerard , Spencer, Sarah , Conduit, Russell , Zhang, Wen-Jing , Fu, Qiang-Qiang , Zheng, Zhen
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 13, no. (2022), p.
- Full Text:
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- Description: Background: Due to concerns about risks associated with antidepressants and/or hypnotics, complementary therapies such as acupuncture have been sought by patients with active or previous depression to manage insomnia. This systematic review aimed to clarify if acupuncture is effective and safe enough to be recommended as an alternative or adjuvant therapy to standard care in ameliorating concomitant or residual insomnia, two types of insomnia associated with depression. Methods: Randomized controlled trials (RCTs) of depression-related insomnia (DI) treatment via acupuncture vs. waitlist-control or placebo-/sham-acupuncture and RCTs of DI treatment via acupuncture alone or combined with standard care [Western pharmacotherapy and/or cognitive-behavioral therapy (CBT)] vs. standard care alone were searched for from seven databases from inception to December 2021. Cochrane criteria were followed. Results: Twenty-one studies involving 1,571 participants were analyzed. For insomnia as a major symptom of active depression, meta-analyses suggested that acupuncture significantly reduced the global scores of both the Pittsburg Sleep Quality Index (PSQI) [MD = −3.12, 95% CI (−5.16, −1.08), p < 0.01] and Hamilton Depression Scale (HAMD) [SMD = −2.67, 95% CI (−3.51, −1.84), p < 0.01], in comparison with placebo-acupuncture. When compared with conventional pharmacotherapy (antidepressants and/or hypnotics), the results favored acupuncture in decreasing PSQI [MD = −1.17, 95% CI (−2.26, −0.08), p = 0.03] and HAMD [SMD = −0.47, 95% CI (−0.91, −0.02), p = 0.04]. Acupuncture was comparable to conventional pharmacotherapy in reducing scores of each domain of PSQI. For insomnia as a residual symptom of previous or partially remitted depression, acupuncture conferred a very limited, non-significant therapeutic advantage against sham-/placebo-acupuncture. Whether acupuncture has an add-on effect to conventional pharmacotherapy in this type of insomnia has not been investigated. Also, no study was available to address the efficacy differences between acupuncture and CBT or the synergistic effect of these two therapies. Conclusions: There is a low to moderate level of evidence supporting acupuncture as a safe and effective remedy alternative to or adjuvant to conventional pharmacotherapy (antidepressant and/or hypnotic) in improving insomnia and other depression symptoms among patients with active depression. Furthermore, the patients' complaint of disrupted sleep continuity is most likely to benefit from acupuncture. The benefit of acupuncture on residual insomnia associated with previous or partially remitted depression is limited. Future acupuncture studies need to consider applying optimal dosage and addressing deficiencies in trial quality. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021269880, PROSPERO, identifier: CRD42021269880. Copyright © 2022 Zhao, Kennedy, Spencer, Conduit, Zhang, Fu and Zheng.
- Authors: Zhao, Fei-Yi , Kennedy, Gerard , Spencer, Sarah , Conduit, Russell , Zhang, Wen-Jing , Fu, Qiang-Qiang , Zheng, Zhen
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 13, no. (2022), p.
- Full Text:
- Reviewed:
- Description: Background: Due to concerns about risks associated with antidepressants and/or hypnotics, complementary therapies such as acupuncture have been sought by patients with active or previous depression to manage insomnia. This systematic review aimed to clarify if acupuncture is effective and safe enough to be recommended as an alternative or adjuvant therapy to standard care in ameliorating concomitant or residual insomnia, two types of insomnia associated with depression. Methods: Randomized controlled trials (RCTs) of depression-related insomnia (DI) treatment via acupuncture vs. waitlist-control or placebo-/sham-acupuncture and RCTs of DI treatment via acupuncture alone or combined with standard care [Western pharmacotherapy and/or cognitive-behavioral therapy (CBT)] vs. standard care alone were searched for from seven databases from inception to December 2021. Cochrane criteria were followed. Results: Twenty-one studies involving 1,571 participants were analyzed. For insomnia as a major symptom of active depression, meta-analyses suggested that acupuncture significantly reduced the global scores of both the Pittsburg Sleep Quality Index (PSQI) [MD = −3.12, 95% CI (−5.16, −1.08), p < 0.01] and Hamilton Depression Scale (HAMD) [SMD = −2.67, 95% CI (−3.51, −1.84), p < 0.01], in comparison with placebo-acupuncture. When compared with conventional pharmacotherapy (antidepressants and/or hypnotics), the results favored acupuncture in decreasing PSQI [MD = −1.17, 95% CI (−2.26, −0.08), p = 0.03] and HAMD [SMD = −0.47, 95% CI (−0.91, −0.02), p = 0.04]. Acupuncture was comparable to conventional pharmacotherapy in reducing scores of each domain of PSQI. For insomnia as a residual symptom of previous or partially remitted depression, acupuncture conferred a very limited, non-significant therapeutic advantage against sham-/placebo-acupuncture. Whether acupuncture has an add-on effect to conventional pharmacotherapy in this type of insomnia has not been investigated. Also, no study was available to address the efficacy differences between acupuncture and CBT or the synergistic effect of these two therapies. Conclusions: There is a low to moderate level of evidence supporting acupuncture as a safe and effective remedy alternative to or adjuvant to conventional pharmacotherapy (antidepressant and/or hypnotic) in improving insomnia and other depression symptoms among patients with active depression. Furthermore, the patients' complaint of disrupted sleep continuity is most likely to benefit from acupuncture. The benefit of acupuncture on residual insomnia associated with previous or partially remitted depression is limited. Future acupuncture studies need to consider applying optimal dosage and addressing deficiencies in trial quality. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021269880, PROSPERO, identifier: CRD42021269880. Copyright © 2022 Zhao, Kennedy, Spencer, Conduit, Zhang, Fu and Zheng.
Acupuncture as an independent or adjuvant management to standard care for perimenopausal depression : a systematic review and meta-analysis
- Zhao, Fei, Fu, Qiang-Qiang, Kennedy, Gerard, Conduit, Russell, Zhang, Wen-Jing, Zheng, Zhen
- Authors: Zhao, Fei , Fu, Qiang-Qiang , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Zheng, Zhen
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 12, no. (2021), p.
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- Description: Background: Many women with perimenopausal depression (PMD) have sought alternative therapies such as acupuncture because of concerns about risks associated with antidepressant and hormone replacement therapy (HRT). This systematic review aimed to clarify if acupuncture is effective for PMD compared with waitlist control or placebo/sham acupuncture, and if acupuncture alone or combined with standard care (antidepressant and/or HRT) is more effective in ameliorating PMD in comparison with standard care alone. Methods: Randomized controlled trials (RCTs) of PMD treatment via acupuncture vs. waitlist control or placebo/sham acupuncture, and RCTs of PMD treatment via acupuncture alone or combined with Western pharmacotherapy vs. Western pharmacotherapy were searched for from seven databases from inception to December 2020. Cochrane criteria were followed. Results: Twenty-five studies involving 2,213 women were analyzed. Meta-analyses indicated that acupuncture significantly reduced the global scores of Hamilton Depression Scale (HAMD) [standardized mean difference (SMD) = −0.54, 95% CI (−0.91, −0.16), p < 0.01], compared with standard care. The therapeutic effect of acupuncture maintained at 2-, 4-, and 12-week follow-ups. Acupuncture combined with standard care was more effective than standard care alone in decreasing HAMD scores [SMD = −0.82, 95% CI (−1.07, −0.58), p < 0.01]. Too few RCTs were available to assess the clinical efficacy differences between acupuncture and placebo/sham acupuncture or HRT alone. Acupuncture also showed better effects in decreasing Kupperman index (KI) scores, whether compared with antidepressant alone [MD = −4.55, 95% CI (−8.46, −0.65), p = 0.02] or antidepressant combined with HRT [MD = −0.89, 95% CI (−1.34, −0.43), p < 0.01]. Conclusions: In comparison with standard care, acupuncture alone or combined with standard care was associated with significant improvements in PMD and reductions of other menopausal symptoms. This finding suggests that acupuncture may be a useful addition to treatment for PMD. © Copyright © 2021 Zhao, Fu, Kennedy, Conduit, Zhang and Zheng.
- Authors: Zhao, Fei , Fu, Qiang-Qiang , Kennedy, Gerard , Conduit, Russell , Zhang, Wen-Jing , Zheng, Zhen
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Frontiers in Psychiatry Vol. 12, no. (2021), p.
- Full Text:
- Reviewed:
- Description: Background: Many women with perimenopausal depression (PMD) have sought alternative therapies such as acupuncture because of concerns about risks associated with antidepressant and hormone replacement therapy (HRT). This systematic review aimed to clarify if acupuncture is effective for PMD compared with waitlist control or placebo/sham acupuncture, and if acupuncture alone or combined with standard care (antidepressant and/or HRT) is more effective in ameliorating PMD in comparison with standard care alone. Methods: Randomized controlled trials (RCTs) of PMD treatment via acupuncture vs. waitlist control or placebo/sham acupuncture, and RCTs of PMD treatment via acupuncture alone or combined with Western pharmacotherapy vs. Western pharmacotherapy were searched for from seven databases from inception to December 2020. Cochrane criteria were followed. Results: Twenty-five studies involving 2,213 women were analyzed. Meta-analyses indicated that acupuncture significantly reduced the global scores of Hamilton Depression Scale (HAMD) [standardized mean difference (SMD) = −0.54, 95% CI (−0.91, −0.16), p < 0.01], compared with standard care. The therapeutic effect of acupuncture maintained at 2-, 4-, and 12-week follow-ups. Acupuncture combined with standard care was more effective than standard care alone in decreasing HAMD scores [SMD = −0.82, 95% CI (−1.07, −0.58), p < 0.01]. Too few RCTs were available to assess the clinical efficacy differences between acupuncture and placebo/sham acupuncture or HRT alone. Acupuncture also showed better effects in decreasing Kupperman index (KI) scores, whether compared with antidepressant alone [MD = −4.55, 95% CI (−8.46, −0.65), p = 0.02] or antidepressant combined with HRT [MD = −0.89, 95% CI (−1.34, −0.43), p < 0.01]. Conclusions: In comparison with standard care, acupuncture alone or combined with standard care was associated with significant improvements in PMD and reductions of other menopausal symptoms. This finding suggests that acupuncture may be a useful addition to treatment for PMD. © Copyright © 2021 Zhao, Fu, Kennedy, Conduit, Zhang and Zheng.
The Australian digital online farm trials database increases the quality of systematic reviews and meta-analyses in grains crop research
- Authors: Walters, Judi , Light, Kate
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Crop and Pasture Science Vol. 72, no. 10 (2021), p. 789-800
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- Reviewed:
- Description: Synthesis and analysis of past cropping research can provide valuable information to direct future decisions around crop management. Systematic reviews and meta-analyses are considered gold standards in the synthesis and analysis of scientific research because they distil large amounts of information about complex issues, provide a summary of knowledge to date, and identify knowledge gaps. However, several issues concerning the methodologies employed to conduct systematic reviews have been identified; among them is the risk of publication bias when a review relies too heavily on 'white' literature from published academic sources and in so doing fails identify relevant 'grey' literature. Grey literature is inherently difficult to identify and collect, but forms a large portion of information available in many fields including agricultural-based research within Australia. The Online Farm Trials (OFT) database is a digital database of crop research field trial data from across Australia that has the potential for use as a discipline-specific source of grey literature to inform systematic reviews and meta-analyses. Using a case study approach to investigate the amount of information available on time of sowing (sowing date) on crop yield across Australia, we demonstrate that the OFT database provides easy access to transparent and reproducible search results similar to other commonly used academic databases. © 2021 Journal Compilation
- Authors: Walters, Judi , Light, Kate
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Crop and Pasture Science Vol. 72, no. 10 (2021), p. 789-800
- Full Text:
- Reviewed:
- Description: Synthesis and analysis of past cropping research can provide valuable information to direct future decisions around crop management. Systematic reviews and meta-analyses are considered gold standards in the synthesis and analysis of scientific research because they distil large amounts of information about complex issues, provide a summary of knowledge to date, and identify knowledge gaps. However, several issues concerning the methodologies employed to conduct systematic reviews have been identified; among them is the risk of publication bias when a review relies too heavily on 'white' literature from published academic sources and in so doing fails identify relevant 'grey' literature. Grey literature is inherently difficult to identify and collect, but forms a large portion of information available in many fields including agricultural-based research within Australia. The Online Farm Trials (OFT) database is a digital database of crop research field trial data from across Australia that has the potential for use as a discipline-specific source of grey literature to inform systematic reviews and meta-analyses. Using a case study approach to investigate the amount of information available on time of sowing (sowing date) on crop yield across Australia, we demonstrate that the OFT database provides easy access to transparent and reproducible search results similar to other commonly used academic databases. © 2021 Journal Compilation
- Jayaraj, Rama, Kumarasamy, Chellan, Norbury, Luke, Piedrafita, David, Smooker, Peter
- Authors: Jayaraj, Rama , Kumarasamy, Chellan , Norbury, Luke , Piedrafita, David , Smooker, Peter
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Veterinary Parasitology Vol. 267, no. (2019), p. 90-98
- Full Text: false
- Reviewed:
- Description: The immunogenicity and efficacy of Fasciola DNA vaccines have not yet been comprehensively summarised in the form of a systematic review and meta-analysis. Though multiple vaccine studies with respect to Fasciola vaccines exist, the variance in the experimental parameters has made comparison difficult. We conducted a bibliographic database search in Scopus, PubMed, Science Direct, Cochrane Library, EMBASE and Web of Science databases, limited to publications from 1998 to 2017. The key words: Liver fluke, Fasciola hepatica, Fasciola gigantica, DNA vaccination, and immunogenicity were used in combination to form search strings. A total of 4760 studies were identified after initial screening, of which 14 qualified for systematic review and 7 for meta-analysis. The mean Odds Ratio (OR) for all studies was 0.565 (95% confidence interval (CI) of 0.293 to 1.087), which means the percentage of protection in terms of decreased fluke burden in animals vaccinated with DNA vaccines was 43.5%. A moderate protective efficacy was observed for cysteine protease and phosphoglycerate kinase vaccine antigen candidates (pooled OR and 95% CI, [0.542; 0.179–1.721] and [0.616; 0.219–1.735], respectively). Vaccine effectiveness was observed in individual studies and cohorts; however, the overall pooled efficacy for all vaccine candidates was found to be non-significant. Despite multiple individual studies showing promising results for various DNA vaccine candidates against fascioliasis, the pooled studies showed the non-significant effect of the vaccine formulations against fluke burden, and displayed minimal protective efficacy against Fasciola infection. Though promising results are observed in isolated studies, further animal trials with standardised experimental parameters are required to develop new vaccine candidates effective against Fasciola. © 2019 Elsevier B.V.
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