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Electroacupuncture and cognitive behavioural therapy for sub-syndromal depression among undergraduates: a controlled clinical trial
  1. Tianwei Guo1,2,
  2. Zhuo Guo2,
  3. Wenyue Zhang2,
  4. Wenhao Ma3,
  5. Xinjing Yang4,
  6. Xueqin Yang5,
  7. Jiwon Hwang2,
  8. Xiaotian He6,
  9. Xinyi Chen1,
  10. Tu Ya2
  1. 1Department of Oncology and Hematology, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine, Beijing, China
  2. 2School of Acupuncture Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
  3. 3Department of Human Resources, Beijing University of Chinese Medicine, Beijing, China
  4. 4Department of Chinese Medicine, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
  5. 5School of Basic Medical Science, Beijing University of Chinese Medicine, Beijing, China
  6. 6Department of Chinese Medicine, Sanlitun Community Health Service Center, Beijing, China
  1. Correspondence to Dr Tu Ya, School of Acupuncture Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11 Bei San Huan Dong Lu, Beijing 100029, China; tuya_tcm{at}


Background Individuals with sub-syndromal depression (SSD) are at increased risk of incident depressive disorders; however, the ideal therapeutic approach to SSD remains unknown.

Objective To evaluate the effects of electroacupuncture (EA) and cognitive behavioural therapy (CBT), alone or in combination, on depressive symptoms.

Methods Undergraduate students with SSD were recruited and allocated to one of four groups based on their preferences: EA (n=6), CBT (n=10), EA+CBT (n=6), and untreated control (n=11) groups. Six weeks of treatment were provided in the first three groups. Clinical outcomes were measured using the 17-item Hamilton Depression (HAMD-17) rating scale, Center for Epidemiologic Depression (CES-D) scale, WHO Quality of Life-Brief version (WHOQOL-BREF) questionnaire, and clinical remission rate.

Results All 33 subjects were included in an intent-to-treat analysis. Statistically significant improvements in HAMD-17, CES-D, and WHOQOL-BREF scores and a higher remission rate were found in the EA, CBT, and EA+CBT intervention groups compared with the control group (all p<0.05). No significant differences were found between the three intervention groups. HAMD-17 factor score analysis revealed that EA reduced sleep disturbance scores more than CBT or EA+CBT (p<0.05), and CBT reduced retardation scores more than EA (p<0.01). EA+CBT reduced anxiety/somatisation scores more than EA or CBT (p<0.05) and retardation scores more than EA (p<0.05).

Conclusions Early intervention may alleviate depressive symptoms in SSD. EA and CBT may have differential effects on certain symptoms. Combination therapy targeting both physical and psychological symptoms may represent an ideal strategy for SSD intervention. However, randomised trials with larger sample sizes are needed.

Trial registration number ChiCTR-TRC-10000889; Results.


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  • Contributors TY, TG and WZ conceived and designed the trial. TG, WZ, WM, JH and XH conducted the questionnaire survey. WZ and XY conducted the HAMD-17 assessments. ZG and XY performed the EA and CBT, respectively. TG and XC analysed the data. TG and TY drafted and revised the manuscript. All authors approved the final version before publication.

  • Funding This study was supported by an international cooperation project supported by the China Ministry of Science and Technology (reference no. 2007DFA30780).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Medical Ethical Committee of the Third Affiliated Hospital of Beijing University of Chinese Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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