The Emotion And Polysomnography Regulation Effect Of TIP And Electro Acupuncture On Depression Associated With Insomnia

ObjectiveTo examine the clinical efficacy and correlation of Low Resistance Thought Induction Psychotherapy (TIP) and Electroacupuncture in the treatment of depression with insomnia.MethodsOur study is a randomized clinical trial which includes90outpatients with depression accompanied by insomnia in the psychological clinic of Guang’an men hospital, China academy of Chinese Medical Science. These patients were randomly divided into low resistance thought Induction Psychotherapy (TIP) group、 Electroacupuncture group and citalopram treatment (CP) group. Each group of thirty patients. The observation period was6months. The effect of treatment on depression was evaluated by the self-rating depression scale (SDS), Self-rating anxiety scale (SAS), and Montgomery-Asberg Depression Rating Scale (MADRS). The effect of treatment on sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Polysomnogram (PSG).All evaluations were conducted at pre-treatment baseline,3-months post treatment and6-months post treatment. Safety assessment was based on blood test, routine urine test, liver function test, renal function tests and the electrocardiogram (ECG). In the TIP group, patients received two session of treatment per week. In the Electroacupuncture group, patients received three session of treatment per week. In the CP group, drug dosage was Citalopram20-40mg per day in the morning. All data are analyzed by software SPSS17.0.Result1.Psychological scale1.1The comparison between the groupsAfter three months of the treatment, citalopram treatment (CP) group improve SDS and SAS is superior to TIP and Electroacupuncture group (p＜0.05).After six months of the treatment, citalopram treatment (CP) group improve SAS is superior to TIP and Electroacupuncture group (p＜0.05). citalopram treatment (CP) and TIP group improve SDS is superior to Electroacupuncture group (p<0.05). After three and six months treatment, TIP、citalopram treatment (CP) and Electroacupuncture group in MADRS comparison has no significant difference.1.2The comparison of self group before and after treatmentAfter three months of the treatment, TIP group improve SAS and MADRS is superior than before treatment (p＜0.05),After six months of the treatment, TIP group improve SDS、SAS and MADRS is superior than before treatment (p<0.05).After three and six months of the treatment, citalopram treatment and Electroacupuncture group improve SDS、SAS and MADRS is superior than before treatment (p＜0.05).1.3The comparison between the difference groupsAfter three months of the treatment, citalopram treatment (CP) group improve difference of SDS is superior to TIP group (p＜0.05).After six months treatment, TIP、citalopram treatment and Electroacupuncture group in SDS、SAS and MADRS comparison has no significant difference.2. Pittsburgh Sleep Quality Index (PSQI)2.1The comparison between the groupsAfter three months of the treatment, TIP improve hypnotic drugs of PSQI is superior to citalopram treatment group (p＜0.05); After six months treatment, TIP、 citalopram treatment and Electroacupuncture group in PSQI comparison has no significant difference.2.2The comparison of inner group before and after treatmentAfter three months of the treatment, TIP group improve sleep quality,sleep latency, sleep disorder, total score of PSQI is superior than before treatment (p<0.05),After six months of the treatment, TIP group improve sleep quality,sleep latency, sleep time, sleep efficiency, sleep disoder and daytime function, total score of PSQI is superior than before treatment (p＜0.05).After three months of the treatment, citalopram treatment group improve sleep quality,sleep latency, sleep time, total score of PSQI is superior than before treatment (p＜0.05). After six months of the treatment, citalopram treatment group improve sleep quality,sleep time, sleep efficiency, and daytime function,total score of PSQI is superior than before treatment (p<0.05). After three months of the treatment, Electroacupuncture group improve sleep quality,sleep latency,sleep time, sleep efficiency, hypnotic drugs and total score of PSQI is superior than before treatment (p＜0.05),After six months of the treatment, Electroacupuncture group improve sleep quality,sleep latency, sleep time, sleep efficiency, sleep disorder,hypnotic drugs and daytime function, total score of PSQI is superior than before treatment (p＜0.05).2.3The comparison between the difference groupsAfter three months of the treatment, Electroacupuncture group improve difference of sleep efficiency of PSQI is superior to TIP group (p＜0.05).After six months of the treatment, Electroacupuncture group improve difference of sleep efficiency of PSQI is superior to TIP and citalopram treatment group (p＜0.05).3. Polysomnogram3.1The comparison between the groupsAfter three and six months of the treatment, TIP、citalopram treatment (CP) and Electroacupuncture group in PSG comparison has no significant difference.3.2The comparison of inner group before and after treatmentAfter three months of the treatment, TIP group improve REM time,REM%NREM%, NREM latency of PSG is superior than before treatment (p＜0.05),After six months of the treatment, TIP group improve awakening times,REM time,REM%, NREM%of PSG is superior than before treatment (p＜0.05).After three months of the treatment, citalopram treatment group improve Sleep time,NREM time,NREM latency of PSG is superior than before treatment (p＜0.05),After six months of the treatment, citalopram treatment group improve Sleep time,REM times,S3+S4sleep time,S3%+S4%,REM sleep time of PSG is superior than before treatment (p＜0.05).After six months of the treatment, Electroacupuncture group improve awakening times of PSG is superior than before treatment (p＜0.05).3.3The comparison between the difference groupsAfter three months of the treatment, TIP group improve difference of REM time,REM%of PSG is superior to citalopram treatment group (p＜0.05). citalopram treatment group improve difference of NREM%of PSG is superior to TIP group.After six months of the treatment, TIP group improve difference of REM time,REM%of PSG is superior to Electroacupuncture and citalopram treatment group (p＜0.05). Electroacupuncture and citalopram treatment group improve difference of NREM%of PSG is superior to TIP group (p＜0.05).4. Correlation of Psychological scale and sleep scaleBefore treatment SDS is positive correlation with SAS and MADRS (p＜0.05). SAS and MADRS is positive correlation with sleep disorder of PSQI, has no significant correlation with other items. SAS is positive correlation with S1sleep time and S1%, MADRS negative correlation with S2sleep time, S2%and REM latency.After six months of the treatment, Improve sleep quality of PSQI is positive correlation with SDS, SAS. Improve total scale is positive correlation with SAS.REM times is negative correlation with SDS.NREM%is negative correlation with SAS.Conclusion1. Low Resistance Thought Induction Psychotherapy (TIP)、Electroacupuncture and citalopram treatment are effective on depression with insomnia.three group comparison has no significant difference,but effects of citalopram treatment faster than TIP and Electroacupuncture.2. Low Resistance Thought Induction Psychotherapy (TIP)、Electroacupuncture and citalopram treatment for depression with insomnia sleep have obvious improvement, no significant difference between the three groups.3.Before treatment SDS is positive correlation with SAS and MADRS (p<0.05). SAS and MADRS is positive correlation with sleep disorder of PSQI, has no significant correlation with other items. SAS is positive correlation with S1sleep time and S1%, MADRS negative correlation with S2sleep time, S2%and REM latency.4.After six months of the treatment, Improve sleep quality of PSQI is positive correlation with SDS, SAS. Improve total scale is positive correlation with SAS.REM times is negative correlation with SDS.NREM%is negative correlation with SAS.