Presentation Information
[P-28-07]Electroacupuncture effects on cortisol levels and explosive behavior in Intermittent Explosive Disorder patients - Grant Contest2
*Leonardo Guimarães Stocco1, Ciro Blujus dos Santos Rohde2, Liliana Seger2, Raquel Chacon Ruiz Martinez2,3, Hermano Tavares2 (1.Faculty of Medicine of São Paulo University(Brazil), 2.Department of Psychiatry, Institute of Psyhiatry, Faculty of Medicine of São Paulo University(Brazil), 3.Instituto Sírio-Libanês de Ensino e Pesquisa(Brazil))
Keywords:
Intermittent Explosive Disorder,Impulse disorders,Acupuncture,Electroacupuncture,Cortisol
Background: Intermittent Explosive Disorder (IED) is characterized by impulsive and unproportional aggressive outbursts, engendering significant interpersonal impairment for patients. Different neurobiological features are related to IED, such as hypothalamic-pituitary-adrenal (HPA) axis dysfunctions: IED patients have lower morning cortisol levels compared to non-IED individuals. Electroacupuncture (EA) is a contemporary acupuncture technique that applies electric microcurrents to needles inserted in the body. EA can modulate neural pathways related to IED, such as the HPA axis, increasing serum cortisol levels. It also affects central serotonin release and amygdala’s connectivity. This study evaluates the effect of acupuncture on explosive symptoms and cortisol levels in IED patients.
Methods: IED outpatients were evaluated by the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Constitution in Chinese Medicine Questionnaire (CCMQ) before treatment. Blood samples were collected for analysis of testosterone, serum and salivary cortisol, and other stress markers. They underwent 12 weekly acupuncture sessions and electroacupuncture was applied to points ST36, Ex-HN3, and GV20, with manual stimulation of PC6. The same questionnaires and blood samples were reapplied on week 6 and 12.
Results: 16 patients completed all 12 sessions, and other 7 patients completed at least 6 sessions. There was a statistically significant reduction in the incidence of explosive outbursts as reported by patients, and a significant decrease in salivary cortisol. Reductions in anxiety and depression scores were not significant. All patients reported a subjective impression of improved self-control and reduced irritability.
Discussion: The explosive symptoms reduction and salivary cortisol levels suggests an acupuncture’s promising potential in IED treatment, which was also supported by the improved self-control and reduced irritability reports. Further clinical trials with larger samples and extended follow-ups can bring new insights related to acupuncture's efficacy and its mechanisms. Integrating acupuncture into conventional IED treatment protocols could improve patients’ quality of life.
Methods: IED outpatients were evaluated by the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Constitution in Chinese Medicine Questionnaire (CCMQ) before treatment. Blood samples were collected for analysis of testosterone, serum and salivary cortisol, and other stress markers. They underwent 12 weekly acupuncture sessions and electroacupuncture was applied to points ST36, Ex-HN3, and GV20, with manual stimulation of PC6. The same questionnaires and blood samples were reapplied on week 6 and 12.
Results: 16 patients completed all 12 sessions, and other 7 patients completed at least 6 sessions. There was a statistically significant reduction in the incidence of explosive outbursts as reported by patients, and a significant decrease in salivary cortisol. Reductions in anxiety and depression scores were not significant. All patients reported a subjective impression of improved self-control and reduced irritability.
Discussion: The explosive symptoms reduction and salivary cortisol levels suggests an acupuncture’s promising potential in IED treatment, which was also supported by the improved self-control and reduced irritability reports. Further clinical trials with larger samples and extended follow-ups can bring new insights related to acupuncture's efficacy and its mechanisms. Integrating acupuncture into conventional IED treatment protocols could improve patients’ quality of life.