Post-schizophrenia comorbid depressive disorder and insomnia treated by acupuncture combined with Chinese medicine:A retrospective case series based on JBI reporting checklist

Background:Acupuncture combined with Chinese herbal medicine was performed on 24 patients with post-schizophrenia comorbid depressive disorder and insomnia admitted to the Psychiatry Department,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine from 2016 to 2020,and provided satisfactory results.Considering post-schizophrenia comorbid depressive disorder and insomnia is not a common clinical disorder in hospital of traditional Chinese medicine,the treatment and follow-up cycle is long,and the dropout rate is high,a retrospective case series based on Joanna Briggs Institute(JBI) reporting checklist were conducted instead of a randomized controlled trial.Objective:To retrospectively summary the short-,mid-and long-term effects of acupuncture combined with Chinese herbal medicine for post-schizophrenia comorbid depressive disorder and insomnia,and analyze the principles of the prescriptions.Methods:A retrospective analysis based on case series JBI reporting checklist were performed to investigate effects of 24 patients with post-schizophrenia comorbid depressive disorder and insomnia undergoing 12-week combined acupuncture and Chinese herbal medicine treatment(patients did not receive full dosage treatments,or received western medicine or other physical and psychological therapies during the treatment period were excluded).The psychotic symptoms,depression,insomnia,and self-care ability for daily living were measured by the Positive and Negative Syndrome Scale(PANSS),Calgary Depression Scale for Schizophrenia(CDSS),Pittsburgh Sleep Quality Index(PSQI),and Activity of Daily Living Questionnaire(ADL-Q),respectively.Follow-ups were conducted at 8 and 16 weeks after treatment.Meanwhile,Acupuncture Beliefs Scale(ABS) was assessed at pre-and post-treatment as well as 16-week follow-up to investigate patients’ beliefs and expectations for acupuncture treatment.Results:(1) compared with pre-treatment,the PANSS global scores did not decrease significantly at posttreatment and follow-up periods(P> 0.05).(2) compared with pre-treatment,the global scores of CDSS and PSQI decreased significantly at post-treatment and follow-up periods(both P<0.05).The PSQI global scores at the 16-week follow-up were even significantly lower than at port-treatment(P<0.05).(3) after treatment,the ADL-Q.global scores decreased significantly(P<0.05),and continued to decrease during the follow-ups(P<0.05).(4) effective treatment improved patients’ beliefs and expectations of acupuncture therapy.Conclusions:Acupuncture combined with Chinese herbal medicine can significantly improve the insomnia and depressed mood following schizophrenia,with satisfactory short-,medium-and long-term effects;effective treatment experience can increase patients’ beliefs and expectations for acupuncture therapy.