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. 2021 Sep 24:12:651649.
doi: 10.3389/fpsyg.2021.651649. eCollection 2021.

Acupuncture for Psychosomatic Symptoms of Hwa-byung, an Anger Syndrome: A Feasibility Randomized Controlled Trial

Yujin Choi  1 , In-Hye Park  2 , Jung-Eun Kim  3 , Ojin Kwon  1 , Ae-Ran Kim  4 , Hyo-Ju Park  4 , Jun-Hwan Lee  1   5 , Joo-Hee Kim  6   7
Affiliations

Acupuncture for Psychosomatic Symptoms of Hwa-byung, an Anger Syndrome: A Feasibility Randomized Controlled Trial

Yujin Choi et al. Front Psychol. .

Abstract

Objectives: Emerging studies found the potential effects of acupuncture for treating chronic pain and mental disorders, namely, depressive and anxiety disorders. Acupuncture is widely used for treating culture-related anger syndrome, Hwa-byung. This pilot trial aimed to investigate the feasibility of a clinical trial testing acupuncture for the psychosomatic symptoms of Hwa-byung. Methods: A total of 26 patients with Hwa-byung planned to be randomly assigned to the acupuncture or sham acupuncture groups. About 10 treatment sessions were applied over 4 weeks. The 100-mm visual analog scale was used to measure the six major Hwa-byung symptoms: stuffiness in the chest, heat sensations, pushing-up in the chest, feeling a mass in the throat, feelings of unfairness, and hard feelings. The criteria for assessing the success of this pilot trial were defined as improvement in three or more of the six Hwa-byung symptoms after treatment, with an effect size >0.2. Results: A total of 15 patients were finally included and randomly assigned to the acupuncture group (n = 7) or the sham acupuncture group (n = 8). After 10 treatment sessions, the Cohen's d effect sizes for acupuncture compared to sham acupuncture were >0.2 for each one of the six major Hwa-byung symptoms, which met our a priori criteria for success. Also, the effect size for the somatic symptoms of "stuffiness in the chest" was 0.81 (95% CI -0.40, 2.20), referring to a large effect size. Conclusions: Our results suggest that acupuncture treatment would be regarded as an acceptable intervention for a full-scale study of psychosomatic symptoms in patients with Hwa-byung. Trial Registration: cris.nih.go.kr, identifier: KCT0001732.

Keywords: Hwa-byung; acupuncture; anger syndrome; feasibility trial; psychosomatic symptoms; randomized controlled trial; stuffiness.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of participants in the feasibility trial.
Figure 2
Figure 2
(A-D) Effect of acupuncture and sham acupuncture on BDI-II and SRI-SF subscales (somatization, depression, and anger). BDI-II, Beck Depression Inventory-II; SRI-SF, Stress Response Inventory-short form. *, <0.05; **, <0.01.
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