Effects of Electroacupuncture Combined With Psychological Intervention on Depressive Status and Contingent Negative Variation in Patients With Internet Addiction Disorder: A Randomized Controlled Trial

Abstract

Background: Depressive symptoms often accompany people with Internet addiction syndrome (IAD). Acupuncture has been found to have significant advantages in improving the severity and depressive symptoms of IAD. Contingent negative variation (CNV) is a common method to explore the mechanism of neurophysiology. Objective: The purpose of this study was to observe the efficacy of electroacupuncture (EA), psychological intervention (PI), and comprehensive intervention (CI) in the treatment of depression in Internet addiction disorder (IAD), and to observe the changes of contingent negative variation (CNV) in each group. Methods: One hundred and twenty subjects diagnosed with IAD were randomly assigned to the EA group, the PI group, or the CI group. They received EA, PI, or a combination of EA and PI for 40 days. The Internet Addiction Test (IAT), the Zung Self-rating Depression Scale (SDS), and the Hamilton Depression Scale (HAMD) were evaluated for all subjects at baseline, 20th, and 40th days of treatment, while CNV data were collected at baseline and 40th days of treatment. Results: Three treatments effectively reduced IAT, SDS, and HAMD scores, and the intergroup comparison showed that CI was superior to EA, while EA was superior to PI. CNV results indicated that the CNV amplitude increased in all three groups of IAD patients after treatment. The CNV latency of point A and A-S2' wave area of the EA group and the CI group did not change significantly after treatment. Only the A-S2' wave area of the PI group increased significantly compared with the baseline period. In addition, IAD's IAT score was positively correlated with SDS and HAMD score at baseline but negatively correlated with CNV latency. After treatment, only the change of HAMD score in the CI group was negatively correlated with amplitude. Conclusion: Our results demonstrate the efficacy of acupuncture and psychological intervention in the treatment of IAD from an electrophysiological perspective. Simultaneously, the increase in CNV amplitude might be the underlying neurophysiological mechanism by which CI improves depression and cognitive function in IAD patients. Clinical Trial Registration: ClinicalTrials.gov, identifier NCT02362698.

Keywords: acupuncture; cognitive-behavioral therapy; contingent negative variation; depression; internet addiction disorder; psychological intervention.

Figure 1

Flowchart of the screening, enrollment, randomization, assessment, and treatment. Day 20, 20th day of treatment; Day 40, 40th day of treatment; CNV, contingent negative variation.

Figure 2

Location of acupoints in electroacupuncture group. The acupuncture points in the electroacupuncture group included six types of acupoints (a total of 13 points). The points marked by the yellow lightning bolt were the points that require electrical stimulation with electrodes attached. cun, a measure of length in traditional Chinese medicine.

Figure 3

CNV waveform diagram. Point A is the point where the CNV wave leaves the baseline, point B is the peak point of the negative deflection of the E-wave, point C is the point where CNV returns to the baseline after S2.

Figure 4

Changes in the score of the clinical evaluation scale. (A) Changes of IAT scores in the three groups at different treatment time points. (B) Changes of SDS scores in the three groups at different treatment time points. (C) Changes of HAMD scores in the three groups at different treatment time points. EA, electropuncture; PI, psychological intervention; CI, comprehensive intervention; IAT, Young's Internet addiction test; SDS, Zung Self-rating depression scale; HAMD, Hamilton Depression Scale; Day 20, 20th day of treatment; Day 40, 40th day of treatment.