Developing a traditional chinese medicine diagnostic structure for post-traumatic stress disorder

J Altern Complement Med. Jan-Feb 2006;12(1):45-57. doi: 10.1089/acm.2006.12.45.

Abstract

Background: Post-traumatic stress disorder (PTSD) is a common, disabling condition with many diverse symptoms including anxiety, depression, insomnia, and body pain. These symptoms are likely to be helped by treatment with Traditional Chinese Medicine (TCM); however, PTSD is not yet a recognized disorder (bing ming) in Chinese medicine. In preparation for a phase II clinical trial comparing TCM and cognitive behavioral therapy (CBT) treatment of PTSD symptoms, a TCM diagnostic pattern framework for persons who meet the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) definition of PTSD was sought.

Methods: Three approaches were used to identify the most likely TCM pattern differentiations for PTSD: an English-language TCM textbook review on the conditions "depression," "anxiety," and "insomnia"; a survey of 20 experienced practitioners of TCM; and TCM assessments of 21 individuals affected by PTSD. Two TCM practitioners synthesized the information into a list of pattern differentiations.

Results: The most likely pattern differentiations for PTSD were Heart Shen disturbance caused by Heat, Fire, or a constitutional deficiency; Liver Qi stagnation; and Kidney deficiency. Secondary patterns identified were outcomes of long-term Liver Qi stagnation-Liver overacting on Spleen/Stomach, Liver Fire, Phlegm Fire, Phlegm-Damp, and Heart Fire-and constitutional deficiencies in the Heart, Kidney, and Spleen organ systems.

Conclusions: The use of extant literature, expert knowledge, and clinical TCM diagnoses contributed to the development of a TCM diagnostic structure for PTSD. The results can inform the clinical practice of TCM. The method can be used to guide research design involving different diagnostic systems.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Anxiety / complications
  • Anxiety / diagnosis
  • Depression / complications
  • Depression / diagnosis
  • Diagnosis, Differential
  • Diagnostic and Statistical Manual of Mental Disorders
  • Humans
  • Medicine, Chinese Traditional*
  • Pain / complications
  • Pain / diagnosis
  • Psychometrics
  • Sleep Initiation and Maintenance Disorders / complications
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Stress Disorders, Post-Traumatic / complications*
  • Stress Disorders, Post-Traumatic / diagnosis*