Traditional Chinese Medicine Body Constitutions as Predictors for Depression: A Systematic Review and Meta-Analysis

QI-pathological constitution is associated with mental fatigue in class among university students: a cross-sectional study

BACKGROUND

Mental fatigue in class is a common phenomenon among university students in China. However, there is limited research exploring the impact of QI-pathological constitution on mental fatigue in university students.

METHODS

We employed a convenience sampling method to survey 588 students aged 17 to 24 from a western university in China in May 2024. The study measured QI-pathological constitution and mental fatigue among these students. Additionally, diet quality, physical exercise, sleep quality, and academic pressure were assessed as controlled variables. Descriptive statistics, Pearson correlation, and structural equation modeling were utilized to analyze these cross-sectional data.

RESULTS

The results showed that university students experience low levels of mental fatigue in class (M = 2.41, SD = 0.75) and a slight QI-pathological constitution (M = 1.96, SD = 0.71 for QI stagnation and M = 2.41, SD = 0.91 for QI deficiency) on a 5-point Likert scale ranging from 1(never) to 5(often). Pearson correlation analysis revealed a weak positive association between QI-pathological constitution (r = 0.205, p < 0.01 for QI stagnation; and r = 0.256, p < 0.01 for QI deficiency) and mental fatigue in class. Controlling for diet quality, physical exercise, sleep quality, and academic pressure in the structural equation model showed that QI-pathological constitution has a significantly positive effect on mental fatigue in class (β = 0.228, p < 0.01).

CONCLUSION

The study identified a low level of mental fatigue in class and a slight presence of QI-pathological constitution among university students. The QI-pathological constitution has a significantly positive impact on the level of mental fatigue experienced by university students in the classroom.

Harmonizing the mind and body: The interrelationship between traditional Chinese medicine body constitution, mental health and sleep quality

BACKGROUND

Traditional Chinese medicine (TCM) body constitution is a key factor in determining and influencing the occurrence, development, and variation of diseases. As the mind interact with the body, TCM body constitution is useful in preventing and treating psychiatric disorders and insomnia.

AIM

To investigate the interrelationship between TCM body constitution, psychiatric disorders and sleep quality.

METHODS

A total of 2441 participants were enrolled in our study. TCM body constitution was measured using the Constitution in Chinese Medicine Questionnaire, sleep quality was assessed using the Chinese version of the Pittsburgh Sleep Quality Index, and psychopathological symptoms were evaluated using Symptom Checklist-90. Logistic regression was used to estimate the interrelationship between TCM body constitution, psychiatric disorders and sleep quality.

RESULTS

The Pittsburgh Sleep Quality Index score and the proportions of participants with Qi-deficiency constitution, Qi-stagnation constitution, and blood-stasis constitution were significantly higher in the psychiatric symptoms group. Additionally, psychiatric symptoms were considerably associated with sleep quality, Qi-deficiency constitution, and Qi-stagnation constitution, but were inversely associated with male sex. Obsessive-compulsive symptoms were considerably associated with sleep quality, Qi-deficiency constitution and Qi-stagnation constitution. Depression was considerably associated with sleep quality, hyperuricemia, and Qi-stagnation constitution. Anxiety was considerably associated with sleep quality, diabetes, and Qi-stagnation constitution. Finally, poor sleep quality was considerably associated with Qi-deficiency constitution, Qi-stagnation constitution, dampness-heat constitution, phlegm-dampness constitution, and blood-stasis constitution but was inversely associated with male sex and body mass index > 23.9.

CONCLUSION

TCM body constitutions are strongly associated with psychiatric symptoms and sleep quality. Further research is needed to verify whether TCM body constitution can be used to treat and prevent psychiatric conditions as well as enhance sleep quality.

Protocol for a nested case-control study: identifying neuroimaging biomarkers for the progression of subclinical depression and qi-stagnation constitution to major depressive disorder in adolescents

Background

Major depressive disorder (MDD) frequently results in suboptimal treatment outcomes and elevated recurrence rate, with patients frequently engaging in self-harm and suicidal behavior, thereby placing a heavy burden on families and society. Specifically, MDD in adolescents is linked to an elevated suicide risk. Thus, early identification and intervention is crucial for adolescents at high risk for developing MDD. Subclinical depression (SD), characterized by depressive symptoms that do not meet the full criteria for MDD, substantially increases the risk of developing MDD. According to Traditional Chinese Medicine body constitution theory, Qi-stagnation constitution (QSC) is also considered a significant risk factor for the progression to MDD. This study protocol aims to identify neuroimaging biomarkers for the progression from adolescents with SD and QSC to those with MDD, facilitating early intervention strategies.

Methods and analysis

This nested case-control study includes both longitudinal follow-up and cross-sectional comparison. Three hundred first-year senior high school students diagnosed with SD and QSC will be recruited. The 300 adolescents will undergo rs-fMRI scans at baseline and again after one year. We then divide the 300 adolescents with SD and QSC into two groups based on whether they progress to MDD after one year. Functional brain networks will be constructed based on 400 regions of interest (ROIs). Neuroimaging measures, including regional homogeneity and low-frequency fluctuation for each ROI, as well as graph-based global efficiency, nodal efficiency, and nodal centrality from the binary networks, will then be calculated. Finally, differences in these neuroimaging measures between the two groups at baseline will be analyzed to identify biomarkers that can predict the progression from adolescents with SD and QSC to those with MDD.

Study registration

This study protocol does not involve clinical interventions and is classified as an observational study, so it was not subject to prior registration.

Associations of Polygenic Risk for Depression, Traditional Chinese Medicine Constitution, and Depression: A Population-Based Study in Taiwan

To comprehensively investigate the risk factors associated with depression, traditional Chinese medicine constitution (TCMC) has been found to be related to depression. However, the underlying mechanism remains unclear. This study examined the association between the concept of unbalanced TCMCs and major depressive disorder (MDD), investigated the overlapping polygenic risks between unbalanced TCMC and MDD, and performed a mediation test to establish potential pathways. In total, 11,030 individuals were recruited from the Taiwan Biobank, and the polygenic risk score (PRS) for MDD for each participant was calculated using the data from the Psychiatric Genomics Consortium. Unbalanced TCMC were classified as yang-deficiency, yin-deficiency, and stasis. The MDD PRS was associated with yang-deficiency odds ratio [OR] per standard deviation increase in standardized (PRS = 1.07, p = 0.0080), yin-deficiency (OR = 1.07, p = 0.0030), and stasis constitution (OR = 1.06, p = 0.0331). Yang-deficiency (OR = 2.07, p < 0.0001) and stasis constitutions (OR = 1.65, p = 0.0015) were associated with an increased risk of MDD. A higher number of unbalanced constitutions was associated with MDD (p < 0.0001). The effect of MDD PRS on MDD was partly mediated by yang-deficiency (10.21%) and stasis (8.41%) constitutions. This study provides evidence for the shared polygenic risk mechanism underlying depression and TCMC and the potential mediating role of TCMC in the polygenic liability for MDD.

Association between varicose veins and constitution of traditional Chinese medicine plus heart-failure-like symptoms

Background

Varicose veins are a common issue for employees in jobs that require prolonged standing compared with all other employees. However, its relationship with presentations of traditional Chinese medicine constitution is unknown. This study aimed to investigate their association.

Material and methods

Data in the study were obtained from questionnaires of patients in Taiwan Biobank, enrolled from 2008 to 2020. The responses to the statement "I can see distorted blood vessels on my four limbs (varicose veins)." were categorized into none, mild, moderate, severe. and more severe, and the same scale was also used to classify breathing difficulties and hypotension.

Results

A total of 11,293 participants were enrolled in the study. The prevalence of women was higher in the studied group compared with the control. Patients complained of breathing difficulties with moderate (30.49%) and severe discomfort (12.44%) in the diseased group. Regarding hypotension, 28.81% and 9.82% of the patients presented with moderate and severe hypotension, respectively. The cofactor odds ratio was 1.775 for severe breathing difficulty/moderate hypotension and 2.235 for severe breathing difficulty/severe hypotension, with statistical significance. The combined impact of breathing difficulties and hypotension increased with severity.

Conclusions

Varicose veins had a higher association with breathing difficulties and hypotension as the severity of the condition worsened. The combined impact of breathing difficulties and hypotension increased as the disease progressed. Therefore, self-reported assessments can be a useful tool for evaluating patients with asymptomatic varicose veins before the development of "heart-failure-like symptoms" to reduce the risk of underdiagnosis.

A comprehensive study of psychological well-being and traditional Chinese medicine constitutions among model workers in Beijing

Background

Body constitution is the foundation of Traditional Chinese Medicine (TCM), and model workers consist of a special group of workers within China. This study aims to research the relationship between the physical body constitutions based on TCM and the mental health of model workers.

Methods

We recruited 314 model workers from Beijing Rehabilitation Hospital to conduct the questionnaires such as SCL-90 and CCMQ to investigate if there is an association between mental health status and TCM body constitutions. We performed a Partial Least Squares Path Modeling (PLS path modeling).

Results

Our path model results revealed associations between different TCM constitution types and SCL scores, which serve as indicators of psychological well-being. Our research findings demonstrate a strong correlation between the Balanced constitution and elevated levels of psychological well-being, with a path coefficient of -0.503. In contrast, the other eight constitutional types exhibit path coefficients exceeding 0.3, indicating a tendency toward lower levels of psychological well-being. We also investigated the intricate connections between various TCM constitutional types and both mild and severe psychological well-being.

Conclusion

In conclusion, the Balanced constitution continues to be closely associated with higher levels of psychological well-being, while the remaining eight body constitution types are consistently linked to lower levels of psychological well-being.

Exploring the transformative impact of traditional Chinese medicine on depression: Insights from animal models

Depression, a prevalent and complex mental health condition, presents a significant global health burden. Depression is one of the most frequent mental disorders; deaths from it account for 14.3% of people worldwide. In recent years, the integration of complementary and alternative medicine, including traditional Chinese medicine (TCM), has gained attention as a potential avenue for addressing depression. This comprehensive review critically assesses the efficacy of TCM interventions in alleviating depressive symptoms. An in-depth look at different research studies, clinical trials, and meta-analyses is used in this review to look into how TCM practices like herbal formulations, acupuncture, and mind-body practices work. The review looks at the quality of the evidence, the rigor of the methods, and any possible flaws in the current studies. This gives us an idea of where TCM stands right now in terms of treating depression. This comprehensive review aims to assess the efficacy of TCM interventions in alleviating depressive symptoms. In order to learn more about their possible healing effects, the study also looks into how different types of TCM work, such as herbal formulas, acupuncture, and mind-body practices.

Development and validation of non-invasive prediction models for migraine in Chinese adults

BACKGROUND

Migraine is a common disabling neurological disorder with severe physical and psychological damage, but there is a lack of convenient and effective non-invasive early prediction methods. This study aimed to develop a new series of non-invasive prediction models for migraine with external validation.

METHODS

A total of 188 and 94 subjects were included in the training and validation sets, respectively. A standardized professional questionnaire was used to collect the subjects' 9-item traditional Chinese medicine constitution (TCMC) scores, Pittsburgh Sleep Quality Index (PSQI) score, Zung's Self-rating Anxiety Scale and Self-rating Depression Scale scores. Logistic regression was used to analyze the risk predictors of migraine, and a series of prediction models for migraine were developed. Receiver operating characteristic (ROC) curve and calibration curve were used to assess the discrimination and calibration of the models. The predictive performance of the models were further validated using external datasets and subgroup analyses were conducted.

RESULTS

PSQI score and Qi-depression score were significantly and positively associated with the risk of migraine, with the area of the ROC curves (AUCs) predicting migraine of 0.83 (95% CI:0.77-0.89) and 0.76 (95% CI:0.68-0.84), respectively. Eight non-invasive predictive models for migraine containing one to eight variables were developed using logistic regression, with AUCs ranging from 0.83 (95% CI: 0.77-0.89) to 0.92 (95% CI: 0.89-0.96) for the training set and from 0.76 (95% CI: 0.66-0.85) to 0.83 (95% CI: 0.75-0.91) for the validation set. Subgroup analyses showed that the AUCs of the eight prediction models for predicting migraine in the training and validation sets of different gender and age subgroups ranged from 0.80 (95% CI: 0.63-0.97) to 0.95 (95% CI: 0.91-1.00) and 0.73 (95% CI: 0.64-0.84) to 0.93 (95% CI: 0.82-1.00), respectively.

CONCLUSIONS

This study developed and validated a series of convenient and novel non-invasive prediction models for migraine, which have good predictive ability for migraine in Chinese adults of different genders and ages. It is of great significance for the early prevention, screening, and diagnosis of migraine.

Traditional Chinese Medicine constitution among patients with allergic rhinitis and its correlation with anxiety and depression

OBJECTIVE

To preliminary investigate the distribution of Traditional Chinese Medicine (TCM) constitution among patients with allergic rhinitis (AR) and reveal the related factors with anxiety and depression.

METHODS

Between July 2020 and June 2021, specialist doctor recruited AR patients in Beijing and Shanghai. A total of 630 patients admitted to participate in the survey, and 516 (81.9%) (male 54.3%, female 45.7%) participants completed the questionnaires. Three scales including Constitution in Chinese Medicine Questionnaire (CCMQ), Generalized Anxiety Disorder Questionnaire (GAD-7) and The Patient Health Queationaire-9 (PHQ-9) were applied. The χ2 and the Fisher's exact test were used to evaluate the classification data, multivariate logistic regression was used to explore the related factors of anxiety and depression.

RESULTS

According to 516 AR patients, the most commonly first-constitution was Yang-deficiency (22.1%) and frequent of all constitutions was inherited-special (21.6%). One third of AR patients (33.5%) suffered from anxiety, nearly half of AR patients (46.5%) were found to be depressive. Inherited-special (27.7%) was the most common constitution in patients with anxiety whereas Yang-deficiency (26.7%) was most common constitution in patients with depression. Sex, duration of symptoms, balanced, Qi-deficiency, phlegm-dampness, Qi-stagnation, and inherited-special constitutions were related with anxiety; Sex, income, duration of symptoms, balanced, Qi-deficiency, Yang-deficiency, phlegm-dampness, Qi-stagnation, and inherited-special constitutions were related with depression.

CONCLUSIONS

According to our study, the commonly constitution types of AR were Yang-deficiency and inherited-special. We found that the prevalence value of anxiety and depression were high. People with Qi-deficiency, phlegm-dampness, Qi-stagnation, and inherited-special constitutions were more likely to have mental problems than the others. Controlling these influential factors might be beneficial for clinical health management of AR patients, and the government should apply appropriate mental health treatment services to offer psychiatric support.