A systematic review 1 including 10 RCTs (n=1 010) and 2 non-randomised trials (n=124) was abstracted in DARE. Studies evaluated traditional or Western acupuncture (ear acupuncture, electroacupuncture and acupressure treatments). The only RCT (n=56) studying patients with generalised anxiety that used a sham acupuncture control reported a significantly improved Clinical Global Impression score, clinical improvement at 10 weeks and an increased percentage of responders in the acupuncture group compared with the control group, but the majority of patients had minor depression rather than anxiety. Two RCTs (n=39 and n=296) that compared acupuncture with drug treatments reported no significant difference between treatments. One RCT (n=240) reported a significantly greater 'cure rate' in patients allocated to acupuncture plus electromyographic biofeedback (EMG BFB) than in those allocated to EMG BFB alone. When studying patients with situational anxiety (6 RCTs), all 4 RCTs that compared acupuncture with sham acupuncture (n=249) reported some positive outcomes with acupuncture interventions compared with controls. One RCT (n=90) reported no significant difference in anxiety between patients treated with acupuncture, diazepam and progressive relaxation.
Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment), by inconsistency (heterogeneity in patient populations, interventions and outcomes) and imprecise results (limited study size for each comparison).
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