Depression Clinical Trial
Official title:
Prospective Open Randomized Monocentric Two-armed Controlled Clinical Trial in Parallel Groups to Investigate the Influence of Complementary Medicine (CAM) Interventions on Quality of Life and The Treatment Process of Patients Undergoing Allogenic Stem Cell Transplantation
The allogenic stem cell transplantation (aSCT), the only curative approach for many hematological diseases, often leads to severe diseases or chronic conditions, leaving patients with physical disabilities and severe depression and impacting their quality of life in many cases. These consequences are still not adequately addressed by conventional therapies. In this study, the investigators examine the influence of the three complementary medicine methods (CAM) namely acupuncture according to Traditional Chinese Medicine (TCM), music therapy according to the TaKeTiNa method and the psychological disease processing by theatrical clown performance on the quality of life and the therapy process of patients before and after aSCT.
The allogenic stem cell transplantation (aSCT) is still the only curative approach for many
hematological diseases. Despite new therapeutic developments in the past few years, the
therapy-associated mortality rate is around 20%. Patients develop a Graft versus Host Disease
(GvHD) in 30-70% of the cases, some with persistent, severe progression and often complicated
by infections. In severe chronic conditions, physical disabilities such as weakness,
paralysis, scarred vulnerable skin, and blindness may occur. A significant reduction in the
quality of life of these patients including severe depression is the consequence.
The demand of patients for supplementary therapy possibilities in the sense of an
integrative, complementary medicine is great. There are indications that complementary
methods can help improve the quality of life and reduce the associated side effects. However,
there are no scientific studies to clarify the efficacy or safety of such therapies in the
aSCT.
In this project, the investigators examine the influence of three complementary medicine
methods, namely acupuncture according to Traditional Chinese Medicine (TCM), music therapy
according to the TaKeTiNa method and the psychological disease processing by theatrical clown
performance, on the quality of life and the therapy process of patients before and after
aSCT.
Acupuncture according to TCM is an evidence-based therapy approach with few side effects for
many diseases. In the past few years, not only their superiority over placebo treatment, but
also the point-specific effect has been shown. Based on the numerous published data on pain,
nausea, fatigue and depression, it can be assumed that acupuncture reduces the side effects
of drug therapy in aSCT and thus improves the quality of life of patients.
According to TCM, the points influence the flow of the energy (referred to as "Qi") in the
body and stimulate its self-regulation. In addition, each organ system associated to a
different emotion. The unimpeded flow of the ongoing arising of emotions and body energies
is, according to TCM, a prerequisite for the health of the organism.
In TCM, the acupuncture used to stimulate the self-regulation of the body is accompanied by
the regular practice of Qi-Gong or Tai-Qi by the patient to achieve the greatest therapeutic
effect between the treatments. This additive component can hardly be realized because of the
severely restricted general state of the patients.
In order to mobilize the energy and emotions, this study also implements two further
treatment modalities, which are practiced with the patient and which the patient can practice
on a daily basis by himself:
TaKeTiNa is a form of music therapy founded by Reinhard Flatischler, in which body, voice and
movement are used to develop present consciousness, physical feeling and rhythm skills. It
has been used therapeutically for more than 20 years.
Furthermore, the processing of arising emotions needs to be facilitated. Patients undergoing
an aSCT are exposed to a deeply invasive and debilitating situation for a period of at least
four weeks. Characteristics are social isolation through limited visits as well as
confinement to a small room, almost complete loss of the privacy and independence through
frequent monitoring and lavation necessary during aSCT. Finally the confrontation with the
illness, the side effects of the drug treatment and the possible death. Arising emotions can
lead to a blockade in the energy flow of the respective organ according to TCM and can cause
illness. Therefore, the introduction of six basic gestures from the clown performance
according to the Metzler method (KANA-Institut für Koerperprache Freiburg) is intended to
give the patient the opportunity to process his emotions in a playful manner in real time or
to communicate them directly to another person without words.
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