Indian Journal of Private Psychiatry

Register      Login

VOLUME 15 , ISSUE 1 ( January-June, 2021 ) > List of Articles

CASE REPORT

Cranial Electrotherapy Stimulation in Patients Suffering from Medically Unexplained Somatic Symptoms: A Case Series

Sagar Karia, Shorouq Motwani, Krishnapriya Murlimanohar, Avinash De Sousa, Nilesh Shah

Keywords : CES, Cranial electrotherapy stimulation, Medically unexplained somatic symptoms, Pain

Citation Information : Karia S, Motwani S, Murlimanohar K, De Sousa A, Shah N. Cranial Electrotherapy Stimulation in Patients Suffering from Medically Unexplained Somatic Symptoms: A Case Series. Ind J Priv Psychiatry 2021; 15 (1):42-44.

DOI: 10.5005/jp-journals-10067-0069

License: CC BY-NC 4.0

Published Online: 14-10-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Patients with medically unexplained somatic symptoms (MUSS) are encountered commonly in clinical practice. These symptoms are often difficult to treat and do not respond well to medication. There have been some studies demonstrating the efficacy of cranial electrotherapy stimulation (CES) in the management of somatic symptoms. Most studies on CES are for the management of anxiety and there is a dearth of literature with regard to the use of CES in MUSS. This case series is aimed at demonstrating the efficacy of CES in the management of MUSS. Methods: This case series consisted of patients with MUSS that presented to the psychiatry outpatient department of a tertiary general hospital. Patients with MUSS with no other medical cause and not relieved with available medications were included in the case series. Patients were administered CES daily for 10–20 sessions with each session lasting 30 minutes. The efficacy was evaluated by applying Somatic Symptom Scale-8(SSS-8)and the results of all cases were analyzed. Results: Thirty-five patients (26 females and 9 males) between the ages 18–66 years were part of the case series. Majority of them had a diagnosis of major depressive disorder. There was statistically significant improvement in somatic symptoms after CES sessions in majority of the patients at the end of day 20 (29 of 35 patients). Conclusions: CES is a safe treatment option for MUSS, and further studies in larger samples to establish its efficacy is warranted.


PDF Share
  1. Kirsch DL, Smith RB. The use of cranial electrotherapy stimulation in the management of chronic pain: a review. Neurorehabilitation 2000;14(2):85–94. DOI: 10.3233/NRE-2000-14204.
  2. Lichtbroun AS, Raicer MM, Smith RB. The treatment of fibromyalgia with cranial electrotherapy stimulation. J Clin Rheumatol 2001;7(2): 72–78. DOI: 10.1097/00124743-200104000-00003.
  3. Schroeder MJ, Barr RE. Quantitative analysis of the electroencephalogram during cranial electrotherapy stimulation. Clin Neurophysiol 2001;112(11):2075–2083. DOI: 10.1016/s1388-2457(01)00657-5.
  4. Shealy CN, Thomlinson P. Safe effective nondrug treatment of chronic depression: a review of research on low-voltage cranial electrical stimulation and other adjunctive therapies. Complement Health Pract Rev 2008;13(2):92–99. DOI: 10.1177/1533210108317232.
  5. Sharpe M, Carson A. “Unexplained” somatic symptoms, functional syndromes, and somatization: do we need a paradigm shift? Ann Intern Med 2001;134(9):926–930. DOI: 10.7326/0003-4819-134-9_part_2-200105011-00018.
  6. Kar SK, Sarkar S. Neuro-stimulation techniques for the management of anxiety disorders: an update. Clin Psychopharmacol Neurosci 2016;14(4):330–337. DOI: 10.9758/cpn.2016.14.4.330.
  7. American Psychiatric Association. DSM 5. Arlington, VA: American Psychiatric Publishing; 2013. p. 70.
  8. Available from: https://www.indiamart.com/proddetail/ces-stress-relive-device-20518718297.html.
  9. Gierk B, Kohlmann S, Kroenke K, et al. The somatic symptom scale–8 (SSS-8): a brief measure of somatic symptom burden. JAMA Intern Med 2014;174(3):399–407. DOI: 10.1001/jamainternmed.2013. 12179.
  10. Toussaint A, Kroenke K, Baye F, et al. Comparing the Patient Health Questionnaire–15 and the Somatic Symptom Scale–8 as measures of somatic symptom burden. J Psychosom Res 2017;101:44–50. DOI: 10.1016/j.jpsychores.2017.08.002.
  11. Gierk B, Kohlmann S, Toussaint A, et al. Assessing somatic symptom burden: a psychometric comparison of the patient health questionnaire—15 (phq-15) and the somatic symptom scale—8 (SSS-8). J Psychosom Res 2015;78(4):352–355. DOI: 10.1016/j.jpsychores.2014.11.006.
  12. Taylor DN, Lee CT, Katims JJ. Effects of cranial transcutaneous electrical nerve stimulation in normal subjects at rest and during psychological stress. Acupunct Electrotherapeut Res 1991;16(1–2): 65–74. DOI: 10.3727/036012991816358080.
  13. Kirsch DL, Nichols F. Cranial electrotherapy stimulation for treatment of anxiety, depression, and insomnia. Psychiatric Clinics. 2013 Mar 1;36(1):169-176. DOI: 10.1016/j.psc.2013.01.006.
  14. Brunyé TT, Patterson JE, Wooten T, Hussey EK. A critical review of cranial electrotherapy stimulation for neuromodulation in clinical and non-clinical samples. Front Human Neurosci 2021;15:12. DOI: 10.3389/fnhum.2021.625321.
  15. Barclay TH, Barclay RD. A clinical trial of cranial electrotherapy stimulation for anxiety and comorbid depression. J Affect Disord 2014;164:171–177. DOI: 10.1016/j.jad.2014.04.029.
  16. Gordeev SA. Cognitive functions and the state of nonspecific brain systems in panic disorders. Neurosci Behav Physiol 2008;38(7):707–714. DOI: 10.1007/s11055-008-9036-z.
  17. olde Hartman TC, Lucassen PL, van de Lisdonk EH, Bor HH, van Weel C. Chronic functional somatic symptoms: a single syndrome?. British Journal of General Practice. 2004 Dec 1;54(509):922-927. PMID: 15588538.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.