• Roth L
• Zelman D
• Clum L
• Roth J

• Adult
• Affiliation / Alliant International University
• Affiliation / Private Practice of Chiropractic
• Affiliation(G) / China / Hong Kong
• Affiliation(G) / United States / California / Oakland
• Affiliation(G) / United States / California / San Francisco
• Affiliation(G) / United States / Connecticut / Kensington
• Anxiety
• Depression
• Upper Cervical Techniques

Objective: To evaluate a 12-session upper cervical chiropractic intervention for individuals presenting with anxiety and depression symptoms.

Methods: This is a prospective case study of 6 adults with (1) at least mild to moderate anxiety and/or depression symptoms based on pre-treatment interview and scores on the Generalized Anxiety Disorder–7 (GAD-7) and Patient History Questionnaire–9 (PHQ-9), and (2) the presence of upper cervical subluxation. Participants received care as usual at the community practice of a board-certified chiropractor with extensive post-graduate training in upper cervical specific chiropractic who was blind to patient psychological data. Participants completed the Symptom Checklist-90-Revised (SCL-90-R) pre- and post-treatment, and completed anxiety and depression measures weekly throughout treatment. A numeric chiropractic care outcome measure tracked stability and effectiveness of weekly chiropractic visits. A post-treatment interview conducted by a psychology researcher evaluated subjective effectiveness and effects on other domains (e.g. pain). Repeated measures and paired ANOVAs evaluated change on the psychological measures.

Results: Five of six patients completed all 12 recommended chiropractic visits. Repeated measures ANOVA detected significant decreases in both GAD-7 and PHQ-9 scores across treatment (p<.01). The SCL-90-R General Symptoms Index significantly decreased from pre- to post-treatment (p<.05). Four of five study completers expressed satisfaction with the outcome and that they would recommend similar care to others with anxiety or depression. Participants also reported decrease in muscle tension and pain and increase in mental clarity and physical energy.

Conclusion: The results provide tentative support for the effectiveness of upper cervical chiropractic care for anxiety and depression symptoms. Limitations of the study are discussed. Follow-up research should use randomized controlled blinded designs with samples of sufficient size to evaluate the relationship between the extent of upper cervical subluxation, the extent of resolution of psychological concerns and the extent of change in any concurrent physical concerns (e.g., pain).

Author keywords: Chiropractic, upper cervical chiropractic, subluxation, mental health, spinal manipulation, spinal adjustment, complementary care, depression, anxiety

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