Effects of semipermanent needle and low-level laser auricular acupuncture for emotional disorders in undergraduate students postcovid-19: multicentric randomized clinical trial

Undergraduate students are at risk for developing emotional disorders, which have exacerbated during the coronavirus disease 2019 (COVID-19) pandemic. Auricular acupuncture is a complementary and integrative therapy that may help manage these conditions. This study aimed to compare the effects of semipermanent needle acupuncture and low-level laser auricular acupuncture for the treatment of emotional disorders in undergraduate students post-COVID-19. This was an open-label, multicenter, randomized, parallel-group, superiority clinical trial. Following the CONSORT statement recommendations, 397 participants were randomized to either the semipermanent needle auricular acupuncture group or the low-level laser auricular acupuncture group. Data were collected at three time points: before the first session (baseline), after the last session (final), and seven days after the end of the treatment (follow-up). The Perceived Stress Scale, Hospital Anxiety and Depression Scale, digital algometer, glucometer, and salivary α-amylase biosensor were used for data collection. Generalized estimating equation models were applied to examine the associations between interventions and outcomes. Semipermanent needle auricular acupuncture was more effective than low-level laser auricular acupuncture in reducing stress levels. Both groups showed significant reductions in anxiety, depression, and stress levels over time. Furthermore, the semipermanent needle auricular group showed an increased pressure pain threshold in the trapezius muscle between baseline and follow-up, while the low-level laser auricular acupuncture group presented a reduction in stress-related capillary glucose between baseline and the final assessment. Regarding safety, low-level laser auricular acupuncture group was associated with fewer and milder adverse reactions. Symptoms of stress, anxiety, and depression improved over time in both groups, with semipermanent needles showing a greater reduction in stress levels compared to laser. Both modalities demonstrated comparable clinical performance and high participant satisfaction. Low-level laser acupuncture presented a superior safety profile with fewer and milder adverse reactions. RBR-8cxnvr2 (Brazilian Registry of Clinical Trials – ReBEC))/ UTN: U1111-1284-7974. • Both needle and laser auricular acupuncture reduced anxiety and depression symptoms. • No significant differences were found between the two auricular modalities. • Semipermanent needle was more effective than laser in reducing stress. • The low-level laser group experienced fewer and milder adverse reactions.