This threefold presentation addresses the link between Qigong and mental health based on both the philosophy of Qigong and empirical research evidence. First, the relation of Qigong to mental health was embraced in the dialectical philosophy underlying the traditional Chinese medicine. This Daoist worldview expresses the ideas of health and life in a holistic and dynamic perspective, described in a set of energy- and/or function-oriented system theories with a nature of mind-body interaction. Its spirit was rooted in the ancient Yi-Jing/I-Ching (The Book of Changes), which represents the origin of an intellectual tradition ontologically different from its Western counterpart. In ancient Greece, Aristotelian philosophy described the world in a systematic structure, complemented by Democritus' pioneering thoughts on atoms, seen as the basic material substance. In contrast, Yi-Jing viewed the dynamic aspect of nature as full of changing patterns, driven by polar movements, regardless of their constant, substantive aspects. Following these changing principles, the Five-Element and Yin-Yang theories serve as a parsimonious coding system for registering the complex movement of energy and as the foundation of Qigong diagnosis and intervention. Second, this holistic view of health implies that clinical evaluation of Qigong should not completely follow that for the disease-specific model in allopathic medicine but encompass the evaluation of mental health/functioning in trials on given diseases. Studies on Qigong and mental health or psychological traits outside and within the U.S. are described and critiqued concerning their research designs and methodological limitations. Finally, because the goal of clinical evaluation is to assess efficacy, risk, and cost-effectiveness of any treatment, the potential side effect on mental health (e.g., 'Qigong Deviation,' as termed in China, or 'Qigong Psychotic Reaction,' as termed in the U.S.) of inappropriate practice is discussed, along with the scientific investigation of this undesirable reaction at the Department of Psychiatry, Shanghai Medical University. According to other studies, this potential adverse effect could be a phenomenon across various energy practices with different manifestations, and thus deserves attention in terms of ethics in research design and informed consent. In closing, clinical evaluation of Qigong, a treatment modality that is not solely materialistically-based, challenges both the philosophy of allopathic medicine and research methodology. Based on this discussion and the ethic principle of conducting clinical evaluation, suggestions are provided concerning assessment, protocol design, risk prevention and treatment, and consent form to improve the quality of research design on energy healing.
