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Intervention Review

Acupuncture for depression

  1. Caroline A Smith1,*,
  2. Phillipa PJ Hay2

Editorial Group: Cochrane Depression, Anxiety and Neurosis Group

Published Online: 19 JUL 2004

Assessed as up-to-date: 16 MAR 2004

DOI: 10.1002/14651858.CD004046.pub2

How to Cite

Smith CA, Hay PPJ. Acupuncture for depression. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD004046. DOI: 10.1002/14651858.CD004046.pub2.

Author Information

  1. 1

    The University of Western Sydney, Centre for Complementary Medicine Research, Penrith South DC, New South Wales, Australia

  2. 2

    Building 3 , Mental Health School of Medicine , Penrith South, New South Wales, Australia

*Caroline A Smith, Centre for Complementary Medicine Research, The University of Western Sydney, Locked Bag 1797, Penrith South DC, New South Wales, 1797, Australia. caroline.smith@uws.edu.au.

Publication History

  1. Publication Status: Unchanged
  2. Published Online: 19 JUL 2004

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

Background

There is interest from the community in the use of self help and complementary therapies for depression. This review examined the currently available evidence supporting the use of acupuncture to treat depression.

Objectives

To examine the efficacy and adverse effects of acupuncture for depression.

Search strategy

The following databases were searched: Cochrane Central Register of Controlled Trials (CENTRAL) MEDLINE (1966 to Sept 2003) EMBASE (1980 to Sept 2003) PSYCINFO (1874 to Sept 2003) the Database of Abstracts of Reviews of Effectiveness (DARE) CISCOM, CINAHL (January 1980 to Sept 2003). The following terms were used: depression, depressive disorder, dysthymic disorder and acupuncture.

Selection criteria

Inclusion criteria included all published and unpublished randomised controlled trials comparing acupuncture with sham acupuncture, no treatment, pharmacological treatment, other structured psychotherapies (cognitive behavioural therapy, psychotherapy or counselling), or standard care. The following modes of treatment were included: acupuncture, electro acupuncture or laser acupuncture. The subjects included adult men and women with depression defined by clinical state description, or diagnosed by the Diagnostic and Statistical Manual (DSM-IV), Research Diagnostic Criteria (RDC), or the International Classification of Disease (ICD).

Data collection and analysis

Meta analysis was performed using relative risk for dichotomous outcomes and weighted mean differences for continuous outcomes, with 95% confidence intervals. Primary outcomes were reduction in the severity of depression, measured by self rating scales, or by clinician rated scales; and an improvement in depression defined as remission vs no remission.

Main results

Seven trials comprising 517 subjects met the inclusion criteria. Five trials (409 subjects) included a comparison between acupuncture and medication. Two other trials compared acupuncture with a wait list control or sham acupuncture. Subjects generally had mild to moderate depression. There was no evidence that medication was better than acupuncture in reducing the severity of depression (WMD 0.53, 95%CI -1.42 to 2.47), or in improving depression, defined as remission versus no remission (RR1.2, 95%CI 0.94 to 1.51).

Authors' conclusions

There is insufficient evidence to determine the efficacy of acupuncture compared to medication, or to wait list control or sham acupuncture, in the management of depression. Scientific study design was poor and the number of people studied was small.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Acupuncture for depression

In clinical depression people often report a lack of interest in life and normally enjoyed activities, accompanied by other symptoms including weight loss/over-eating, feelings of uselessness, sleep disturbance, self neglect and social withdrawal, insomnia/hypersomnia, loss of energy, low self esteem and poor concentration. Depression is widely experienced in our communities. There are studies indicating a preference for treatment with self-help and complementary therapies for depression. This review examined the efficacy and adverse effects of acupuncture in treating depression. Based on the findings from seven trials of low quality, there is insufficient evidence to determine whether acupuncture is effective in the management of depression.