Tag Archives: Depression

Acupuncture and depression, mental health

by Helen Smallwood, acupuncturist, Shaftesbury Clinic

This blog post will concentrate on the use and research regarding acupuncture and mental health, and with a particular focus on depression.

Acupuncture is known by many as being holistic, which means it looks at the workings of the body and the mind overall in an integrated way, as opposed to seeing them as separate entities. Some people are surprised when I tell them acupuncture can be very beneficial for mental health as their first impression is that acupuncture is a very physical therapy and they are mainly associating it with its uses for pain and injuries.

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Helen
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Depression – Condition Resources

Important to know: Chronic health conditions should be addressed under direct medical supervision of your GP or consultant, and acupuncture would be an adjunct or complement to usual care – we advise that you let you doctor know when you use this approach.

About the research: It is worth noting that in research, randomised controlled studies (RCT) are the most reliable in terms of quality of evidence, with a systematic review or meta analysis of numerous studies being the best way of seeing the overall picture of the state of the evidence. Below we have a selection of the available research, which does include some larger RCTs, and reviews of the literature alongside smaller studies. The n= figure tells you how many people were participants in the study.

A large UK RCT into depression (MacPherson et al, 2013; n=755) compared patients under GP care for depression in three groups, i acupuncture, ii counselling or iii usual care alone. Compared to usual care, there was a statistically significant reduction in mean depression scores (ad measured by the PHQ-9) at 3 months for both the acupuncture and the counselling groups, meaning acupuncture significantly reduced depression, this as much as did counselling. Some of the same researchers in the 2013 team (Hopton et al, 2014) also looked at the outcomes of the above study in secondary analysis of depression where there is also comorbid (concurrent) pain, published in the BMJ, where they found reductions in both pain and depression highest in the acupuncture group.

Acupuncture was also found cost effective in depression (Spackman et al, 2014) as measured in QALY (an NHS measurement of quality adjusted life years gained by a treatment) in comparison to usual care alone and was also less costly per gain in QALY compared to counselling.

A Cochrane systematic review of trials regarding acupuncture in depression (Smith et al, 2018) looked at 64 studies; n=7104 in total, found tentative evidence for reduction of the severity of depression, they were reserved in their findings by the quality of some of the evidence as regards the design of some of the trials, and the researchers called for further high quality studies.

A systematic review and meta-analysis of 18 RCTS (Dong et al, 2017) looked at depression related insomnia and acupuncture was promising for this as an approach.

Other studies have looked at depression secondary to other conditions, for example stroke where a large Cochrane systematic review of trials looked at 31 trials (n=2257 in total) (Yang et al, 2016), again, there were methodological issues with many of the included papers, but the area shows promise.

References:

Dong, B., Chen, Z., Yin, X., Li, D., Ma, J., Yin, P., Cao, Y., Lao, L. and Xu, S., 2017. The efficacy of acupuncture for treating depression-related insomnia compared with a control group: a systematic review and meta-analysis. BioMed research international2017.

Hopton, A., MacPherson, H., Keding, A. and Morley, S., 2014. Acupuncture, counselling or usual care for depression and comorbid pain: secondary analysis of a randomised controlled trial. BMJ open4(5).

MacPherson, H., Richmond, S., Bland, M., Brealey, S., Gabe, R., Hopton, A., Keding, A., Lansdown, H., Perren, S., Sculpher, M. and Spackman, E., 2013. Acupuncture and counselling for depression in primary care: a randomised controlled trial. PLoS Med10(9), p.e1001518.

Smith, C.A., Armour, M., Lee, M.S., Wang, L.Q. and Hay, P.J., 2018. Acupuncture for depression. Cochrane database of systematic reviews, (3).

Spackman, E., Richmond, S., Sculpher, M., Bland, M., Brealey, S., Gabe, R., Hopton, A., Keding, A., Lansdown, H., Perren, S. and Torgerson, D., 2014. Cost-effectiveness analysis of acupuncture, counselling and usual care in treating patients with depression: the results of the ACUDep trial. PloS one9(11), p.e113726.

Yang, A., Wu, H.M., Tang, J.L., Xu, L., Yang, M. and Liu, G.J., 2016. Acupuncture for stroke rehabilitation. Cochrane Database of Systematic Reviews, (8).

Resources:

British Acupuncture Council Research Digest – Mental Health Depression section (toward the base of the document

British Acupuncture Council evidence based factsheet about Depression including specific research, trials and mechanisms of action for acupuncture in this condition.

Helen
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