Using acupuncture to treat major depressive disorder: a pilot investigation

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Abstract

Context: Depression is one of the most common and painful forms of mental suffering. Treatment with acupuncture may help to alleviate, transform and perhaps eliminate symptomology.

Objective: To determine if acupuncture’s extraordinary vessels are effective in treating major depressive disorder.

Design: Observational, mixed-method, pilot study.

Setting: Participants were recruited through a newspaper advertisements and prescreened for Major Depressive Disorder.

Participants: Ten men and women (34–66 years of age), screened for Major Depressive Disorder, were treated with acupuncture.

Interventions: Acupuncture’s extraordinary vessels – treatment involved four weeks of twice weekly acupuncture treatments followed by four weeks of once weekly treatments.

Main Outcome Measures: Structured Clinical Interview for DSM-IV (SCID). Beck and Reynolds Depression Inventories.

Results: Those who completed the treatments showed significant improvement on both the Beck and Reynolds Depression Inventories and on retakes of the SCID suggesting that acupuncture can provide significant relief from depression in both men and women.

Introduction

Depression is a common and potentially disabling disorder that is characterized by chronicity and recurrence.1 Though figures vary, it is estimated that between 10% and 20% of the population will experience a major depressive episode sometime during their adult lifetime.2 Until recently, depression was treated almost exclusively with medication, some form of traditional psychotherapy or a combination of the two. The development of new therapies, including those considered unconventional, have permitted sufferers of depression to explore new avenues for treatment and relief. According to Eisenberg et al.,[3], [4] the use of unconventional therapies, including those that can impact depression are widespread. The use of acupuncture to ameliorate depressive symptomology has grown in recent years and has begun to be studied in controlled settings.[5], [6] Among categories of interest that speak to the increasing popularity of complementary and alternative medicine exist issues regarding a quality of life.7 In view of the fact that depression can have such an enormous impact on quality of life, it behooves researchers to investigate the degree of that impact from the perspective of the person experiencing the depression. It is also relevant that components of what is labeled unconventional treatment be explored through responsible and appropriate methods.8

Historically, depression as a disease entity and psychology as a field of study have not existed in Chinese medicine. Chinese medical philosophy does not separate the soma and non-soma (body and mind) in a way that required a separate discussion of the psyche. It has instead, historically observed and routinely outlined, a sophisticated and detailed accounting of soma/non-soma co-occurrences or interactions. Inherent in all Chinese medical discussions are two constructs relative to the soma/non-soma. The first addresses somatic aspects of what are primarily non-somatic (psychological) illnesses and the second speaks to non-somatic (psychological) aspects of what are primarily somatic illnesses. These constructs serve to clarify the classical Chinese understanding of the central indivisible wholeness of the human experience and speak to the methods for gathering information about that understanding.

Modern Chinese medical practitioners are able to understand and approach psychiatric disease classifications such as Major Depressive Episodes in ways the ancient Chinese had neither the opportunity nor inclination to do themselves. Many of these practitioners of Chinese medicine have developed new models from the existing principles, creating differential diagnostic techniques used to define, describe and treat psychological issues and depression within the context of the selected model.

The purpose of this pilot investigation was to assess the utility of acupuncture’s extraordinary vessels in treating participants with major depression. The mixed method design emphasized both quantitative and qualitative methods of inquiry that focused on the perceptions of the investigation’s various stakeholders. Three research questions guided the process of understanding the nature of participants’ depression and the role played by the acupuncture treatments in transforming symptomology. They are: (1) what is the impact of acupuncture’s extraordinary vessel treatments on participants who have been diagnosed with a major depressive episode; (2) what are the pre- and post-understandings of participants who receive extraordinary vessel treatments for a prescribed period of time; and (3) what are appropriate methods of diagnosis and treatment using acupuncture’s extraordinary vessels for participants who have been diagnosed with a major depressive episode.

Additionally, a Clinical Reference Manual (CRM)9 designed for future use by acupuncturists trained in the methods of treatment used in this study was assessed for its effectiveness in addressing participant concerns, its correspondence to the production of significantly effective treatments and its general utility. The manual emphasized three components: (1) theory: providing a theoretical framework for sections that follow; (2) diagnostics: including intake and exam, analysis, and methods for establishing a treatment plan; and (3) it therapeutics and treatment principles: discussing master and couple points, and topical treatments.

Section snippets

Methods

The research questions were investigated through the administration of 12 acupuncture treatments based on the extraordinary vessels to 10 participants over an eight week period. To best replicate a private clinical practice, each participant was assessed at each visit, using the four methods of Chinese medicine which include observation, audio-olfaction, inquiry, and palpation.10 Information gathered through the four methods permitted a specific differential diagnosis leading to a specific

Data analysis

Data analysis revealed that study participants experienced changes in mood state, as recorded through quantitative measurements including the Beck and Reynolds Inventories for depression and the Structured Clinical Interview for DSM-IV (SCID). Data gathered during interview sessions, and related to the three stated research questions, uncovered significant information relative to participant quality of life; participant understandings of self, the healing process including interactions with

Results and conclusions

Ten participants (eight female and two male) received 12 treatments over an eight-week period. Two female participants did not complete the treatment cycle. Following the series of treatments designed specifically to treat depression, 100% of the participants (n=8) experienced a full remission. Results from this pilot investigation suggest that a reduction in symptomology is possible using acupuncture, particularly, acupuncture’s extraordinary vessels. A larger scale investigation may reveal a

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