Clinical practice guidelines for using acupuncture to treat depression

Abstract

A clinical practice guideline of acupuncture for depression was compiled according to the grading of recommendations assessment, development and evaluation (GRADE) method, including the clinical characteristics, diagnosis, treatment and other information about depression, while several acupuncture treatments of depression, severe depression, depression after stroke were recommended.

Complementary and alternative medicine recommendations for depression: a systematic review and assessment of clinical practice guidelines

“…Searches retrieved 1043 total items, 931 were unique, and 863 titles and abstracts were eliminated, leaving 68 full-text guidelines that were considered. Of those, 49 were not eligible, because they were not clinical practice guidelines (n = 16), they were not focused on depression (n = 1), they addressed depression associated with another condition or disease (n = 5), there was a more recent version of the guideline available (n = 4), they were not in English (n = 9), they were published prior to the eligible timeframe (n = 5), they did not focus on the target population (n = 7), they were not treatment focused (n = 1), or they were withdrawn/invalid guidelines (n = 1), leaving 19 guidelines eligible for review [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70].…”

“…Eligible guidelines were published from 2008 to 2018 in the USA (n = 5), Canada (n = 4), Germany (n = 3), the UK (n = 2), Australia (n = 1), China (n = 1), Poland (n = 1), Scotland (n = 1), and Spain (n = 1) [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70]. The guidelines were funded and/or developed by professional associations or societies (n = 5), academic institutions (n = 2), international organizations (n = 2), specialty/expert groups (n = 7), a combination of a specialty/expert body and a government agency (n = 1), a combination of a specialty/expert group and an international organization (n = 1), and a specialty/expert group and an academic body (n = 1).…”

“…The guidelines were funded and/or developed by professional associations or societies (n = 5), academic institutions (n = 2), international organizations (n = 2), specialty/expert groups (n = 7), a combination of a specialty/expert body and a government agency (n = 1), a combination of a specialty/expert group and an international organization (n = 1), and a specialty/expert group and an academic body (n = 1). CAM recommendations were made in 16 guidelines [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67] and included the following therapies: St. John's Wort (Hypercium perforatum) (n = 9), SAMe (S-adenosyl-L-methionine) (n = 4), exercise/physical activity (n = 12), yoga (n = 1), acupuncture (n = 3), specialized forms of acupuncture including electro-acupuncture, scalp acupuncture, filiform needle acupuncture, body acupuncture involving regulating mind and soothing the 'Gan', scalp electro-acupuncture (n = 1), ear (pressure) therapy/ pressing of ear points with herbal seeds (n = 1), relaxation training/therapy (n = 1), (bright) light therapy (n = 5), (guided) self-help/self-management (n = 5), bibliotherapy (n = 3), mindfulness based therapy/mindfulness based cognitive therapy (MBT/MCBT) (n = 6), acceptance and commitment therapy (ACT) (n = 2), sleep deprivation/wake therapy (n = 2), saffron (Crocus sativus) (n = 1), omega-3/ polyunsaturated fatty acids (n = 4), vitamin D (n = 1), folate/L-methylfolate (n = 3), inositol (n = 1), dehydroepiandrosterone (DHEA) (n = 1), tryptophan (n = 1), acetyl-Lcarnitine (ALC) (n = 1), lavender (Lavendula) (n = 1), and rose root (Rhodiola rosea) (n = 1). The aforementioned characteristics of these 16 guidelines are described in Table 1 and a summary of the CAM recommendations in these eligible guidelines are presented in Fig.…”

“…Most guidelines described the guideline development group members well; two guidelines fulfilled all of the criteria including the names, affiliations, expertise and geographical locations of the development members [52,55], while the remaining were missing at least one of the criteria [53,54,[56][57][58][59][60][61][62][63][64][65][66][67]. A few guidelines included CAM experts; some provided the same level of description for CAM experts as the other members [54-56, 58, 63, 66], and one guideline had CAM experts listed as some of the consulted stakeholders, with unclear involvement and little to no description [65].…”

“…None of the guidelines explicitly had CAM experts involved in an external review process, except for one [66]. Most guidelines provided a statement that the guideline will be updated [55,57,58,61,62,[64][65][66], with one outlining a detailed methodology for the updating procedure. The CAM scores were the same as the overall scores for the updating procedure.…”