A study recently published in PLoS Medicine suggests a surprising new treatment for even severe depression — acupuncture. Yes, acupuncture.
In this randomized U.K. clinical trial, primary care subjects who received a protocol of acupuncture did even better than those who received a form of humanistic counseling for the treatment of depression.
So if all else has failed for depression, should you give acupuncture a go?
The new study (MacPherson et al. 2013) examined 755 depressed patients in the U.K. who visited their primary care physician and scored high on a depression measure. They were then divided into three treatment groups — acupuncture treatment, humanistic counseling, or usual care. The outcome measure was the Patient Health Questionnaire (PHQ-9) scores at 3 months with secondary analyses over 12 months follow-up. At 3 months, 614 patients were measured, and at 12 months, 572 patients were measured. The majority of patients, nearly 69 percent, were taking antidepressant medications at the start of the study.
At the 3-month time period, 33 percent of those who underwent acupuncture improved more than 50 percent on their depression score, compared to 29 percent of the humanistic counseling group. This was not a statistically significant different, demonstrating, in effect, that these two groups were largely the same.
However, since the researchers also continued measuring depression further out — at 9 and 12 months — they found something else, too. The usual care group “catches up” with the two other treatment groups, so that all interventions look about the same:
The scores in the usual care group continued to reduce over time, such that differences were no longer statistically significant at 9 and 12 months. There was no evidence of significant differences between acupuncture and counselling throughout.
This reinforces the fact that time itself helps “treat” many mental health concerns, including depression.
The only problem I have with this study — not described in the limitations section of the research — is that humanistic counseling isn’t known as a robust, well-proven treatment method for clinical depression. There simply isn’t a lot of supporting research for this particular form of talk therapy, as compared to cognitive-behavioral approaches.
Counseling is typically humanistic, following the teachings of Carl Rogers. The researchers describe it as “a “talking therapy” that provides patients with a safe, non-judgmental place to express feelings and emotions and that helps them recognize their capacity for growth and fulfillment.”
The researchers do not offer a whole lot of rationale for choosing humanistic counseling, which is more popularly practiced in the U.K., over CBT:
A widely used intervention for patients with depression is counselling, which is provided in approximately half of the 9,000 primary care practices in England. Most counsellors provide a humanistic style of counselling. Recent National Institute for Health and Care Excellence (NICE) guidance is equivocal in recommending counselling for mild to moderate depression, identifying uncertainty regarding its effectiveness.
So the researchers acknowledge up-front that this form of counseling they’ve chosen isn’t even reliably recommended for “mild to moderate” depression — with but they’re actually going to compare using it on subjects with “moderate-to-severe” depression.1
What they’ve demonstrated is that there is a significant difference between usual care from your primary care physician and one of these two types of intervention — either acupuncture or counseling. Something in addition to taking antidepressants seems to make you feel better and resolve depression symptoms faster than nothing at all. But after 9 and 12 months… all groups looked the same. So if you want to feel better, faster, you might try acupuncture for depression (but it may not be any cheaper than seeing a therapist).2
After 12 months, 56.5 percent of the subjects were still taking antidepressants, down just over 12 percent from the start. Which is probably a more telling statistic than anything else the researchers found.
Read our news article about the study: Acupuncture Works Just as Well as Counseling for Depression
MacPherson, H. et al. (2013). Acupuncture and Counselling for Depression in Primary Care: A Randomised Controlled Trial. PLoS Medicine.
National Collaborating Centre for Mental Health (2010) The NICE guideline on the treatment and management of depression in adults: 1–707. Available: http://www.nice.org.uk/nicemedia/live/12329/45896/45896.pdf (PDF).
- In fact, the NICE guidelines are pretty clear: “Overall the evidence for counselling [in the treatment of depression] is very limited.” And in reading the NICE document (2010), they actually found very little support for counseling as a treatment intervention, especially when you look at how patients are doing at the 6- or 12-month mark. [↩]
- Depending on where you live, acupuncture may or may not be cheaper than counseling or therapy. But unlike psychotherapy, most insurance companies won’t cover your acupuncture treatments. [↩]