Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jan 19, 2022; 12(1): 169-186
Published online Jan 19, 2022. doi: 10.5498/wjp.v12.i1.169
Impacts of acupressure treatment on depression: A systematic review and meta-analysis
Jingxia Lin, Tianhao Chen, Jiali He, Raymond CK Chung, Haixia Ma, HWH Tsang
Jingxia Lin, Tianhao Chen, Jiali He, Raymond CK Chung, Haixia Ma, HWH Tsang, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 00852, China
Jingxia Lin, HWH Tsang, Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong 00852, China
Author contributions: Lin J acquisition of data, analysis and interpretation of data, drafting the article, final approval; Chen T acquisition of data, analysis of data, drafting the results, final approval; He J acquisition of data, quality and risk of bias assessment, drafting the introduction, final approval; Chung RC analysis and interpretation of data, final approval; Ma H results interpretation and critical revision; Tsang H conception and design of the study, critical revision, final approval.
Conflict-of-interest statement: All the authors have no conflict-of-interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: HWH Tsang, PhD, Chair Professor, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong 00852, China.
Received: April 27, 2021
Peer-review started: April 27, 2021
First decision: June 17, 2021
Revised: July 18, 2021
Accepted: November 26, 2021
Article in press: November 26, 2021
Published online: January 19, 2022
Research background

Originated from traditional Chinese medicine (TCM), acupressure is a safe and cost-effective complementary treatment for depression.

Research motivation

An increase body of research has been undertaken to assess effectiveness of acupressure in depression, but the evidence thus far is inconclusive.

Research objectives

Via the systematic review and meta-analysis, we compared clinical data using acupressure and controls with usual care or sham treatment.

Research methods

The databases PubMed, PsycINFO, Scopus, Embase, MEDLINE, and China National Knowledge (CNKI) were searched. Randomized clinical trials (RCTs) or single-group trials in which acupressure was compared with control methods or baseline in people with depressive symptoms were included. The primary outcomes were the change between pre- and post-treatment in depression measures. Data were synthesized using a random-effects or a fixed-effects model to analyze the impacts of acupressure treatment on depression and anxiety in people with depression.

Research results

A total of 14 RCTs (1439 participants) were identified. Analysis of the between-group showed that acupressure was effective in reducing depression (SMD = -0.58, 95%CI: -0.85 to -0.32, P < 0.0001) and anxiety (SMD = -0.67, 95%CI: -0.99 to -0.36, P < 0.0001) in clinical patients with depressive symptoms. The evidence of acupressure for mild-to-moderate depressive symptoms in patients with chronic diseases was significant. The evidence of certainty in moderate-to-severe primary depression was low. No severe adverse events were reported.

Research conclusions

This present review indicated acupressure to be safe and exert certain positive effects in people with mild-to-moderate depressive symptoms. Importantly, the findings should be interpreted with caution due to study limitaitons, including heterogeneity of participants, treatment frequency and duration, the selected acupoints, and sample size.

Research perspectives

Future research with a well-designed mixed method is required to provide stronger evidence for clinical decisions and recommendations for its application, as well as an in-depth understanding of acupressure mechanisms and symptoms domains in depression.