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Rosa N. Schnyer, John J. B. Allen PhD, Sabrina K. Hitt PhD, Rachel Manber PhD, Ted J. Kaptchuck OMD, Michael E. Thase MD, John Allen

"Acupuncture in the Treatment of Depression: A Manual for Practice and Research"

A 1998 study at University of Arizona into the treatment of depression in 33 women by acupuncture was fairly widely reported in the acupuncture profession and elsewhere. The study found that 64% of the women experienced full remission of depression following depression-specific acupuncture treatment, appearing to show that acupuncture can provide significant symptom relief at rates comparable to standard treatments such as psychotherapy or pharmacotherapy.

This textbook by the authors of the study is subtitled A Manual for Practice and Research and indeed can almost be seen as two books in one. As a clinical manual for the treatment of depression it has a very great deal to offer practitioners, with detailed discussion of both western and Chinese medicine approaches. As far as the former is concerned, there are sections on the definition of major depression, description of conventional treatments for depression and their efficacy, and theories on the causation of depression (psychological and biological). The larger part of the book however is occupied with the Chinese medicine approach. Apart from fairly short sections offering a presentation of basic theories, most of it is aimed at a level that will inform students and practitioners: disease causes (including the six depressions and six stagnations, and yin fire), depression and the life cycle (adolescence, the menstrual cycle, menopause, pregnancy, postpartum and ageing), analysis of the main presenting patterns, treatment strategies and techniques etc., and three case studies. Much of this is offered in impressive detail and is accompanied by further useful discussion of the patient-practitioner relationship, assessing the risk of suicide in depressed patients, and when physician referral might be necessary.

As far as the research aspect is concerned, the authors discuss various study designs and describe their own study and its protocols and results. This part will be of value to anyone contemplating acupuncture research.

The two main facets of the book sit together reasonably comfortably, although the need for standardised treatment that informed their research project does seep into the clinical sections, and criteria such as limiting point selection to the list offered in the book, using only 7 body points and 3 auricular points per treatment, or only using front-mu points for the first seven weeks, should not determine how practitioners approach the treatment of depression outside this specific research setting.

I have minor queries concerning one or two passages on point selection and treatment approaches. For example the Chong mai (Penetrating vessel) is described as connecting the Liver with the Pericardium, and yet again the outer Bladder channel points Pohu BL-42, Shentang BL-44, Hunmen BL-47, Yishe BL-49 and Zhishi BL-52 are emphasised as important in the treatment of mental and emotional disorders. As far as the Chong mai is concerned I have never heard of this connection. As for the Bladder channel points, I am mainly curious where this by now well established tradition comes from. There does not seem to have been such an understanding of these points in classical Chinese acupuncture, and whether it comes from some other classical acupuncture tradition, or has developed more recently from a fascination with their names, is something I have often wondered about.

These quibbles apart, I would say that any practitioner (and judging by a typical clinic’s patient population this would be every practitioner) who treats depression will find material of substantial value in the book.

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