Impacts of acupressure treatment on depression: A systematic review and meta-analysis

Table 1 Characteristics of included studies

Ref.	Type of study	Participants (sample size, mean age ± SD)	Drop-out rate, n (%)	Treatment (frequency and duration)	Manupilation techniques (acupoints composition, and techniques used)	Control	Depressive symptoms at baseline M (SD)	Outcome measures
Bergmann et al[27], 2014	RCT	Acute myocardial infarction with PPS acore ≥ 60 (213, 61.0 ± 8.1)	32 (15.0)	Acupressure (45 min twice a day for 12 wk)	Figure pressure on two points at the sternum	Treat as usual (TAU)	MDI: 8.9 (7.4), PPS: 81 (13)	MDI, QOL, WHO-5’s well-being index, PPS
Dehghanmehr et al[31], 2020	RCT	Hemodialysis with no severe depression and anxiety (60, 39.2 ± 11.32)	0	Acupressure (8 min, 3 d weekly for 4 wk)	Figure pressure on acupoint Saiyinjiao	Sham, TAU	BDI: 31.44 (20.95), STAI: 47.60 (7.04)	STAI, BDI
Hmwe et al[32],2015	RCT	Hemodialysis with depressive symptom (108, 58.06 ± 11.4)	0	Acupressure (12 min per session, 3 sessions weekly for 4 wk)	Figure pressure on acupoints Yintang, Shenmen, and Taixi	TAU	DASS depression: 10.93 (8.38), GHQ total: 25.33 (12.56)	DASS, GHQ-28
Honda et al[35], 2012	RCT	College students with depressive symptoms (25, 33.2 ± 10.0)	Not mentioned	Acupressure (30 seconds per session, 3 sessions daily for 4 wk)	Figure pressure on six points on the neck (three points on the left and right side each)	TAU	BDI: 55 (10)	BDI
Kalani et al[33], 2019	RCT	Hemodialysis with BDI score ≥ 10 (96, 53.4 ± 13.9)	0	Acupressure (18 min per session, 3 sessions weekly for 4 wk)	Figure pressure on acupoints Sanyinjiao, Zusanli, Yanglingquan, Yongquan, Shenshu, and Shenmen	Sham, TAU	BDI: 27.5 (9.1)	BDI
Lanza et al[23], 2018	RCT	Alzheimer with CDR score ≤ 2 (12, 80.0 ± 9.0)	0	Acupressure (40 min weekly for 40 wk)	Figure pressure on relevant trigger points of the meridians	TAU	GDS: 13 (2)	GDS, MMSE, ADL, IADL
Molassiotis et al[24], 2020	RCT	Depression with GDS score ≥ 8 (118, 79.5 ± 14.5)	34 (28.8)	Acupressure (5 min per session, twice weekly for 12 wk)	Figure pressure on acupoints Zusanli, Zhongfu, Shenmen, Taichong, Baihui	Sham, TAU	GDS: 10.6 (2.1), GHQ: 18.8 (5.9)	GDS, PSQI
Rahimi et al[30], 2020	RCT	Multiple sclerosis with EDSS score = 0-5.5 (106, 20-45 years old)	20 (18.9)	Acupressure (15 min every day for 4 wk)	Figure pressure on acupoints Shenmen and Yintang	Sham	DASS depression: 11.48 (3.1)	DASS, FSS
Rani et al[34], 2020	RCT	Knee osteoarthritis with Kellgrene Lawrance scale grade 2 or 3 (212, 58.07 ± 11.22)	11 (5.2)	Acupressure (15 min per session, 2 sessions per day, 5 d weekly for 32 wk)	Figure pressure on acupoints Liangqiu, Dubi, Zusanli, Yinglingquan, Xuehai, Yanglingquan	TAU	DASS depression: 14.56 (8.63)	DASS, VAS, GHQ-12, BMSWBI, WHOQOL-BREF
Tang et al[26], 2014	RCT	Lung cancer undergoing chemotherapy (40, 64.4 ± 9.2)	10 (25)	Acupressure (3 min once every morning for 20 wk)	Figure pressure on acupoints Hegu, Zusanli, and Sanyinjiao	Sham	HADS: 7.29 (4.39), ECOG-PSR: 11 (45.8)	HADS, TFRS, ECOG-PSR, PSQI
Tseng et al[25], 2020	RCT	Depression with GDS score > 5 (47, 82.78 ± 6.88)	8 (17.0)	Acupressure with a magnetic bead (7 d weekly for 2 wk)	Magnetic bead on ear Shenmen point	Sham	GDS: 8.71 (2.31) BAI: 13.63 (7.36)	GDS, BAI
Wu et al[22], 2007	RCT	Chronic obstructive pulmonary disease with depressive symptom (44, 73.0 ± 9.7)	0	Acupressure (16 min per session, 5 sessions weekly for 4 wk)	Figure pressure on acupoints Dazhui, Tiantu, Shousaili, Feishu, Shenshu	Sham	GDS score at basline not available	GDS, DVAS
Yu et al[29], 2020	RCT	Postpartum wome with low back pain score ≥ 1 (70, 34.4 ± 4.8)	0	Acupressure (10 min per session, 5 sessions weekly for 4 wk)	Figure pressure on acupoints Shenhu, Dachangshu, Guanyuanshu, Weiyang, and Sanyinjiao	Sham	EPDS: 9.4 (4.5)	EPDS, RMDQ, ODI, VAS
Zick et al[28], 2018	RCT	Breast cancer with depressive symptom (288, 60.5 ± 10.0)	Not mentioned	Acupressure (30 min every day for 10 wk)	Figure pressure on acupoints Hegu, Zusanli, Sanyinjiao, Taixi, Baihui, and Qihai	Sham, TAU	HADS: 6.2 (3.2)	VAS, BPI

ADL: Activity of daily living; BAI: Beck anxiety inventory; BDI: Beck depression inventory; BMSWBI: Body-mind-spirit well-being inventory; BPI: Brief pain inventory; CDR: Clinical dementia rating; COPD: Chronic obstructive pulmonary disease; DASS: Depression anxiety stress scales; DVAS: Dyspnea visual analogue scale; ECOG-PSR: Eastern cooperative oncology group performance status rating; EDSS: Expanded disability status scale; EPDS: Edinburgh postnatal depression scale; FSS: Fatigue severity scale; GDS: Geriatric depression scale; GHQ: General health questionnaire; HADS: Hospital anxiety and depression scale; IADL: Instrumental ADL; MDI: Major depression inventory; MMSE: Mini mental state examination; ODI: Oswestry disability index; PFS: Piper fatigue scale; PPS: Pressure pain sensitivity; PSQI: Pittsburgh sleep quality index; QOL: SF-36 quality of life; RMDQ: Roland-morris disability questionnaire; STAI: Spielberger state-trait anxiety inventory; TAU: treat as usual; TFRS: Tang fatigue rating scale; VAS: Visual analog scale.