human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Previous studies suggest that electroacupuncture possesses therapeutic benefits for depressive disorders . The purpose of this study was to determine whether dense cranial electroacupuncture stimulation ( DCEAS ) could enhance the antidepressant efficacy in the early phase of selective serotonin reuptake inhibitor ( SSRI ) treatment of major depressive disorder ( MDD ) . Methods In this single-blind , r and omized , controlled study , patients with MDD were r and omly assigned to 9-session DCEAS or noninvasive electroacupuncture ( n-EA ) control procedure in combination with fluoxetine ( FLX ) for 3 weeks . Clinical outcomes were measured using the 17-item Hamilton Depression Rating Scale ( HAMD-17 ) , Clinical Global Impression-severity ( CGI-S ) , and Self-rating Depression Scale ( SDS ) as well as the response and remission rates . Results Seventy-three patients were r and omly assigned to n-EA ( n = 35 ) and DCEAS ( n = 38 ) , of whom 34 in n-EA and 36 in DCEAS group were analyzed . DCEAS-treated patients displayed a significantly greater reduction from baseline in HAMD-17 scores at Day 3 through Day 21 and in SDS scores at Day 3 and Day 21 compared to patients receiving n-EA . DCEAS intervention also produced a higher rate of clinical ly significant response compared to n-EA procedure ( 19.4 % ( 7/36 ) vs. 8.8 % ( 3/34 ) ) . The incidence of adverse events was similar in the two groups . Conclusions DCEAS is a safe and effective intervention that augments the antidepressant efficacy . It can be considered as an additional therapy in the early phase of SSRI treatment of depressed patients . Trial Registration Controlled-Trials.com IS RCT In a r and omized controlled trial , Hugh MacPherson and colleagues investigate the effectiveness of acupuncture and counseling compared with usual care alone for the treatment of  depression symptoms  in primary care setting s. Please see later in the article for the Editors ' BACKGROUND Data on the duration of major depressive episodes ( MDE ) in the general population are sparse . AIMS To assess the duration of MDE and its clinical and socio-demographic determinants in a study group drawn from the general population with newly originated episodes of major depression . METHOD The Netherl and s Mental Health Survey and Incidence Study is a prospect i ve epidemiological survey in the adult population ( n=7076 ) , using the Composite International Diagnostic Interview . Duration of MDE over 2 years was assessed with a Life Chart Interview . RESULTS The median duration of MDE was 3.0 months ; 50 % of participants recovered within 3 months , 63 % within 6 months , 76 % within 12 months and nearly 20 % had not recovered at 24 months . Determinants of persistence were severity of depression and comorbid dysthymia . A recurrent episode predicted shorter duration . CONCLUSIONS Although half of those affected with MDE recovered rapidly , the risk of chronicity ( duration 24 months or more ) was considerable . This underlines the necessity of diagnosing and treating those at risk BACKGROUND Postpartum depression affects 10 - 15 % of mothers . Although acupuncture was efficacious for major depressive disorder in pregnancy and in women outside the perinatal period , there has been no r and omized controlled study on the feasibility , tolerability , and efficacy of acupuncture for postpartum depression . METHODS This was a r and omized , subject- and assessor-blind , parallel-group , sham-controlled trial . Twenty women within six months postpartum with DSM-IV-diagnosed major depressive disorder of mild severity , defined as a 17-item Hamilton Depression Rating Scale ( HDRS(17 ) ) score of 12 to 19 , were r and omly assigned to either electroacupuncture or non-invasive sham acupuncture two sessions weekly for four weeks . RESULTS There was significant reduction in HDRS(17 ) score from baseline to 4-week posttreatment in both groups , with an effect size 1.4 and 1.8 for electroacupuncture and sham acupuncture , respectively . Improvement was observed as early as two weeks after commencing acupuncture . The response and remission rate in the electroacupuncture group at 4-week posttreatment was 33 % and 44 % , respectively ; for the sham acupuncture group , it was 60 % and 50 % , respectively . There was no significant between-group difference in all outcome measures , including the HDRS(17 ) , Edinburgh Postnatal Depression Scale , Hospital Anxiety and Depression Scale , Clinical Global Impression , and Sheehan Disability Scale . Treatment credibility , success of blinding , and adverse events were similar between groups . LIMITATION Small sample size and high attrition rate . No waiting list observation group . CONCLUSION Both electroacupuncture and non-invasive sham acupuncture were effective for postpartum depression . Further studies utilizing larger sample size , better recruitment strategies , and home-based acupuncture treatment are warranted . CLINICAL TRIAL INFORMATION Pilot Study on the Use of Acupuncture for Postpartum Depression ; Clinical Trials.gov Registration # NCT01178008 ; URL - http:// clinical trials.gov/ct2/show/NCT01178008?term=postpartum+acupuncture&rank=1 BACKGROUND AND OBJECTIVE Postmortem studies indicate that the number and density of glial cells are reduced in different brain regions of patients with depression . Glial cell line-derived neurotrophic factor ( GDNF ) plays an important role in the pathogenesis of depressive disorder ( DD ) and might be a biomarker for damage to nerve cells . In this study , we compared the therapeutic effects of electroacupuncture ( EA ) and fluoxetine , a serotonin reuptake inhibitor , on DD patients , focusing on the serum level of GDNF . DESIGN This was a prospect i ve , r and omized clinical trial . SETTING Seventy-five patients with DD from the Department of Acupuncture , Beijing Hospital of Traditional Chinese Medicine , were recruited . INTERVENTION Twenty patients were treated with acupuncture for 6 weeks on the acupoints of Baihui ( DU20 ) and Zusanli ( ST36 ) . Sixteen patients were treated with acupuncture for 6 weeks on the acupoints of Taichong ( LR3 ) , Sanyinjiao ( SP6 ) , Neiguan ( PC6 ) , and Shenmen ( HT7 ) , and constituted the electroacupuncture control group . The patients received acupuncture treatment five times per week . Twenty-five patients were treated with oral fluoxetine ( 20 mg/day ) for 6 weeks . OUTCOME MEASURES All subjects were evaluated by the Hamilton Depression Rating Scale at four time points ( 0 [ baseline ] , 2 , 4 , and 6 weeks after treatment ) . Serum GDNF was quantified in duplicate by enzyme-linked immunosorbent assay ( ELISA ) . RESULTS EA and fluoxetine had similar curative effects on DD patients . EA had a faster onset of action , better response rate , and better improvement rate than fluoxetine . Both fluoxetine and EA treatment restored the normal concentration of GDNF in the serum of DD patients . CONCLUSION EA treatment for depression is as effective as a recommended dose of fluoxetine . However , EA demonstrates an advantage in the regulation of the production of GDNF compared with fluoxetine BACKGROUND In a single-blind placebo-controlled study design we investigated the efficacy of acupuncture additionally applied to drug treatment in major depression . METHODS We r and omly included 70 in patients with a major depressive episode in three different treatment groups : verum acupuncture , placebo acupuncture and a control group . All three groups were pharmacologically treated with the antidepressant mianserin . The verum group received acupuncture at specific points considered effective in the treatment of depression . The placebo group was treated with acupuncture at non-specific locations and the control group received pharmacological treatment plus clinical management . Acupuncture was applied three times a week over a period of 4 weeks . Psychopathology was rated by judges blind to verum/placebo conditions twice a week over 8 weeks . RESULTS Patients who experienced acupuncture  improved slightly more than patients treated with mianserin  alone . CONCLUSIONS Additionally applied acupuncture improved the course of depression more than pharmacological treatment with mianserin alone . However , we could not detect any differences between placebo and verum acupuncture Objective To explore the personality-adjusting effect of electro-acupuncture treatment for depression and compared this treatment with paroxetine treatment . Methods A non-blinded , r and omized controlled trial was adopted . Sixty depressed patients , who met trial criteria , were r and omly assigned to the treatment and the control groups . In the treatment group , electro-acupuncture treatment was used , and paroxetine treatment was used in the control group . During the 24-week study period , 12 patients dropped out and 48 patients completed the study . The Minnesota Multiple Personality Inventory ( MMPI ) was adopted as the evaluation tool . At the same time , the Self-rating Depression Scale ( SDS ) , Self-rating Anxiety Scale ( SAS ) and Montgomery-Asberg Depression Rating Scale ( MADRS ) were used to evaluate the psychological state . Evaluations were done before and after treatment . Results After treatment , patients ’ psychological state improved significantly in both groups ( P<0.01 ) . For the treatment group , within-group comparison between baseline and after 24 weeks of treatment showed that severity of depression had significantly decreased ( P<0.01 ) . MADRS and SDS scores decreased significantly ( P<0.05 ) and MMPI subscale scores for hypochondriasis , depression , psychopathic deviate , psychasthenia , social introversion and fake decreased significantly ( P<0.05 ) . For the control group , severity of depression also decreased significantly . MADRS and SDS scores decreased significantly ( P<0.05 ) ; and MMPI subscale scores for hypochondriasis , depression , hysteria , paranoia , and psychasthenia decreased significantly ( P<0.05 ) . Between-group comparison demonstrated that for the MMPI subscales paranoia and social introversion , the decrease of score was greater in the treatment group than in the control group ( P<0.05 ) . However , there were no other significant differences between the control group and the treatment group . Conclusion Electro-acupuncture is effective for treating depression and affects personality traits Objective To observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture ( EA ) in treating depression . Methods Forty-two patients with depression were r and omly assigned to the observation group ( 22 patients ) treated with EA combined with Paroxetine , and the control group ( 20 patients ) treated with Paroxetine alone , and the therapeutic course for both groups was 6 weeks . The therapeutic efficacy and adverse reactions were evaluated with scores by Hamilton depression scale ( HAMD ) and treatment emergent symptoms scale ( TESS ) , respectively . Results HAMD scores determined at the end of the 1st , 2nd , 4th , and 6th week of the treatment course were significantly lower in the observation group than those in the control group ( P<0.05 ) . The significant improvement rate evaluated at the end of the 6-week treatment was remarkably higher in the observation group than that in the control group ( 72.7 % vs 40.0 % ) . No significant difference of TESS scores was found between the two groups . Conclusion EA combined with Paroxetine has better clinical efficacy than that of Paroxetine alone , with milder adverse reaction and quicker initiation of effect In order to observe the therapeutic effects of the brain-resuscitation acupuncture method for post wind-stroke mental depression , 90 such cases were r and omly divided into two groups , each consisting of 45 cases . For the treatment group , the brain-resuscitation acupuncture method was adopted , with Neiguan ( PC 6 ) , Renzhong ( GV 26 ) , Sanyinjiao ( SP 6 ) , Baihui ( GV 20 ) , and Shenmen ( HT 7 ) selected as the main points . For the control group , oral medication of Fluoxetine was prescribed . Therapeutic effects and changes in the HAMD integrals of the two groups were observed . The total effective rate in the treatment group was 77.7 % , and that in the control group was 75.1 % , showing no significant difference between the two groups ( P>0.05 ) . The average effect starting time of the treatment group was 11.58 + /- 4.89 days , while that of the control group was 15.96 + /- 6.50 days , showing a significant difference between the two groups ( P<0.05 ) . It can be concluded that for the post wind-stroke mental depression , the brain-resuscitation acupuncture method may show a good and quicker therapeutic effect with no side effects as compared with pharmacotherapy R and omised controlled trials ( RCTs ) of acupuncture often find equivalent responses to real and placebo acupuncture despite both appearing superior to no treatment . This raises questions regarding the mechanisms of acupuncture , especially the contribution of patient expectancies . We systematic ally review ed previous research assessing the relationship between expectancy and treatment responses following acupuncture , whether real or placebo . To be included , studies needed to assess and /or manipulate expectancies about acupuncture and relate these to at 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Previous studies suggest that electroacupuncture possesses therapeutic benefits for depressive disorders . The purpose of this study was to determine whether dense cranial electroacupuncture stimulation ( DCEAS ) could enhance the antidepressant efficacy in the early phase of selective serotonin reuptake inhibitor ( SSRI ) treatment of major depressive disorder ( MDD ) . Methods In this single-blind , r and omized , controlled study , patients with MDD were r and omly assigned to 9-session DCEAS or noninvasive electroacupuncture ( n-EA ) control procedure in combination with fluoxetine ( FLX ) for 3 weeks . Clinical outcomes were measured using the 17-item Hamilton Depression Rating Scale ( HAMD-17 ) , Clinical Global Impression-severity ( CGI-S ) , and Self-rating Depression Scale ( SDS ) as well as the response and remission rates . Results Seventy-three patients were r and omly assigned to n-EA ( n = 35 ) and DCEAS ( n = 38 ) , of whom 34 in n-EA and 36 in DCEAS group were analyzed . DCEAS-treated patients displayed a significantly greater reduction from baseline in HAMD-17 scores at Day 3 through Day 21 and in SDS scores at Day 3 and Day 21 compared to patients receiving n-EA . DCEAS intervention also produced a higher rate of clinical ly significant response compared to n-EA procedure ( 19.4 % ( 7/36 ) vs. 8.8 % ( 3/34 ) ) . The incidence of adverse events was similar in the two groups . Conclusions DCEAS is a safe and effective intervention that augments the antidepressant efficacy . It can be considered as an additional therapy in the early phase of SSRI treatment of depressed patients . Trial Registration Controlled-Trials.com IS RCT In a r and omized controlled trial , Hugh MacPherson and colleagues investigate the effectiveness of acupuncture and counseling compared with usual care alone for the treatment of  depression symptoms  in primary care setting s. Please see later in the article for the Editors ' BACKGROUND Data on the duration of major depressive episodes ( MDE ) in the general population are sparse . AIMS To assess the duration of MDE and its clinical and socio-demographic determinants in a study group drawn from the general population with newly originated episodes of major depression . METHOD The Netherl and s Mental Health Survey and Incidence Study is a prospect i ve epidemiological survey in the adult population ( n=7076 ) , using the Composite International Diagnostic Interview . Duration of MDE over 2 years was assessed with a Life Chart Interview . RESULTS The median duration of MDE was 3.0 months ; 50 % of participants recovered within 3 months , 63 % within 6 months , 76 % within 12 months and nearly 20 % had not recovered at 24 months . Determinants of persistence were severity of depression and comorbid dysthymia . A recurrent episode predicted shorter duration . CONCLUSIONS Although half of those affected with MDE recovered rapidly , the risk of chronicity ( duration 24 months or more ) was considerable . This underlines the necessity of diagnosing and treating those at risk BACKGROUND Postpartum depression affects 10 - 15 % of mothers . Although acupuncture was efficacious for major depressive disorder in pregnancy and in women outside the perinatal period , there has been no r and omized controlled study on the feasibility , tolerability , and efficacy of acupuncture for postpartum depression . METHODS This was a r and omized , subject- and assessor-blind , parallel-group , sham-controlled trial . Twenty women within six months postpartum with DSM-IV-diagnosed major depressive disorder of mild severity , defined as a 17-item Hamilton Depression Rating Scale ( HDRS(17 ) ) score of 12 to 19 , were r and omly assigned to either electroacupuncture or non-invasive sham acupuncture two sessions weekly for four weeks . RESULTS There was significant reduction in HDRS(17 ) score from baseline to 4-week posttreatment in both groups , with an effect size 1.4 and 1.8 for electroacupuncture and sham acupuncture , respectively . Improvement was observed as early as two weeks after commencing acupuncture . The response and remission rate in the electroacupuncture group at 4-week posttreatment was 33 % and 44 % , respectively ; for the sham acupuncture group , it was 60 % and 50 % , respectively . There was no significant between-group difference in all outcome measures , including the HDRS(17 ) , Edinburgh Postnatal Depression Scale , Hospital Anxiety and Depression Scale , Clinical Global Impression , and Sheehan Disability Scale . Treatment credibility , success of blinding , and adverse events were similar between groups . LIMITATION Small sample size and high attrition rate . No waiting list observation group . CONCLUSION Both electroacupuncture and non-invasive sham acupuncture were effective for postpartum depression . Further studies utilizing larger sample size , better recruitment strategies , and home-based acupuncture treatment are warranted . CLINICAL TRIAL INFORMATION Pilot Study on the Use of Acupuncture for Postpartum Depression ; Clinical Trials.gov Registration # NCT01178008 ; URL - http:// clinical trials.gov/ct2/show/NCT01178008?term=postpartum+acupuncture&rank=1 BACKGROUND AND OBJECTIVE Postmortem studies indicate that the number and density of glial cells are reduced in different brain regions of patients with depression . Glial cell line-derived neurotrophic factor ( GDNF ) plays an important role in the pathogenesis of depressive disorder ( DD ) and might be a biomarker for damage to nerve cells . In this study , we compared the therapeutic effects of electroacupuncture ( EA ) and fluoxetine , a serotonin reuptake inhibitor , on DD patients , focusing on the serum level of GDNF . DESIGN This was a prospect i ve , r and omized clinical trial . SETTING Seventy-five patients with DD from the Department of Acupuncture , Beijing Hospital of Traditional Chinese Medicine , were recruited . INTERVENTION Twenty patients were treated with acupuncture for 6 weeks on the acupoints of Baihui ( DU20 ) and Zusanli ( ST36 ) . Sixteen patients were treated with acupuncture for 6 weeks on the acupoints of Taichong ( LR3 ) , Sanyinjiao ( SP6 ) , Neiguan ( PC6 ) , and Shenmen ( HT7 ) , and constituted the electroacupuncture control group . The patients received acupuncture treatment five times per week . Twenty-five patients were treated with oral fluoxetine ( 20 mg/day ) for 6 weeks . OUTCOME MEASURES All subjects were evaluated by the Hamilton Depression Rating Scale at four time points ( 0 [ baseline ] , 2 , 4 , and 6 weeks after treatment ) . Serum GDNF was quantified in duplicate by enzyme-linked immunosorbent assay ( ELISA ) . RESULTS EA and fluoxetine had similar curative effects on DD patients . EA had a faster onset of action , better response rate , and better improvement rate than fluoxetine . Both fluoxetine and EA treatment restored the normal concentration of GDNF in the serum of DD patients . CONCLUSION EA treatment for depression is as effective as a recommended dose of fluoxetine . However , EA demonstrates an advantage in the regulation of the production of GDNF compared with fluoxetine BACKGROUND In a single-blind placebo-controlled study design we investigated the efficacy of acupuncture additionally applied to drug treatment in major depression . METHODS We r and omly included 70 in patients with a major depressive episode in three different treatment groups : verum acupuncture , placebo acupuncture and a control group . All three groups were pharmacologically treated with the antidepressant mianserin . The verum group received acupuncture at specific points considered effective in the treatment of depression . The placebo group was treated with acupuncture at non-specific locations and the control group received pharmacological treatment plus clinical management . Acupuncture was applied three times a week over a period of 4 weeks . Psychopathology was rated by judges blind to verum/placebo conditions twice a week over 8 weeks . RESULTS Patients who experienced acupuncture  improved slightly more than patients treated with mianserin  alone . CONCLUSIONS Additionally applied acupuncture improved the course of depression more than pharmacological treatment with mianserin alone . However , we could not detect any differences between placebo and verum acupuncture Objective To explore the personality-adjusting effect of electro-acupuncture treatment for depression and compared this treatment with paroxetine treatment . Methods A non-blinded , r and omized controlled trial was adopted . Sixty depressed patients , who met trial criteria , were r and omly assigned to the treatment and the control groups . In the treatment group , electro-acupuncture treatment was used , and paroxetine treatment was used in the control group . During the 24-week study period , 12 patients dropped out and 48 patients completed the study . The Minnesota Multiple Personality Inventory ( MMPI ) was adopted as the evaluation tool . At the same time , the Self-rating Depression Scale ( SDS ) , Self-rating Anxiety Scale ( SAS ) and Montgomery-Asberg Depression Rating Scale ( MADRS ) were used to evaluate the psychological state . Evaluations were done before and after treatment . Results After treatment , patients ’ psychological state improved significantly in both groups ( P<0.01 ) . For the treatment group , within-group comparison between baseline and after 24 weeks of treatment showed that severity of depression had significantly decreased ( P<0.01 ) . MADRS and SDS scores decreased significantly ( P<0.05 ) and MMPI subscale scores for hypochondriasis , depression , psychopathic deviate , psychasthenia , social introversion and fake decreased significantly ( P<0.05 ) . For the control group , severity of depression also decreased significantly . MADRS and SDS scores decreased significantly ( P<0.05 ) ; and MMPI subscale scores for hypochondriasis , depression , hysteria , paranoia , and psychasthenia decreased significantly ( P<0.05 ) . Between-group comparison demonstrated that for the MMPI subscales paranoia and social introversion , the decrease of score was greater in the treatment group than in the control group ( P<0.05 ) . However , there were no other significant differences between the control group and the treatment group . Conclusion Electro-acupuncture is effective for treating depression and affects personality traits Objective To observe the clinical efficacy and adverse reactions of Paroxetine combined with electro-acupuncture ( EA ) in treating depression . Methods Forty-two patients with depression were r and omly assigned to the observation group ( 22 patients ) treated with EA combined with Paroxetine , and the control group ( 20 patients ) treated with Paroxetine alone , and the therapeutic course for both groups was 6 weeks . The therapeutic efficacy and adverse reactions were evaluated with scores by Hamilton depression scale ( HAMD ) and treatment emergent symptoms scale ( TESS ) , respectively . Results HAMD scores determined at the end of the 1st , 2nd , 4th , and 6th week of the treatment course were significantly lower in the observation group than those in the control group ( P<0.05 ) . The significant improvement rate evaluated at the end of the 6-week treatment was remarkably higher in the observation group than that in the control group ( 72.7 % vs 40.0 % ) . No significant difference of TESS scores was found between the two groups . Conclusion EA combined with Paroxetine has better clinical efficacy than that of Paroxetine alone , with milder adverse reaction and quicker initiation of effect In order to observe the therapeutic effects of the brain-resuscitation acupuncture method for post wind-stroke mental depression , 90 such cases were r and omly divided into two groups , each consisting of 45 cases . For the treatment group , the brain-resuscitation acupuncture method was adopted , with Neiguan ( PC 6 ) , Renzhong ( GV 26 ) , Sanyinjiao ( SP 6 ) , Baihui ( GV 20 ) , and Shenmen ( HT 7 ) selected as the main points . For the control group , oral medication of Fluoxetine was prescribed . Therapeutic effects and changes in the HAMD integrals of the two groups were observed . The total effective rate in the treatment group was 77.7 % , and that in the control group was 75.1 % , showing no significant difference between the two groups ( P>0.05 ) . The average effect starting time of the treatment group was 11.58 + /- 4.89 days , while that of the control group was 15.96 + /- 6.50 days , showing a significant difference between the two groups ( P<0.05 ) . It can be concluded that for the post wind-stroke mental depression , the brain-resuscitation acupuncture method may show a good and quicker therapeutic effect with no side effects as compared with pharmacotherapy R and omised controlled trials ( RCTs ) of acupuncture often find equivalent responses to real and placebo acupuncture despite both appearing superior to no treatment . This raises questions regarding the mechanisms of acupuncture , especially the contribution of patient expectancies . We systematic ally review ed previous research assessing the relationship between expectancy and treatment responses following acupuncture , whether real or placebo . To be included , studies needed to assess and /or manipulate expectancies about acupuncture and relate these to at 
    Output:
    