Acupuncture and major depressive disorder: is Traditional Chinese Medicine pattern differentiation necessary?

INTERVENTION: Using a 0.25 x 30mm needle, acupuncture will be applied to the points LR14 in the sixth intercostal space, PC6 on the forearm and LR3 on the foot as a standard treatment protocol. There will be another additional point added for three variations to the standard "Liver qi" pattern. For subjects with "Liver qi stasis" alone, the point GB34 on the knee will be added. Where subjects exhibit "Liver qi statis with heat" the point LR8 on the knee will be added. If the subject exhibits "Liver qi invading earth", the point SP6 near the ankle will be added. Consequnelty there will be four points used for any one of three presenting Liver patterns. Once placed, a "de qi" sensation shall be obtained and the needles left in situ for 20 minutes. CONDITION: depression PRIMARY OUTCOME: The Diagnostic and Statistical Manual of Mental Disease version 4 (DSM IV) is used to measure the extent of depression (mild, moderate, severe under the DSM IV classification of major depression) and exclude other mental illnesses eg. bi‐polar, psychotic episodes etc that would otherwise exclude the subject from the trial. SECONDARY OUTCOME: Beck Depression Inventory (BDI‐II) Hamilton Depression Scale SCL‐90‐R (Symptom Checklist) Speilberger State and Trait Anxiety Index (STAI Y1 and Y2) INCLUSION CRITERIA: Patients suffering mild to moderate depression as defined by the DSM IV. Patients must be taking SSRI (selective serotonin re‐uptake inhibitors) drugs and maintain their therapeutic realtionship with their GP/Psychiatrist. Patients must maintain their SSRI therapy throughout the trial. Patients must present with the Chinese Medical diagnostic pattern of "Liver Qi Stagnation".