Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized Controlled Trial of Electroacupuncture for Persistent Insomnia Symptoms Associated With Major Depressive Disorder
Brief Summary: The purpose of this study is to evaluate the clinical effectiveness of acupuncture treatment on residual insomnia in major depressive patients.


Options:
A: Inclusion Criteria:

* Patients with documented stable, ischemic heart disease who have finished heart rehabilitation according to the National Guidelines \> 6 months ago Actual use of aspirin, statins, and blood pressure medication according to the National Guidelines
* Age \< 75 years
* Increased pressure pain sensitivity ≥60 as a sign of persistent stress

Exclusion Criteria:

* Previous diagnosed and treated psychiatric disease besides depression Other Chronic Disease with known significantly reduced life expectancy (as cancer or severe COPD)
* Other Chronic Disease with known significantly reduced Quality of Life as COPD, chronic pain conditions (but not diabetes or heart disease)
* Planned heart operation
* Changed Medication for the Heart (concerning Angina or Heart Failure) within one month
* Previous use of the Pressure Pain Sensitivity Device followed by treatment with Acupressure
B: Inclusion Criteria:

* Willing to give informed consent;
* Hong Kong resident;
* Age 18-65 years;
* Previous DSM-IV Major Depressive Disorder as confirmed with the Structured Clinical Interview for DSM-IV;
* Hamilton Depression Rating Scale scores of 18 or below for at screening and baseline visit;
* A chief complaint of insomnia;
* Able to comply with the trial protocol.

Exclusion Criteria:

* Any symptoms suggestive of specific sleep disorders, including loud snoring, periodic leg movement, parasomnia;
* A diagnosis of sleep apnea or periodic limb movement disorder (PLMD) as assessed by overnight polysomnography (PSG);
* Presence of suicidal risk;
* Previous history of schizophrenia, other psychotic disorders, and bipolar disorder;
* Pregnant, breast-feeding, or woman of childbearing potential not using adequate contraception;
* Infection or abscess close to the site of selected acupoints and in the investigator's opinion inclusion is unsafe.
C: Inclusion Criteria:

* Meet SCID criteria for a Major Depressive Disorder (Single or Recurrent) with a current major depressive episode of mild or moderate severity
* Significant symptoms of depression (HRSD \> 14)
* Ability to communicate in English
* Give informed consent in accordance with local IRB regulations

Exclusion Criteria:

* Personal physician's recommendation against enrollment because the patient is physically unstable or for other reasons
* Having been treated with acupuncture for any condition
* History of seizure disorder or significant risk factors for a seizure disorder (e.g., history of brain trauma, recent stroke, or brain tumor)
* Need to remain on antidepressant or other psychotropic medications
* Absence of depressive symptoms severe enough (i.e., HRSD \< 14) at the baseline assessments
* Significant cognitive impairment, as assessed by a total score on the MMSE \< 25. A recommendation for referral to a neurologist or a psychiatrist will be made to the patient in these cases.
* Chronic major depression (i.e, duration of 2 years or longer) A recommendation for referral to a psychiatrist will be made in these cases.
* Major depressive episode severe or severe with psychotic features (as per DSM-IV/SCID) or with acutely suicidality. A recommendation for psychiatric referral will be made in these cases. Bipolar disorder, psychotic features, or a psychotic disorder (specifically: schizophrenia, delusional disorder, or schizoaffective disorder). A recommendation for psychiatric referral will be made in these cases.
* Met criteria for a diagnosis of alcohol substance abuse or dependence within the past six months. A recommendation for referral to a mental health professional will be made in these cases.
D: Inclusion Criteria:

* Aged 18 years or above
* A previous Diagnostic and Statistical Manual of Mental Disorders-IV Major Depressive Disorder
* Have a current Diagnostic and Statistical Manual of Mental Disorders-IV diagnosis of insomnia disorder
* Insomnia more than 3 nights per week for at least 3 months
* Insomnia Severity Scale (ISI) total score higher than 15 at screening and baseline visit
* Use of antidepressants at the same dosage for at least 12 weeks prior to screening visit
* Hypnotic dosage has not been increased in the last 4 weeks

Exclusion Criteria:

* Have a Hamilton Depression Rating Scale scores above 18
* Have sleep apnea or periodic limbs movement disorder detected by overnight polysomnography
* Have suicidal risk as assessed by the Hamilton Depression Rating Scale suicidal risk item
* Have previous history of schizophrenia, other psychotic disorders, and bipolar disorder
* Have current alcohol or drug abuse and dependence
* Pregnant, breast-feeding, or woman of childbearing potential not using adequate contraception
* Have infection or abscess close to the site of selected acupoints and in the investigator's opinion inclusion is unsafe
* Taking Chinese herbal medicine or over-the-counter drugs which are intending for insomnia within the last 2 weeks prior to baseline or during the study
* Any acupuncture treatment during the previous 12 months prior to baseline and
* Unstable medical conditions.

Answer: D