Clinical evidence on integrated Chinese-Western medicine in depressive disorder

Despite growing interest, evidence on integrated Chinese-Western medicine for depressive disorder (DD) remains fragmented, with no comprehensive summary across treatment modalities and evidence levels. Therefore, we summarized evidence to systematically delineate and visualize the scope, distribution, methodological quality, and results of clinical evidence on integrated Chinese-Western medicine for DD. Adhering to the AI-empowered Clinical Evidence for Integrated Chinese-Western Medicine (ACE-iMed) framework, a dedicated database for DD was established. Four major categories of traditional Chinese medicine intervention were included, namely CHM, acupuncture, moxibustion, and Chinese movement exercises. Eight clinical questions (CQs) with predefined outcomes were formulated, each undergoing a systematic process of targeted searching, screening, and rigorous methodological quality assessment. The search strategy involved comprehensive querying of databases and regulatory websites up to September 6, 2025. Eligible evidence types were restricted to clinical practice guidelines/consensus statements (CPGs/CSs), systematic reviews (SRs) and randomized controlled trials (RCTs). From an initial 41,137 records, 1,402 studies were analyzed, with RCTs constituting the majority (n=1,232; 87.9%). While comprehensive evidence summaries for all eight CQs are presented on the ACE-iMed platform, this study focused on two representative CQs (CQ1 and CQ7). Overall, Chinese medicine treatment modalities, whether as monotherapy or in combination with conventional western therapy, demonstrated enhanced efficacy and a favorable safety profile for DD. Using ACE-iMed, we summarized comprehensive evidence on integrated Chinese-Western medicine for DD, demonstrating favorable efficacy and safety and calling for high-quality studies to validate these findings and enable clinical translation in Hong Kong and beyond.