Procedures
depression, ideation
ADVERSE EVENTS, RECRUITMENT
The study assessors were trained to approach participants similarly to avoid recruitment biases. The study used a protocol of questions and procedures for all phases: prescreening, screening, data collection, and application of protocols.Participants with severe depression levels (PHQ score ≥20) or suicidal ideation did not participate in the study and were followed and consulted by a psychiatrist. The sessions of AA application occurred twice weekly, alternating the application on the right and left auricular pavilions, over 6 weeks, totaling 12 sessions, with a duration of 15 minutes each, in reserved rooms. The acupuncturists instructed the participants to stimulate each point manually (de qi stimulation) 3 times a day (morning, afternoon, and evening) for 30 seconds or until the auricular pavilion became red or sensitive to pressure. In this study, the acupuncturists had specific training in the field, with a minimum of 1200 hours in acupuncture and a minimum of 10 years of experience. They received standardized training before the study began.All participants answered the PHQ-9 questionnaires 4 weeks, 6 weeks, and 3 months after the study initiation and reported adverse events before each AA session (eFigure 1 in 