P de Jonge1, K J Wardenaar2, H R Hoenders3, S Evans-Lacko4, V Kovess-Masfety5, S Aguilar-Gaxiola6, A Al-Hamzawi7, J Alonso8, L H Andrade9, C Benjet10, E J Bromet11, R Bruffaerts12, B Bunting13, J M Caldas-de-Almeida14, R V Dinolova15, S Florescu16, G de Girolamo17, O Gureje18, J M Haro19, C Hu20, Y Huang21, E G Karam22, G Karam23, S Lee24, J-P Lépine25, D Levinson26, V Makanjuola18, F Navarro-Mateu27, B-E Pennell28, J Posada-Villa29, K Scott30, H Tachimori31, D Williams32, B Wojtyniak33, R C Kessler34, G Thornicroft4. 1. Developmental Psychology,Department of Psychology,Rijksuniversiteit Groningen,Groningen,the Netherlands. 2. Department of Psychiatry,University Medical Center Groningen,Groningen,The Netherlands. 3. Center for Integrative Psychiatry (CIP),Lentis,Groningen,the Netherlands. 4. Health Service and Population Research Department,King's College London,Institute of Psychiatry,Psychology & Neuroscience,London,UK. 5. Ecole des Hautes Etudes en Santé Publique (EHESP),EA 4057 Paris Descartes University,Paris,France. 6. Center for Reducing Health Disparities,UC Davis Health System,Sacramento, California,USA. 7. College of Medicine, Al-Qadisiya University,Diwaniya,Iraq. 8. Health Services Research Unit,IMIM-Hospital del Mar Medical Research Institute,Barcelona,Spain. 9. Núcleo de Epidemiologia Psiquiátrica - LIM 23,Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo,Brazil. 10. Department of Epidemiologic and Psychosocial Research,National Institute of Psychiatry Ramón de la Fuente,Mexico City,Mexico. 11. Department of Psychiatry,Stony Brook University School of Medicine,Stony Brook, New York,USA. 12. Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL),Campus Gasthuisberg, Leuven,Belgium. 13. School of Psychology,Ulster University,Londonderry,UK. 14. Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC),NOVA Medical School | Faculdade de Ciências Médicas,Universidade Nova de Lisboa,Lisbon,Portugal. 15. National Center of Public Health and Analyses,Sofia,Bulgaria. 16. National School of Public Health,Management and Professional Development,Bucharest,Romania. 17. IRCCS St John of God Clinical Research Centre//IRCCS Centro S. Giovanni di Dio Fatebenefratelli,Brescia,Italy. 18. Department of Psychiatry,College of Medicine,University of Ibadan,Ibadan,Nigeria. 19. Parc Sanitari Sant Joan de Déu,CIBERSAM, Universitat de Barcelona,Sant Boi de Llobregat, Barcelona,Spain. 20. Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital,Shenzhen,China. 21. Institute of Mental Health,Peking University,Beijing,China. 22. Department of Psychiatry and Clinical Psychology,St George Hospital University Medical Center, Balamand University,Faculty of Medicine,Beirut,Lebanon. 23. Institute for Development, Research, Advocacy and Applied Care (IDRAAC),Beirut,Lebanon. 24. Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong. 25. Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144,University Paris Diderot and Paris Descartes,Paris,France. 26. Mental Health Services,Ministry of Health,Jerusalem,Israel. 27. UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia,Murcia,Spain. 28. Survey Research Center,Institute for Social Research,University of Michigan,Ann Arbor, Michigan,USA. 29. Colegio Mayor de Cundinamarca University,Bogota,Colombia. 30. Department of Psychological Medicine,University of Otago,Dunedin, Otago,New Zealand. 31. National Institute of Mental Health, National Center for Neurology and Psychiatry,Kodaira, Tokyo,Japan. 32. Department of Society,Human Development, and Health,Harvard T.H. Chan School of Public Health,Boston, Massachusetts,USA. 33. Centre of Monitoring and Analyses of Population Health,National Institute of Public Health-National Institute of Hygiene,Warsaw,Poland. 34. Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
Abstract
AIMS: A substantial proportion of persons with mental disorders seek treatment from complementary and alternative medicine (CAM) professionals. However, data on how CAM contacts vary across countries, mental disorders and their severity, and health care settings is largely lacking. The aim was therefore to investigate the prevalence of contacts with CAM providers in a large cross-national sample of persons with 12-month mental disorders. METHODS: In the World Mental Health Surveys, the Composite International Diagnostic Interview was administered to determine the presence of past 12 month mental disorders in 138 801 participants aged 18-100 derived from representative general population samples. Participants were recruited between 2001 and 2012. Rates of self-reported CAM contacts for each of the 28 surveys across 25 countries and 12 mental disorder groups were calculated for all persons with past 12-month mental disorders. Mental disorders were grouped into mood disorders, anxiety disorders or behavioural disorders, and further divided by severity levels. Satisfaction with conventional care was also compared with CAM contact satisfaction. RESULTS: An estimated 3.6% (standard error 0.2%) of persons with a past 12-month mental disorder reported a CAM contact, which was two times higher in high-income countries (4.6%; standard error 0.3%) than in low- and middle-income countries (2.3%; standard error 0.2%). CAM contacts were largely comparable for different disorder types, but particularly high in persons receiving conventional care (8.6-17.8%). CAM contacts increased with increasing mental disorder severity. Among persons receiving specialist mental health care, CAM contacts were reported by 14.0% for severe mood disorders, 16.2% for severe anxiety disorders and 22.5% for severe behavioural disorders. Satisfaction with care was comparable with respect to CAM contacts (78.3%) and conventional care (75.6%) in persons that received both. CONCLUSIONS: CAM contacts are common in persons with severe mental disorders, in high-income countries, and in persons receiving conventional care. Our findings support the notion of CAM as largely complementary but are in contrast to suggestions that this concerns person with only mild, transient complaints. There was no indication that persons were less satisfied by CAM visits than by receiving conventional care. We encourage health care professionals in conventional settings to openly discuss the care patients are receiving, whether conventional or not, and their reasons for doing so.
AIMS: A substantial proportion of persons with mental disorders seek treatment from complementary and alternative medicine (CAM) professionals. However, data on how CAM contacts vary across countries, mental disorders and their severity, and health care settings is largely lacking. The aim was therefore to investigate the prevalence of contacts with CAM providers in a large cross-national sample of persons with 12-month mental disorders. METHODS: In the World Mental Health Surveys, the Composite International Diagnostic Interview was administered to determine the presence of past 12 month mental disorders in 138 801 participants aged 18-100 derived from representative general population samples. Participants were recruited between 2001 and 2012. Rates of self-reported CAM contacts for each of the 28 surveys across 25 countries and 12 mental disorder groups were calculated for all persons with past 12-month mental disorders. Mental disorders were grouped into mood disorders, anxiety disorders or behavioural disorders, and further divided by severity levels. Satisfaction with conventional care was also compared with CAM contact satisfaction. RESULTS: An estimated 3.6% (standard error 0.2%) of persons with a past 12-month mental disorder reported a CAM contact, which was two times higher in high-income countries (4.6%; standard error 0.3%) than in low- and middle-income countries (2.3%; standard error 0.2%). CAM contacts were largely comparable for different disorder types, but particularly high in persons receiving conventional care (8.6-17.8%). CAM contacts increased with increasing mental disorder severity. Among persons receiving specialist mental health care, CAM contacts were reported by 14.0% for severe mood disorders, 16.2% for severe anxiety disorders and 22.5% for severe behavioural disorders. Satisfaction with care was comparable with respect to CAM contacts (78.3%) and conventional care (75.6%) in persons that received both. CONCLUSIONS: CAM contacts are common in persons with severe mental disorders, in high-income countries, and in persons receiving conventional care. Our findings support the notion of CAM as largely complementary but are in contrast to suggestions that this concerns person with only mild, transient complaints. There was no indication that persons were less satisfied by CAM visits than by receiving conventional care. We encourage health care professionals in conventional settings to openly discuss the care patients are receiving, whether conventional or not, and their reasons for doing so.
Entities:
Keywords:
CAM Complementary and Alternative Medicine; CIDI Composite International Diagnostic Interview; DSM-IV Diagnostic Statistical Manual; WHO World Health Organisation; WMH World Mental Health; version 4; Complementary and alternative medicine; mental disorders; unconventional medicine
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