Bazargan Mohsen, Ani Chizobam O, Hindman David W, Bazargan-Hejazi Shahrzad, Baker Richard S, Bell Douglas, Rodriquez Michael
Department of Family Medicine, Charles Drew University of Medicine & Science, Los Angeles, CA 90059, USA.
J Altern Complement Med. 2008 Jun;14(5):537-44. doi: 10.1089/acm.2007.0821.
This study seeks to examine the correlates of complementary and alternative medicine (CAM) use in depressed underserved minority populations receiving medical care in primary care settings.
A prospective study using interviewer-administered surveys and medical record reviews was conducted at 2 large outpatient primary care clinics providing care primarily to underserved African American and Hispanic individuals located in Los Angeles, California. A total of 2321 patients were screened for depression. Of these, 315 met the Patient Health Questionnaire-9 criteria for mild to severe depression.
Over 57% of the sample reported using CAM sometimes or often (24%) and frequently (33%) for treatment of their depressive symptoms. Controlling for demographic characteristics, lack of health care coverage remained one of the strongest predictors of CAM use. Additionally, being moderately depressed, using psychotherapeutic prescription medications, and poorer self-reported health status were all associated with increased frequency of CAM utilization for treating depression.
The underserved African American and Hispanic individuals meeting the diagnostic criteria for depression or subsyndromal depression use CAM extensively for symptoms of depression. CAM is used as a substitute for conventional care when access to care is not available or limited. Since CAM is used so extensively for depression, understanding domains, types, and correlates of such use is imperative. This knowledge could be used to design interventions aimed at improving care for depression.
本研究旨在调查在初级保健机构接受治疗的贫困少数族裔抑郁症患者使用补充和替代医学(CAM)的相关因素。
在加利福尼亚州洛杉矶市的2家大型门诊初级保健诊所开展了一项前瞻性研究,采用访员管理的调查问卷和病历审查。共对2321名患者进行了抑郁症筛查。其中,315名患者符合患者健康问卷-9中轻度至重度抑郁症的标准。
超过57%的样本报告有时或经常(24%)以及频繁(33%)使用CAM来治疗他们的抑郁症状。在控制人口统计学特征后,缺乏医疗保险仍然是使用CAM的最强预测因素之一。此外,中度抑郁、使用心理治疗处方药以及自我报告的健康状况较差均与使用CAM治疗抑郁症的频率增加有关。
符合抑郁症或亚综合征性抑郁症诊断标准的贫困非裔美国人和西班牙裔个体广泛使用CAM来治疗抑郁症状。当无法获得或获得的常规医疗服务有限时,CAM被用作常规医疗服务的替代品。由于CAM在治疗抑郁症方面使用如此广泛,了解其使用的领域、类型和相关因素至关重要。这些知识可用于设计旨在改善抑郁症治疗的干预措施。