Center for Women's Mental Health, Massachusetts General Hospital, Simches Research Building, 185 Cambridge St, Boston, MA 02114, USA.
J Clin Psychiatry. 2009;70 Suppl 5:4-6. doi: 10.4088/JCP.8157su1c.01.
The use of complementary and alternative medicine (CAM) has increased among patients with psychiatric disorders, as it has in the general population, over recent decades. Psychiatrists, therefore, need to inquire about and discuss the use of these treatments with patients and offer up-to-date information about risks and benefits. However, evidence-based information is limited. To address the needs of practicing psychiatrists and the public, the American Psychiatric Association has set up a task force on CAM to review the evidence for the efficacy and safety of CAM treatments in major depressive disorder (MDD). Some CAM treatments have known general health benefits but currently equivocal evidence of benefit in MDD. Exercise, folate, and omega-3 fatty acids can be recommended to most patients with MDD for their general health benefits, and St John's wort and S-adenosyl-L-methionine (SAM-e) may be appropriate to treat depression in some patients. In all instances, use of CAM therapies should not take the place of diagnostic assessment and evaluation for MDD and consideration of standard treatment use. Patients should receive advice about all available treatment options, including risks, benefits, and possible drug interactions, as well as full evaluations and regular monitoring.
在过去几十年中，精神疾病患者和普通人群一样，越来越多地使用补充和替代医学（CAM）。因此，精神科医生需要询问并与患者讨论这些治疗方法的使用情况，并提供有关风险和益处的最新信息。然而，基于证据的信息有限。为了满足执业精神科医生和公众的需求，美国精神病学协会成立了一个 CAM 工作组，以审查 CAM 治疗方法在重度抑郁症（MDD）中的疗效和安全性的证据。一些 CAM 治疗方法具有已知的一般健康益处，但目前在 MDD 中的益处证据尚不确定。运动、叶酸和欧米伽-3 脂肪酸可以推荐给大多数 MDD 患者，以促进其一般健康，而圣约翰草和 S-腺苷甲硫氨酸（SAM-e）可能适合某些患者治疗抑郁症。在所有情况下，CAM 疗法的使用都不应替代 MDD 的诊断评估和标准治疗的使用。患者应获得有关所有可用治疗选择的建议，包括风险、益处和可能的药物相互作用，以及全面评估和定期监测。
