School of Social Work, The University of Michigan, Ann Arbor, MI 48109, USA.
J Altern Complement Med. 2010 Mar;16(3):251-5. doi: 10.1089/acm.2009.0325.
Recent research shows a high rate of complementary and alternative medicine (CAM) use among persons with mental disorders, although correlates and patterns of CAM use are relatively unknown. This study tested whether CAM use is associated with perceived effectiveness of conventional treatment (i.e., psychotropic medication and psychotherapy) and medication compliance among persons with bipolar disorder.
Patients with bipolar disorder (n = 435) were included as part of a naturalistic cohort study. Measures of CAM utilization, medication compliance, and perceptions of the effectiveness of psychotropic medications and psychotherapy were based on previously established questionnaires. Associations were tested using bivariate and multivariate analyses.
Bivariate analyses showed that patients who did not perceive psychotherapy as effective at improving social, family, or job functioning reported greater CAM use. However, medication compliance was not significantly associated with use of CAM. Patients who used oral (e.g., herbal therapies) or cognitive (e.g., meditation) CAM were more likely to report that their medications were not effective at relieving manic or depressive symptoms. Users of cognitive CAM were more likely to report that their medications did not help with social, job, or family functioning, and that they did not prevent recurrences of manic or depressive episodes. None of the bivariate associations remained significant in multivariate analyses.
Prior research has suggested that persons who are dissatisfied with treatment for medical conditions are more likely to use CAM therapies. However, the results of this study do not show CAM therapies to be associated with perceived effectiveness of treatments for mental health problems among this sample of persons with serious mental illnesses. This suggests that motivations for CAM use may vary by population and condition. Because few correlates of CAM use among persons with serious mental illnesses are known, providers should conduct routine assessments of CAM use.
最近的研究表明，精神障碍患者中补充和替代医学（CAM）的使用率很高，尽管 CAM 的使用相关因素和模式尚不清楚。本研究检验了 CAM 的使用是否与双相障碍患者对常规治疗（即精神药物治疗和心理治疗）的疗效感知和药物依从性相关。
作为自然队列研究的一部分，纳入了双相障碍患者（n=435）。CAM 利用、药物依从性以及对精神药物和心理治疗效果的感知的测量是基于先前建立的问卷。使用双变量和多变量分析来检验相关性。
双变量分析显示，那些认为心理治疗对改善社交、家庭或工作功能没有效果的患者报告了更多的 CAM 利用。然而，药物依从性与 CAM 的使用无显著关联。使用口服（例如，草药疗法）或认知（例如，冥想）CAM 的患者更有可能报告他们的药物在缓解躁狂或抑郁症状方面没有效果。使用认知 CAM 的患者更有可能报告他们的药物对社交、工作或家庭功能没有帮助，也没有预防躁狂或抑郁发作的复发。在多变量分析中，没有一个双变量关联仍然具有统计学意义。
先前的研究表明，对医疗状况的治疗不满意的人更有可能使用 CAM 疗法。然而，本研究的结果并未表明 CAM 疗法与该严重精神疾病患者样本中对心理健康问题治疗效果的感知有关。这表明，CAM 使用的动机可能因人群和病情而异。由于严重精神疾病患者中 CAM 使用的相关性知之甚少，提供者应定期评估 CAM 的使用情况。
