Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton 3053Victoria, Australia.
BMC Complement Altern Med. 2014 Jun 26;14:204. doi: 10.1186/1472-6882-14-204.
While depression is frequently managed by general practitioners, often patients self-manage these symptoms with alternative therapies, including St John's wort (SJW). We tested whether use of SJW was associated with different patterns of conventional and complementary health service use, strategies used for management of depression, or user dissatisfaction with or lack of trust in their general practitioner or clinic overall.
Secondary analysis of data collected from an Australian population screened for a longitudinal cohort study of depression. Main outcome measures were CES-D for depressive symptoms, satisfaction with their general practitioner (GPAQ), Trust in Physician scale, self-report of health services usage and strategies used to manage depression, stress or worries.
Response rate was 7667/17,780 (43.1%). Of these, 4.3% (320/7,432) had used SJW in the past 12 months (recent 'SJW users'). SJW users were significantly more likely to be depressed and to have a higher CES-D score. There were no statistically significant differences between recent SJW users and non-SJW users in satisfaction with their general practice or in trust in their general practitioner (GP) when adjusted for multiple factors. SJW users were significantly more likely to use all health services, whether conventional or complementary, as well as other strategies used for mental health care. SJW users were also more likely to consider themselves the main carer for their depression.
Primary care attendees with symptoms of depression who use SJW appear not to be rejecting conventional medicine. Rather, they may be proactive care seekers who try both conventional and complementary strategies to manage their depressive symptoms. If GPs enquire and find that their depressed patients are using SJW, this may indicate that they might explore for unrelieved symptoms of depression and also consider the issue of potential for interactions between SJW and other medicines.
虽然抑郁症经常由全科医生管理，但患者经常会自行使用替代疗法来管理这些症状，包括贯叶金丝桃（SJW）。我们测试了 SJW 的使用是否与常规和补充卫生服务使用的不同模式、管理抑郁症的策略、用户对其全科医生或诊所的不满或缺乏信任有关。
对澳大利亚人群进行的纵向队列研究的筛查数据进行二次分析。主要结果指标为 CES-D 用于评估抑郁症状、对全科医生的满意度（GPAQ）、对医生的信任量表、自我报告的卫生服务使用情况以及用于管理抑郁、压力或担忧的策略。
回应率为 17780/7667（43.1%）。其中，12 个月内（最近“SJW 用户”）使用 SJW 的比例为 4.3%（320/7432）。SJW 用户明显更可能抑郁，且 CES-D 评分更高。最近的 SJW 用户和非 SJW 用户在对其常规实践的满意度或对其全科医生的信任方面没有统计学上的显著差异，调整了多个因素后也是如此。SJW 用户更有可能使用所有卫生服务，无论是常规还是补充，以及其他用于心理健康护理的策略。SJW 用户也更有可能认为自己是自己抑郁的主要照顾者。
有抑郁症状的初级保健患者使用 SJW 似乎并没有拒绝传统医学。相反，他们可能是积极主动的寻求者，尝试使用常规和补充策略来管理他们的抑郁症状。如果全科医生询问并发现他们的抑郁患者正在使用 SJW，这可能表明他们可能会探讨未缓解的抑郁症状，并考虑 SJW 与其他药物之间相互作用的可能性。
