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Benjamin G. Druss, MD, MPH; Robert A. Rosenheck, MD

Arch Gen Psychiatry. 2000;57:708-714.

Background  To our knowledge, this study provides the first national estimates for use of practitioner-based complementary treatments by US residents reporting mental conditions.

Methods  A total of 16,038 respondents to the 1996 Medical Expenditure Panel Survey were asked about visits for 12 complementary medical services (eg, chiropractic services and herbal remedies). Bivariate and multiple regression models examined use of these therapies in individuals reporting a mental condition (n=1803), fair or poor mental health status (n=992), and 1 of 4 chronic medical conditions (n=3262) and in the remainder of the sample (n=10,793).

Results  A total of 9.8% of those reporting a mental condition made a complementary visit, and about half of these (4.5%) made a visit to treat the mental condition. Persons reporting transient stress or adjustment disorders were most likely (odds ratio, 9.1%; 95% confidence interval, 5.5%-12.7%), and those with psychotic (odds ratio, 1.5%; 95% confidence interval, 0.0%-4.2%) and affective (odds ratio, 2.6%; 95% confidence interval, 1.5%-3.8%) conditions least likely, to use complementary therapies to treat their mental condition. In multivariate models controlling for medical comorbidity, fair or poor mental health status, and demographic factors, report of a mental condition predicted a 1.27-fold increase in the odds of a complementary visit (95% confidence interval, 1.04-1.54).

Conclusions  Self-reported mental conditions were associated with increased use of complementary treatments, although use of these treatments was concentrated in respondents with transient distress rather than chronic and serious conditions. More research using structured diagnostic interviews is needed to examine the prevalence, patterns, and clinical implications of use of these treatments by individuals with mental conditions in "real world" community settings.

From the Departments of Psychiatry and Public Health, Yale University and the Northeast Program Evaluation Center, VA Healthcare System, West Haven, Conn.

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