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Dehghan M, Mirza HK, Alaeifar S, Jazinizadeh M, Iranmanesh MH, Mohammadiakbarabadi F, Salehi M, Ghonchehpour A, Zakeri MA. Quality of Life and Use of Complementary and Alternative Medicines among Narcotics Anonymous Patients: A Cross-Sectional Study in Southeast Iran. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2023; 2023:3003247. [PMID: 37727769 PMCID: PMC10506870 DOI: 10.1155/2023/3003247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 08/11/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
Background Addiction, a chronic and recurrent disorder, is associated with lasting changes in the brain and can significantly affect the quality of life of people. Complementary and alternative medicine (CAM) along with modern medical treatments can improve the quality of life of individuals. This study aimed to investigate the relationship between the use of complementary and alternative medicines (CAMs) and quality of life in narcotics anonymous patients. Methods This cross-sectional study was performed on 189 narcotics anonymous patients in southeastern Iran. Using questionnaires such as the demographic information, the World Health Organization Quality of Life-BREF (WHOQOL-BREF), CAM, and satisfaction with the use of CAM, the researcher was able to compile a comprehensive picture of the population. Results The mean score of overall quality of life and general health was 64.02 ± 23.32. Overall, 66.1 percent (n = 125) of the participants reported using at least one type of CAM in the previous year. Last year, 25.9% of participants used at least one kind of CAM, 22.8% used two types of CAM, 7.9% used three types of CAM, and 4.8% used four to five types of CAM. Thirty-nine point seven percent of them reported using prayer, 36.5% reported using medicinal herbs, 15.3% of participants reported using massage, 14.3% of participants reported using dietary supplements, 12.2% reported using wet cupping, and 8.5% reported using meditation. There were no significant differences in physical, psychological, environmental, and overall quality of life between CAM users and non-CAM users. The prayer users had significantly higher scores in terms of social relationships, environment, and overall quality of life than nonprayer users. Employed participants and opium users had significantly higher overall quality of life than others. Conclusion Although there was no difference in quality of life between CAM and non-CAM users, the present study showed that prayer and medicinal herbs were the most commonly used methods among narcotics anonymous patients. However, prayer and religious beliefs were successful in improving the quality of life of these individuals. Physicians and other healthcare providers must advise patients with addiction to use different CAMs in order to improve their quality of life and quit narcotics. Future in-depth studies could help these patients use CAMs and improve their quality of life.
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Affiliation(s)
- Mahlagha Dehghan
- Department of Critical Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Sobhan Alaeifar
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | | | | | - Mina Salehi
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Asma Ghonchehpour
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Zakeri
- Clinical Research Development Unit, Ali-Ibn Abi-Talib Hospital, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Gliedt JA, Spector AL, Schneider MJ, Williams J, Young S. Disparities in chiropractic utilization by race, ethnicity and socioeconomic status: A scoping review of the literature. JOURNAL OF INTEGRATIVE MEDICINE 2023; 21:159-167. [PMID: 36841750 DOI: 10.1016/j.joim.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 11/14/2022] [Indexed: 02/19/2023]
Abstract
BACKGROUND Chiropractic is the largest complementary and alternative medicine profession in the United States, with increasing global growth. A preliminary literature review suggests a lack of widespread diversity of chiropractic patient profiles. OBJECTIVE There have been no prior studies to comprehensively integrate the literature on chiropractic utilization rates by race, ethnicity, and socioeconomic status. The purpose of this scoping review is to identify and describe the current state of knowledge of chiropractic utilization by race, ethnicity, education level, employment status, and income and poverty level. SEARCH STRATEGY Systematic searches were conducted in PubMed, Ovid MEDLINE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews, and Index to Chiropractic Literature from inception to May 2021. INCLUSION CRITERIA Articles that reported race or ethnicity, education level, employment status, income or poverty level variables and chiropractic utilization rates for adults (≥18 years of age) were eligible for this review. DATA EXTRACTION AND ANALYSIS Data extracted from articles were citation information, patient characteristics, race and ethnicity, education level, employment status, income and poverty level, and chiropractic utilization rate. A descriptive numerical summary of included studies is provided. This study provides a qualitative thematic narrative of chiropractic utilization with attention to race and ethnicity, education level, income and poverty level, and employment status. RESULTS A total of 69 articles were eligible for review. Most articles were published since 2003 and reported data from study populations in the United States. Of the race, ethnicity and socioeconomic categories that were most commonly reported, chiropractic utilization was the highest for individuals identifying as European American/White/non-Hispanic White/Caucasian (median 20.00%; interquartile range 2.70%-64.60%), those with employment as a main income source (median utilization 78.50%; interquartile range 77.90%-79.10%), individuals with an individual or household/family annual income between $40,001 and $60,000 (median utilization 29.40%; interquartile range 25.15%-33.65%), and individuals with less than or equal to (12 years) high school diploma/general educational development certificate completion (median utilization 30.70%; interquartile range 15.10%-37.00%). CONCLUSION This comprehensive review of the literature on chiropractic utilization by race, ethnicity and socioeconomic status indicates differences in chiropractic utilization across diverse racial and ethnic and socioeconomic populations. Heterogeneity existed among definitions of key variables, including race, ethnicity, education level, employment status, and income and poverty level in the included studies, reducing clarity in rates of chiropractic utilization for these populations. Please cite this article as: Gliedt JA, Spector AL, Schneider MJ, Williams J, Young S. Disparities in chiropractic utilization by race, ethnicity and socioeconomic status: a scoping review of the literature. J Integr Med. 2023; Epub ahead of print.
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Affiliation(s)
- Jordan A Gliedt
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
| | - Antoinette L Spector
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA
| | - Michael J Schneider
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA 15219, USA; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Joni Williams
- Department of Medicine, Division of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Staci Young
- Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Kwon CY, Lee B. The efficacy of acupuncture on suicidal behavior: A protocol for systematic review and meta-analysis. AIMS Public Health 2022; 9:651-660. [PMID: 36636152 PMCID: PMC9807412 DOI: 10.3934/publichealth.2022046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 01/16/2023] Open
Abstract
Background One of the leading causes of death worldwide is suicide. Acupuncture has been reported to be related to clinical improvement of some risk factors for suicide including depression. Moreover, practitioner-patient communication is an important component of the acupuncture procedure, which may contribute to suicide risk reduction as a social contact. This systematic review was performed to evaluate the effectiveness and safety of acupuncture for suicidal behavior. Methods A comprehensive search will be conducted in electronic medical databases including MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, Allied and Complementary Medicine Database, PsycARTICLES, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, Wanfang data, VIP Chinese Science and Technology Periodicals, Citation Information by NII, Koreanstudies Information Service System, Korea Citation Index, Research Information Sharing Service, Oriental Medicine Advanced Searching Integrated System, and Korean Medical database. Interventional studies regardless of its design to assess the role of acupuncture on suicide prevention will be included. The validated measure of suicidal ideation including Beck scale for suicidal ideation will be considered as a primary outcome. The validated tools will be used to assess methodological quality of included studies according to its design (e.g., Cochrane Collaboration's risk of bias tool-2). If sufficient homogeneous data from controlled clinical trials exist, a quantitative synthesis will be performed. According to the heterogeneity of included studies, either a random-effects or fixed-effects model will be used. Discussion The findings of this systematic review and meta-analysis will help to address the emerging major public health problem, suicide, in terms of evidence-based medicine.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, 52–57, Yangjeong-ro, Busanjin-gu, Busan, Republic of Korea,* Correspondence: ; Tel: +82518508808; Fax: +82518675162
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, 1672, Yuseong-daero, Yuseong-gu, Daejeon, Republic of Korea
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Sylvain B, Barbara B, Jean-Michel G, Thierry FC. Complementary and alternative medicines in patients with alcohol or tobacco use disorder: Use, Expectations and Beliefs. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sharifian N, Sol K, Zaheed AB, Morris EP, Palms JD, Martino AG, Zahodne LB. Depressive Symptoms, Leisure Activity Engagement, and Global Cognition in Non-Hispanic Black and White Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 77:2137-2147. [PMID: 34387343 PMCID: PMC9683487 DOI: 10.1093/geronb/gbab153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Prior research indicates that depressive symptoms disproportionately affect cognition in non-Hispanic Blacks relative to non-Hispanic Whites. Depressive symptoms have been linked to worse global cognition in older adulthood through lower leisure activity engagement, but less is known regarding the distinct types of activities that drive these associations and whether associations involving depressive symptoms, leisure activities, and cognition differ across racial groups. METHODS This cross-sectional study used data from the Michigan Cognitive Aging Project (n = 453, 52.80% Black, Mage = 63.60 years). Principal components analysis identified 6 subtypes of leisure activities (cognitive, creative, community, physical, children, and games). Mediation models examined whether distinct leisure activity subtypes mediated the association between depressive symptoms and performance on a comprehensive neuropsychological battery and whether race moderated these associations. RESULTS There were no racial differences in the level of depressive symptoms after adjusting for sociodemographic, socioeconomic, and health covariates. Only lower cognitive activity engagement mediated the negative association between depressive symptoms and global cognition. Multigroup models revealed that this indirect effect was only evident in Blacks, who showed a stronger negative association between depressive symptoms and cognitive activity engagement than Whites. After accounting for indirect effects, a direct effect of higher depressive symptoms on worse cognition remained and did not differ across racial groups. DISCUSSION Depressive symptoms may disproportionately affect cognition among Blacks through a greater negative impact on engagement in cognitively stimulating activities that have been shown to promote cognitive reserve. Additional research is necessary to identify other mechanisms linking depressive symptoms and cognition.
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Affiliation(s)
- Neika Sharifian
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Ketlyne Sol
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Afsara B Zaheed
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Emily P Morris
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Jordan D Palms
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Alexa G Martino
- Department of Psychology, University of Michigan, Ann Arbor, USA
| | - Laura B Zahodne
- Address correspondence to: Laura Zahodne, PhD, Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA. E-mail:
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Whaley AL. Associations between seeking help from indigenous healers and symptoms of depression versus psychosis in the African diaspora of the United States. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Use of complementary and alternative medicine among patients with cancer in a sub-Himalayan state in India: An exploratory study. J Ayurveda Integr Med 2021; 12:126-130. [PMID: 33637425 PMCID: PMC8039360 DOI: 10.1016/j.jaim.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/21/2020] [Accepted: 01/05/2021] [Indexed: 11/26/2022] Open
Abstract
Background The use of complementary and alternative medicine (CAM) is widespread among cancer patients in India. Objective The present study elucidated usage patterns of CAM and the factors responsible for its adoption among the patients with cancer, and the therapeutic impact of CAM. Materials and methods This was a questionnaire-based study, conducted among patients with cancer in a tertiary care hospital in a sub-Himalayan city. Data were analyzed using statistical methods. Results A total of 2614 patients with cancer were included. Almost half of the patients (n = 1208, 46.2%) reported to have been treated with CAM. Breast cancer (n = 274, 23.0%) was most prevalent with majority at advanced stages. Ayurveda (n = 428, 35.9%) Yoga/Naturopathy (n = 381, 32.0%) Homeopathy (n = 143, 12.0%) and Unani (n = 71, 5.9%) were used commonly. Among CAM users, 85.0% (n = 1012) of patients used CAM as the sole method of treatment, while 58.9% (n = 702) patients reported initial symptomatic benefit. Conclusion Using CAM benefitted a significant number of patients with cancer. However, there is an urgent need to integrate CAM with modern system of medicine. CAM is widely used in India including in cancer patients. Almost half of the patients reported to have been treated with CAM. CAM needs integration with modern system of medicine.
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Taylor RJ, Chatters LM. Psychiatric Disorders Among Older Black Americans: Within- and Between-Group Differences. Innov Aging 2020; 4:igaa007. [PMID: 32313842 PMCID: PMC7156931 DOI: 10.1093/geroni/igaa007] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Indexed: 11/29/2022] Open
Abstract
Psychiatric disorders impose significant personal, social, and financial costs for individuals, families, and the nation. Despite a large amount of research and several journals focused on psychiatric conditions, there is a paucity of research on psychiatric disorders among Black Americans (i.e., African Americans and Black Caribbeans), particularly older Black Americans. The present literature review examines research on psychiatric disorders among older Black Americans and provides a broad overview of research findings that are based on nationally representative studies. Collectively, this research finds: (1) older African Americans have lower rates of psychiatric disorders than younger African Americans; (2) family support is not protective of psychiatric disorders, whereas negative interaction with family members is a risk factor; (3) everyday discrimination is a risk factor for psychiatric disorders; (4) both older African Americans and African American across the adult age range have lower prevalence rates of psychiatric disorders than non-Latino whites; (5) Black Caribbean men have particularly high rates of depression, posttraumatic stress disorder, and suicide attempts; and (6) a significant proportion of African American older adults with mental health disorders do not receive professional help. This literature review also discusses the “Race Paradox” in mental health, the Environmental Affordances Model, and the importance of investigating ethnicity differences among Black Americans. Future research directions address issues that are directly relevant to the Black American population and include the following: (1) understanding the impact of mass incarceration on the psychiatric disorders of prisoners’ family members, (2) assessing the impact of immigration from African countries for ethnic diversity within the Black American population, (3) examining the impact of racial identity and racial socialization as potential protective factors for psychiatric morbidities, and (4) assessing racial diversity in life-course events and their impact on mental health.
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Affiliation(s)
- Robert Joseph Taylor
- School of Social Work, University of Michigan, Ann Arbor.,Institute for Social Research, University of Michigan, Ann Arbor
| | - Linda M Chatters
- School of Social Work, University of Michigan, Ann Arbor.,Institute for Social Research, University of Michigan, Ann Arbor.,Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor
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Seet V, Abdin E, Vaingankar JA, Shahwan S, Chang S, Lee B, Chong SA, Subramaniam M. The use of complementary and alternative medicine in a multi-ethnic Asian population: results from the 2016 Singapore Mental Health Study. BMC Complement Med Ther 2020; 20:52. [PMID: 32054477 PMCID: PMC7076843 DOI: 10.1186/s12906-020-2843-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 02/04/2020] [Indexed: 01/12/2023] Open
Abstract
Background This study seeks to investigate factors associated with using complementary and alternative medicine (CAM) for a mental illness among the three major ethnic groups (Chinese, Indians and Malays) in the general population of Singapore. Methods Data from the 2016 Singapore Mental Health Study was used; responses from the “Services” section of the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) administered during face-to-face household interviews with participants were analyzed to establish prevalence of CAM use among Singaporeans. Additionally, sociodemographic variables of interest were selected for sub-group regression analyses to yield correlates of CAM use among the three ethnic groups. Results 6.4% of Singaporeans used at least one form of CAM in the past 12 months for their mental illness. Malays reported using CAM the most, followed by Indians and Chinese. Sociodemographic variables such as education and employment were differently associated with CAM use among the ethnicities. Across all three ethnic groups, CAM users were more likely to report poorer mental health-related quality of life. Conclusion Despite the significant differences in CAM use among Chinese, Malays and Indians, those who had a mental illness were significantly more likely to use CAM regardless of ethnicity. This highlights the need for communication between CAM practitioners and conventional mental healthcare providers for early referral when appropriate which would lead to improved healthcare delivery and better clinical outcomes.
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Affiliation(s)
- Vanessa Seet
- Research Division, Institute of Mental Health, Singapore, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore
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Groden SR, Woodward AT, Chatters LM, Taylor RJ. Use of Complementary and Alternative Medicine among Older Adults: Differences between Baby Boomers and Pre-Boomers. Am J Geriatr Psychiatry 2017; 25:1393-1401. [PMID: 28958866 PMCID: PMC5694360 DOI: 10.1016/j.jagp.2017.08.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 07/27/2017] [Accepted: 08/02/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To compare use of complementary and alternative medicine (CAM) across age cohorts. DESIGN Secondary analysis of data from the Collaborative Psychiatric Epidemiology Surveys. PARTICIPANTS Adults born in 1964 or earlier (N = 11,371). Over half (61.3%) are baby boomers and 53% are female. Seventy-five percent of the sample is white, 10.2% African American, 0.6% black Caribbean, 9.35% Latino, and 4.1% Asian. MEASUREMENTS The dependent variable is a dichotomous variable indicating use of any CAM. The main predictor of interest is age cohort categorized as pre-boomers (those born in 1945 or earlier) and baby boomers (those born between 1946 and 1964). Covariates include the use of traditional service providers in the past 12 months and 12-month levels of mood, anxiety, and substance disorder. Disorders were assessed with the Diagnostic and Statistical Manual World Mental Health Composite International Diagnostic Interview. Logistic regression was used to test the association between use of CAM and age cohort. RESULTS Baby boomers were more likely than pre-boomers to report using CAM for a mental disorder. Among identified CAM users, a higher proportion of baby boomers reported using most individual CAM modalities. Prayer and spiritual practices was the only CAM used by more pre-boomers. CONCLUSIONS Age cohort plays a significant role in shaping individual healthcare behaviors and service use and may influence future trends in the use of CAM for behavioral health. Healthcare providers need to be aware of patient use of CAM and communicate with them about the pros and cons of alternative therapies.
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Bal U, Cengisiz C, Yılmaz E, Karaytuğ MO, Tamam L. Psikiyatri polikliniğine başvuran hastalarda geleneksel ve tamamlayıcı tıp uygulamalarının özellikleri ve yaygınlığı. ACTA ACUST UNITED AC 2017. [DOI: 10.17826/cutf.321175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Dalencour M, Wong EC, Tang L, Dixon E, Lucas-Wright A, Wells K, Miranda J. The Role of Faith-Based Organizations in the Depression Care of African Americans and Hispanics in Los Angeles. Psychiatr Serv 2017; 68:368-374. [PMID: 27842468 PMCID: PMC5726521 DOI: 10.1176/appi.ps.201500318] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE This study examined use of depression care provided by faith-based organizations (FBOs) by African Americans and Hispanics and factors associated with the receipt of such care, including mental illness severity and use of traditional mental health services. METHODS The study used baseline data from the Community Partners in Care study, a group-randomized trial comparing a community-partnered approach with a technical-assistance approach to improving depression care in underresourced communities in Los Angeles. A sample of 947 individuals (48% African American, 27% non-U.S.-born Hispanic, 15% U.S.-born Hispanic, and 10% non-Hispanic white) were surveyed about recent visits to a religious or spiritual place and receipt of FBO depression care. Descriptive analyses compared racial-ethnic, sociodemographic, and health service use variables for three groups: those who did not attend a religious place, those who attended a religious place and did not receive FBO depression services, and those who received FBO depression services. Multinomial logistic regression was used to identify predictors of receipt of FBO depression care. RESULTS A larger proportion of African Americans and non-U.S.-born Hispanics received FBO faith-based depression services compared with non-Hispanic whites and with U.S.-born Hispanics. Receipt of FBO depression services was associated with younger age, lifetime diagnosis of mania, use of primary care depression services, and receipt of a mental health service from a substance abuse agency. CONCLUSIONS FBO depression services were used in the community, especially by persons from racial-ethnic minority groups. Collaborative efforts between FBOs and traditional health services may increase access to depression services for African Americans and Latinos.
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Affiliation(s)
- Michelle Dalencour
- When this work was done, Dr. Dalencour was with the Robert Wood Johnson Clinical Scholars program at the University of California, Los Angeles (UCLA). She is now with the Department of Family Medicine, Boston University, Boston (e-mail: ). Dr. Wong is with RAND Corporation, Santa Monica, California. Dr. Tang, Dr. Wells, and Dr. Miranda are with the UCLA Center for Health Services and Society. Dr. Wells and Dr. Miranda are also with the UCLA Department of Psychiatry and Biobehavioral Sciences. Dr. Dixon is with the UCLA School of Nursing. Mrs. Lucas-Wright is an academic/community liaison for the UCLA Clinical and Translational Science Institute at both RAND and Charles R. Drew University of Medicine and Science, Los Angeles
| | - Eunice C Wong
- When this work was done, Dr. Dalencour was with the Robert Wood Johnson Clinical Scholars program at the University of California, Los Angeles (UCLA). She is now with the Department of Family Medicine, Boston University, Boston (e-mail: ). Dr. Wong is with RAND Corporation, Santa Monica, California. Dr. Tang, Dr. Wells, and Dr. Miranda are with the UCLA Center for Health Services and Society. Dr. Wells and Dr. Miranda are also with the UCLA Department of Psychiatry and Biobehavioral Sciences. Dr. Dixon is with the UCLA School of Nursing. Mrs. Lucas-Wright is an academic/community liaison for the UCLA Clinical and Translational Science Institute at both RAND and Charles R. Drew University of Medicine and Science, Los Angeles
| | - Lingqi Tang
- When this work was done, Dr. Dalencour was with the Robert Wood Johnson Clinical Scholars program at the University of California, Los Angeles (UCLA). She is now with the Department of Family Medicine, Boston University, Boston (e-mail: ). Dr. Wong is with RAND Corporation, Santa Monica, California. Dr. Tang, Dr. Wells, and Dr. Miranda are with the UCLA Center for Health Services and Society. Dr. Wells and Dr. Miranda are also with the UCLA Department of Psychiatry and Biobehavioral Sciences. Dr. Dixon is with the UCLA School of Nursing. Mrs. Lucas-Wright is an academic/community liaison for the UCLA Clinical and Translational Science Institute at both RAND and Charles R. Drew University of Medicine and Science, Los Angeles
| | - Elizabeth Dixon
- When this work was done, Dr. Dalencour was with the Robert Wood Johnson Clinical Scholars program at the University of California, Los Angeles (UCLA). She is now with the Department of Family Medicine, Boston University, Boston (e-mail: ). Dr. Wong is with RAND Corporation, Santa Monica, California. Dr. Tang, Dr. Wells, and Dr. Miranda are with the UCLA Center for Health Services and Society. Dr. Wells and Dr. Miranda are also with the UCLA Department of Psychiatry and Biobehavioral Sciences. Dr. Dixon is with the UCLA School of Nursing. Mrs. Lucas-Wright is an academic/community liaison for the UCLA Clinical and Translational Science Institute at both RAND and Charles R. Drew University of Medicine and Science, Los Angeles
| | - Aziza Lucas-Wright
- When this work was done, Dr. Dalencour was with the Robert Wood Johnson Clinical Scholars program at the University of California, Los Angeles (UCLA). She is now with the Department of Family Medicine, Boston University, Boston (e-mail: ). Dr. Wong is with RAND Corporation, Santa Monica, California. Dr. Tang, Dr. Wells, and Dr. Miranda are with the UCLA Center for Health Services and Society. Dr. Wells and Dr. Miranda are also with the UCLA Department of Psychiatry and Biobehavioral Sciences. Dr. Dixon is with the UCLA School of Nursing. Mrs. Lucas-Wright is an academic/community liaison for the UCLA Clinical and Translational Science Institute at both RAND and Charles R. Drew University of Medicine and Science, Los Angeles
| | - Kenneth Wells
- When this work was done, Dr. Dalencour was with the Robert Wood Johnson Clinical Scholars program at the University of California, Los Angeles (UCLA). She is now with the Department of Family Medicine, Boston University, Boston (e-mail: ). Dr. Wong is with RAND Corporation, Santa Monica, California. Dr. Tang, Dr. Wells, and Dr. Miranda are with the UCLA Center for Health Services and Society. Dr. Wells and Dr. Miranda are also with the UCLA Department of Psychiatry and Biobehavioral Sciences. Dr. Dixon is with the UCLA School of Nursing. Mrs. Lucas-Wright is an academic/community liaison for the UCLA Clinical and Translational Science Institute at both RAND and Charles R. Drew University of Medicine and Science, Los Angeles
| | - Jeanne Miranda
- When this work was done, Dr. Dalencour was with the Robert Wood Johnson Clinical Scholars program at the University of California, Los Angeles (UCLA). She is now with the Department of Family Medicine, Boston University, Boston (e-mail: ). Dr. Wong is with RAND Corporation, Santa Monica, California. Dr. Tang, Dr. Wells, and Dr. Miranda are with the UCLA Center for Health Services and Society. Dr. Wells and Dr. Miranda are also with the UCLA Department of Psychiatry and Biobehavioral Sciences. Dr. Dixon is with the UCLA School of Nursing. Mrs. Lucas-Wright is an academic/community liaison for the UCLA Clinical and Translational Science Institute at both RAND and Charles R. Drew University of Medicine and Science, Los Angeles
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Abstract
Many African Americans (AAs) use clergy as their primary source of help for depression, with few being referred to mental health providers. This study used face-to-face workshops to train AA clergy to recognize the symptoms and levels of severity of depression. A pretest/posttest format was used to test knowledge (N = 42) about depression symptoms. Results showed that the participation improved the clergy's ability to recognize depression symptoms. Faith community nurses can develop workshops for clergy to improve recognition and treatment of depression.
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Ravindran AV, Balneaves LG, Faulkner G, Ortiz A, McIntosh D, Morehouse RL, Ravindran L, Yatham LN, Kennedy SH, Lam RW, MacQueen GM, Milev RV, Parikh SV. Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 5. Complementary and Alternative Medicine Treatments. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:576-87. [PMID: 27486153 PMCID: PMC4994794 DOI: 10.1177/0706743716660290] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. METHODS Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. "Complementary and Alternative Medicine Treatments" is the fifth of six sections of the 2016 guidelines. RESULTS Evidence-informed responses were developed for 12 questions for 2 broad categories of complementary and alternative medicine (CAM) interventions: 1) physical and meditative treatments (light therapy, sleep deprivation, exercise, yoga, and acupuncture) and 2) natural health products (St. John's wort, omega-3 fatty acids; S-adenosyl-L-methionine [SAM-e], dehydroepiandrosterone, folate, Crocus sativus, and others). Recommendations were based on available data on efficacy, tolerability, and safety. CONCLUSIONS For MDD of mild to moderate severity, exercise, light therapy, St. John's wort, omega-3 fatty acids, SAM-e, and yoga are recommended as first- or second-line treatments. Adjunctive exercise and adjunctive St. John's wort are second-line recommendations for moderate to severe MDD. Other physical treatments and natural health products have less evidence but may be considered as third-line treatments. CAM treatments are generally well tolerated. Caveats include methodological limitations of studies and paucity of data on long-term outcomes and drug interactions.
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Affiliation(s)
- Arun V Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | | | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia
| | - Abigail Ortiz
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario
| | - Diane McIntosh
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | | | | | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | - Sidney H Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Ontario
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia
| | | | - Roumen V Milev
- Department of Psychiatry, Queen's University, Kingston, Ontario
| | - Sagar V Parikh
- Department of Psychiatry, University of Toronto, Toronto, Ontario Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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Sex Differences in the Use of Complementary and Alternative Medicine among Adults with Multiple Chronic Conditions. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:2067095. [PMID: 27239207 PMCID: PMC4863098 DOI: 10.1155/2016/2067095] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/07/2016] [Indexed: 11/18/2022]
Abstract
Objective. To examine sex differences in complementary and alternative medicine (CAM) use among adults with multiple chronic conditions. Methods. This study used a cross-sectional design with data from the 2012 National Health Interview Survey. The participants were interviewed in 2012 and the reference period for the questions in the survey varied from 1 week to 12 months prior to the interview date. The study included adults (age > 21 years) with no missing data on CAM use variables and who had multiple chronic conditions. Multivariable regression analyses were used to examine the association between sex and CAM use. Results. A significantly higher percentage of women compared to men had ever used CAM (51.5% versus 44.3%); women were more likely to have ever used CAM (AOR = 1.49, 95% CI = 1.35-1.65). Among CAM users, a higher percentage of women compared to men used CAM in the past 12 months (53.5% vs. 42.7%); women were more likely to use CAM in the past 12 months (AOR = 1.71, 95% CI = 1.49-1.97). Factors associated with CAM use in the past 12 months were different for men and women; income and obesity were associated with CAM use in the past 12 months among women and not among men. Conclusion. Among adults with multiple chronic conditions, women were more likely to use CAM as compared to men.
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Shao Z, Richie WD, Bailey RK. Racial and Ethnic Disparity in Major Depressive Disorder. J Racial Ethn Health Disparities 2015; 3:692-705. [DOI: 10.1007/s40615-015-0188-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 11/08/2015] [Accepted: 11/12/2015] [Indexed: 12/15/2022]
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Burnett-Zeigler I, Schuette S, Victorson D, Wisner KL. Mind-Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review. J Altern Complement Med 2015; 22:115-24. [PMID: 26540645 DOI: 10.1089/acm.2015.0038] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Mind-body approaches are commonly used to treat a variety of chronic health conditions, including depression and anxiety. A substantial proportion of individuals with depression and anxiety disorders do not receive conventional treatment; disadvantaged individuals are especially unlikely to receive treatment. Mind-body approaches offer a potentially more accessible and acceptable alternative to conventional mental health treatment for disadvantaged individuals, who may not otherwise receive mental health treatment. This review examines evidence for the efficacy of mind-body interventions for mental health symptoms among disadvantaged populations. While rates of utilization were relatively lower for racial/ethnic minorities, evidence suggests that significant proportions of racial/ethnic minorities are using complementary health approaches as health treatments, especially prayer/healers and natural or herbal remedies. This review of studies on the efficacy of mind-body interventions among disadvantaged populations found evidence for the efficacy of mind-body approaches for several mental and physical health symptoms, functioning, self-care, and overall quality of life.
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Affiliation(s)
- Inger Burnett-Zeigler
- 1 Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, IL
| | - Stephanie Schuette
- 1 Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, IL
| | - David Victorson
- 2 Medical Social Sciences, Northwestern University Feinberg School of Medicine , Chicago, IL
| | - Katherine L Wisner
- 1 Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine , Chicago, IL
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Abstract
African-Americans are approximately half as likely as their white counterparts to use professional mental health services. High levels of religiosity among African-Americans may lend to a greater reliance on religious counseling and coping when facing a mental health problem. This study investigates the relationship between three dimensions of religiosity and professional mental health service utilization among a large (n = 3570), nationally representative sample of African-American adults. African-American adults who reported high levels of organizational and subjective religiosity were less likely than those with lower levels of religiosity to use professional mental health services. This inverse relationship was generally consistent across individuals with and without a diagnosable Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, anxiety, mood, or substance use disorder. No association was found between nonorganizational religiosity and professional mental health service use. Seeking professional mental health care may clash with sociocultural religious norms and values among African-Americans. Strategic efforts should be made to engage African-American clergy and religious communities in the conceptualization and delivery of mental health services.
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Solomon D, Adams J. The use of complementary and alternative medicine in adults with depressive disorders. A critical integrative review. J Affect Disord 2015; 179:101-13. [PMID: 25863008 DOI: 10.1016/j.jad.2015.03.031] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 03/18/2015] [Accepted: 03/18/2015] [Indexed: 01/16/2023]
Abstract
BACKGROUND Depression has been identified as one of the most frequent indications for CAM use and is a strong predictor of CAM use. The present article provides a critical review of CAM use for depressive disorders including bipolar depression by addressing prevalence of CAM use and CAM users׳ characteristics, motivation, decision-making and communication with healthcare providers. METHODS A comprehensive search of 2003-2014 international literature in the Medline, CINAHL, AMED, and SCOPUS databases was conducted. The search was confined to peer-reviewed articles published in English with abstracts and reporting new empirical research findings regarding CAM use and depressive disorders. RESULTS A considerable level of CAM use was observed among both general and clinical populations of people suffering from depressive disorders, many of whom use CAM concurrently with their conventional medicine. In particular, high rates of CAM use were found among those with bipolar disorder, an illness known to cause substantial impairments in health-related quality of life. Concomitant prescription medication use ranged from 0.52% to as high as 100%. LIMITATIONS Study design such as the inclusion of bipolar and depression in the same diagnostic category hamper the differentiation and attribution of CAM usage for symptoms. CONCLUSION Findings of our review show that enduring impairments in function and persistence of symptoms (as reflected by increased CAM use proportional to severity of illness and comorbidity) are the impetus for sufferers of depressive illness to seek out CAM. The psychosocial factors associated with CAM use in depressive illnesses and severe mental illness are yet to be established. Subsequent research amongst those with depressive disorders would be informative in clarifying the range of motivations associated with mental illness.
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Affiliation(s)
- Daniela Solomon
- Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW 2031, Australia.
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, 235-253 Jones St Ultimo, NSW 2007, Australia.
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Moitra E, Lewis-Fernández R, Stout RL, Angert E, Weisberg RB, Keller MB. Disparities in psychosocial functioning in a diverse sample of adults with anxiety disorders. J Anxiety Disord 2014; 28:335-43. [PMID: 24685821 PMCID: PMC4028956 DOI: 10.1016/j.janxdis.2014.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 02/14/2014] [Accepted: 02/25/2014] [Indexed: 11/24/2022]
Abstract
Anxiety disorders are associated with psychosocial functional impairments, but no study has compared how these impairments might vary by ethno-racial status. We examined whether minority status was uniquely associated with functional impairments in 431 adults with anxiety disorders. Functioning was measured in the rater-assessed domains of: Global Assessment of Functioning (GAF); global psychosocial functioning; work, relationship, and recreational functioning; and, self-reported: life satisfaction, mental health functioning, physical functioning, and disability status. After controlling for demographic and clinical variables, results revealed evidence of disparities, whereby African Americans (AAs), particularly those with low income, had worse GAF, worse global psychosocial functioning, and were more likely to be disabled compared to non-Latino Whites. Latinos, particularly those with low income, had worse global psychosocial functioning than non-Latino Whites. Results suggest AAs and Latinos are at increased risk for functional impairments not better accounted for by other demographic or clinical variables.
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Affiliation(s)
- Ethan Moitra
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA.
| | - Roberto Lewis-Fernández
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, Unit 69, New York, NY 10032, USA.
| | - Robert L Stout
- Pacific Institute for Research and Evaluation, 1005 Main Street, Unit 8120, Pawtucket, RI 02860, USA.
| | - Erica Angert
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA.
| | - Risa B Weisberg
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA; Department of Family Medicine, Alpert Medical School of Brown University, USA.
| | - Martin B Keller
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, USA.
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Hwang JH, Han DW, Yoo EK, Kim WY. The utilisation of Complementary and Alternative Medicine (CAM) among ethnic minorities in South Korea. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:103. [PMID: 24641983 PMCID: PMC3994841 DOI: 10.1186/1472-6882-14-103] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 03/12/2014] [Indexed: 11/17/2022]
Abstract
Background Race has been reported to affect the use of complementary and alternative medicine (CAM), but there is very little research on the use of CAM by ethnicity in Korea. This study explores the prevalence of CAM use among ethnic minorities in South Korea. Methods The design is a descriptive and cross-sectional study. A convenience sample of ethnic minorities was recruited from two public healthcare centres in Gyeonggi province. The survey instrument included 37 questions regarding CAM use, factors influencing use of CAM, self-health management, and the socio-demographic profile of study participants. Results Sixty-two percent of study participants reported the use of CAM. Multivitamins (53.3%), acupuncture (48.9%), and traditional Korean herbal medicine (38.9%) were popular CAM modalities in our sample. Other notable CAM modalities included herbal plants, therapeutic massage, and moxibustion therapy. The majority of CAM users (52.2%) received CAM services to treat diseases or as a secondary treatment while receiving conventional care. Having positive perceptions toward the effectiveness of CAM was a major determining factor in CAM use. Conclusions Physicians need to be aware of the fact that many ethnic minorities use CAM therapies. Many CAM users reported that they want doctors to know about their CAM use and have a basic understanding of traditional medicine in their home country. Overcoming language and cultural barriers will help reduce unwanted medical complications. High prevalence of CAM use among ethnic minorities in our study warrants further studies using larger sample population.
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Ennis E. Complementary and alternative medicines (CAMs) and adherence to mental health medications. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:93. [PMID: 24612758 PMCID: PMC3973977 DOI: 10.1186/1472-6882-14-93] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 02/10/2014] [Indexed: 11/29/2022]
Abstract
Background Medication regimes are often poorly adhered to, and the negative consequences of this are well recognised. The dynamics underlying non-adherence are less understood. This paper examines adherence to prescription medications for mental health difficulties in relation to the use of complementary and alternative medicines (CAMs). This was based on suggestions that within medical pluralism, CAMs may reduce adherence to conventional prescription medications for reasons such as their further complicating the medication regime or their being perceived as a substitute with less adverse side effects than conventional prescription medications. Methods Data used was from the National Comorbidity Study Replication (NCS-R), specifically those 1396 individuals who reported taking a prescription drug for mental health difficulties within the last 12 months and under the supervision of a health professional. This subsample was selected due to their being the only subgroup questioned regarding their medication adherence. Other demographic and health factors were also considered. Results The use of complementary medicines alongside the conventional medicines bore no significant relation to odds of reporting adherence versus non adherence. Ethnicity and medication count were significant predictors of adherence versus non-adherence. Conclusions The above findings are discussed from the point of both promoting the use of CAMs and increasing health professionals’ understanding of the dynamics underlying adherence, or the lack thereof, and subsequently informing interventions to reduce the problems associated with this issue in terms of increased health care needs and reduced quality of life.
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Hornik-Lurie T, Cwikel J, Feinson MC, Lerner Y, Zilber N. Use of unconventional therapies by primary care patients – Religious resources vs. complementary or alternative medicine services. Complement Ther Med 2013; 21:517-24. [DOI: 10.1016/j.ctim.2013.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 06/11/2013] [Accepted: 08/12/2013] [Indexed: 02/04/2023] Open
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Akincigil A, Olfson M, Siegel M, Zurlo KA, Walkup JT, Crystal S. Racial and ethnic disparities in depression care in community-dwelling elderly in the United States. Am J Public Health 2012; 102:319-28. [PMID: 22390446 PMCID: PMC3483986 DOI: 10.2105/ajph.2011.300349] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2011] [Indexed: 01/19/2023]
Abstract
OBJECTIVES We investigated racial/ethnic disparities in the diagnosis and treatment of depression among community-dwelling elderly. METHODS We performed a secondary analysis of Medicare Current Beneficiary Survey data (n = 33,708) for 2001 through 2005. We estimated logistic regression models to assess the association of race/ethnicity with the probability of being diagnosed and treated for depression with either antidepressant medication or psychotherapy. RESULTS Depression diagnosis rates were 6.4% for non-Hispanic Whites, 4.2% for African Americans, 7.2% for Hispanics, and 3.8% for others. After we adjusted for a range of covariates including a 2-item depression screener, we found that African Americans were significantly less likely to receive a depression diagnosis from a health care provider (adjusted odds ratio [AOR] = 0.53; 95% confidence interval [CI] = 0.41, 0.69) than were non-Hispanic Whites; those diagnosed were less likely to be treated for depression (AOR = 0.45; 95% CI = 0.30, 0.66). CONCLUSIONS Among elderly Medicare beneficiaries, significant racial/ethnic differences exist in the diagnosis and treatment of depression. Vigorous clinical and public health initiatives are needed to address this persisting disparity in care.
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Affiliation(s)
- Ayse Akincigil
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.
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Levin J, Taylor RJ, Chatters LM. Prevalence and sociodemographic correlates of spiritual healer use: findings from the National Survey of American Life. Complement Ther Med 2011; 19:63-70. [PMID: 21549256 PMCID: PMC3090998 DOI: 10.1016/j.ctim.2011.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 01/06/2011] [Accepted: 02/04/2011] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES This study investigates sociodemographic and health-related correlates of use of a spiritual healer for medical help. A large national, multiracial-multiethnic data source permits a more comprehensive investigation than was possible in previous studies. It also enables a closer focus on socioeconomic disadvantage and health need as determinants of utilization. DESIGN AND SETTING Respondents are from the National Survey of American Life: Coping with Stress in the 21st Century (NSAL), a nationally representative multi-stage area-probability survey of U.S. adult African Americans, Caribbean Blacks, and non-Hispanic Whites conducted from 2001 to 2003. The sample contains 6082 adults aged 18 and over. MAIN OUTCOME MEASURES NSAL respondents were surveyed about lifetime use of alternative providers for medical care or advice. Response categories included two types of spiritual healers: faith healers and psychics. These outcomes were logistically regressed, separately, onto 10 sociodemographic or health-related indicators: race/ethnicity, age, gender, marital status, education, household income, region, medical care use, insurance coverage, and self-rated health. RESULTS Lifetime utilization of a faith healer is more prevalent among respondents in good health and less prevalent among Caribbean Blacks and never married persons. Users of a psychic healer are more likely to be educated, residents of the Northeast or West, and previously married, and less likely to report excellent health. CONCLUSIONS Use a spiritual healer is not due, on average, to poor education, marginal racial/ethnic or socioeconomic status, dire health straits, or lack of other healthcare options. To some extent, the opposite appears to be true. Use of a spiritual healer is not associated with fewer social and personal resources or limitations in health or healthcare.
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Affiliation(s)
- Jeff Levin
- Institute for Studies of Religion, Baylor University, Waco, TX 76798, United States. jeff
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