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Underserved blacks and Hispanics with depression often use complementary and alternative medicine for their symptoms

About 5 to 10 percent of primary care patients suffer from major depression, with another 16 percent estimated to suffer from minor depression. Primary care doctors who treat underserved blacks and Hispanics with depression should be alert to their frequent use of complementary and alternative medicine (CAM) to manage their symptoms, suggests a new study.

A team of California researchers analyzed surveys and medical records of 315 patients who screened positive for depression out of a total of 2,321 patients from 2 large outpatient primary care clinics in Los Angeles. Two-thirds of the group were Hispanic and one-fifth were black.

Over 57 percent of the group reported using CAM sometimes or often (24 percent) and frequently (33 percent) to treat their depressive symptoms. Overall, 43 percent said they rarely or never used CAM. Lack of health care coverage was one of the strongest predictors of CAM use after controlling for demographic characteristics. In addition, being moderately depressed, use of psychotherapeutic prescription medications, and poorer self-reported health status were all linked to increased frequency of CAM use to treat depression.

Among CAM users, biologically based practices were the most often reported (58 percent), followed by mind-body medicine (47 percent), manipulative and body-based practices (9 percent), and whole medical systems (8 percent). Nearly 13 percent of patients used SAMe, St. John's wort, or 5-hydroxytryptophan for treatment of their depressive symptoms. Also, 22 percent reported using a relaxation technique, and one of three studied reported using vitamin therapy to treat depressive symptoms. These findings suggest that CAM use among minority underserved individuals may serve as a substitute for conventional care when access to care is limited or unavailable.

The study was supported in part by the Agency for Healthcare Research and Quality (HS14022).

See "Correlates of complementary and alternative medicine utilization in depressed, underserved African American and Hispanic patients in primary care settings," by Mohsen Bazargan, Ph.D., Chizobam O. Ani, M.D., M.P.H., David W. Hindman, Ph.D., and others, in The Journal of Alternative and Complementary Medicine 14(5), pp. 537-544, 2008.

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