title: Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: School of Social Work, The University of Michigan, Ann Arbor, MI 48109, USA.
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Jarman
authors.forename: Brian E
authors.initials: BE
authors.lastname: Perron
authors.forename: Amy M
authors.initials: AM
authors.lastname: Kilbourne
authors.forename: Carrie Farmer
authors.initials: CF
authors.lastname: Teh
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001294:Attitude to Health; D001714:Bipolar Disorder / Q000188:drug therapy / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011788:Quality of Life; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*
chemical_list: D014150:Antipsychotic Agents