title: St John's wort use in Australian general practice patients with depressive symptoms: their characteristics and use of other health services.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of General Practice, University of Melbourne, 200 Berkeley Street, Carlton 3053Victoria, Australia. mpirotta@unimelb.edu.au.
authors: Marie
authors: M
authors: Pirotta
authors: Konstancja
authors: K
authors: Densley
authors: Kirsty
authors: K
authors: Forsdike
authors: Meg
authors: M
authors: Carter
authors: Jane
authors: J
authors: Gunn
mesh_terms: D000293:Adolescent; D000368:Aged; D001315:Australia / Q000453:epidemiology; D000529:Complementary Therapies / Q000706:statistics & numerical data; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D058006:General Practice / Q000379:methods; D058005:General Practitioners; D006801:Humans; D020902:Hypericum / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000706:statistics & numerical data; D010936:Plant Extracts / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D010936:Plant Extracts