title: The use of complementary and alternative medicine in adults with depressive disorders. A critical integrative review.
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%.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors: Black Dog Institute, University of New South Wales, Hospital Road, Randwick, NSW 2031, Australia. Electronic address: d.solomon@unsw.edu.au.
authors: Daniela
authors: D
authors: Solomon
authors: Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, 235-253 Jones St Ultimo, NSW 2007, Australia. Electronic address: Jon.Adams@uts.edu.au.
authors: Jon
authors: J
authors: Adams
mesh_terms: D001714:Bipolar Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000523:psychology / Q000706:statistics & numerical data; D003142:Communication; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data*; D003657:Decision Making; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D006801:Humans; D009042:Motivation; D011788:Quality of Life
keywords: Bipolar disorder; Complementary and alternative medicine (CAM); Depression; Review