title: Integrative Medicine Patients Have High Stress, Pain, and Psychological Symptoms.
abstract: BACKGROUND
  Integrative medicine (IM) is a rapidly growing field whose providers report clinical success in treating significant stress, chronic pain, and depressive and anxiety symptoms. While IM therapies have demonstrated efficacy for numerous medical conditions, IM for psychological symptoms has been slower to gain recognition in the medical community.
  
  
  OBJECTIVE
  This large, cross-sectional study is the first of its kind to document the psychosocial profiles of 4182 patients at 9 IM clinics that form the BraveNet Practice-Based Research Network (PBRN).
  
  
  RESULTS
  IM patients reported higher levels of perceived stress, pain, and depressive symptoms, and lower levels of quality of life compared with national norms. Per provider reports, 60% of patients had at least one of the following: stress (9.3%), fatigue (10.2%), anxiety (7.7%), depression (7.2%), and/or sleep disorders (4.8%). Pain, having both physiological and psychological components, was also included and is the most common condition treated at IM clinics. Those with high stress, psychological conditions, and pain were most frequently treated with acupuncture, IM physician consultation, exercise, chiropractic services, diet/nutrition counseling, and massage.
  
  
  CONCLUSIONS
  With baseline information on clinical presentation and service utilization, future PBRN studies can examine promising interventions delivered at the clinic to treat stress and psychological conditions.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Duke Integrative Medicine, Duke University Medical Center, Box 102904, Durham, NC 27710. Electronic address: ruth.wolever@duke.edu.
authors.forename: Ruth Q
authors.initials: RQ
authors.lastname: Wolever
authors.affiliation: East Carolina School of Medicine, Greenville, NC.
authors.forename: Nikita S
authors.initials: NS
authors.lastname: Goel
authors.affiliation: Duke University Medical Center, Durham, NC.
authors.forename: Rhonda S
authors.initials: RS
authors.lastname: Roberts
authors.affiliation: Department of Human Development and Psychological Counseling, Appalachian State University, Boone, NC.
authors.forename: Karen
authors.initials: K
authors.lastname: Caldwell
authors.affiliation: Department of Integrative Medicine, Mount Sinai Beth Israel Medical Center, New York, NY.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kligler
authors.affiliation: Penny George Institute for Health and Healing, Minneapolis, MN.
authors.forename: Jeffery A
authors.initials: JA
authors.lastname: Dusek
authors.affiliation: Duke Integrative Medicine, Duke University Medical Center, Durham, NC.
authors.forename: Adam
authors.initials: A
authors.lastname: Perlman
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, NC.
authors.forename: Rowena
authors.initials: R
authors.lastname: Dolor
authors.affiliation: Osher Center for Integrative Medicine, University of California, San Francisco, CA.
authors.forename: Donald I
authors.initials: DI
authors.lastname: Abrams
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D001007:Anxiety / Q000453:epidemiology* / Q000628:therapy; D059350:Chronic Pain / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D000529:Complementary Therapies; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000628:therapy; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006801:Humans; D055048:Integrative Medicine; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000628:therapy
keywords: Integrative medicine; PBRN; pain; psychological disorders; stress