title: Homeopathic medical practice for anxiety and depression in primary care: the EPI3 cohort study.
abstract: BACKGROUND
  The purpose of the study was to compare utilization of conventional psychotropic drugs among patients seeking care for anxiety and depression disorders (ADDs) from general practitioners (GPs) who strictly prescribe conventional medicines (GP-CM), regularly prescribe homeopathy in a mixed practice (GP-Mx), or are certified homeopathic GPs (GP-Ho).
  
  
  METHODS
  This was one of three epidemiological cohort studies (EPI3) on general practice in France, which included GPs and their patients consulting for ADDs (scoring 9 or more in the Hospital Anxiety and Depression Scale, HADS). Information on all medication utilization was obtained by a standardised telephone interview at inclusion, 1, 3 and 12 months.
  
  
  RESULTS
  Of 1562 eligible patients consulting for ADDs, 710 (45.5 %) agreed to participate. Adjusted multivariate analyses showed that GP-Ho and GP-Mx patients were less likely to use psychotropic drugs over 12 months, with Odds ratio (OR) = 0.29; 95 % confidence interval (CI): 0.19 to 0.44, and OR = 0.62; 95 % CI: 0.41 to 0.94 respectively, compared to GP-CM patients. The rate of clinical improvement (HADS <9) was marginally superior for the GP-Ho group as compared to the GP-CM group (OR = 1.70; 95 % CI: 1.00 to 2.87), but not for the GP-Mx group (OR = 1.49; 95 % CI: 0.89 to 2.50).
  
  
  CONCLUSIONS
  Patients with ADD, who chose to consult GPs prescribing homeopathy reported less use of psychotropic drugs, and were marginally more likely to experience clinical improvement, than patients managed with conventional care. Results may reflect differences in physicians' management and patients' preferences as well as statistical regression to the mean.
authors.affiliation: LA-SER, 10 place de Catalogne, 75014, Paris, France. Lamiae.Grimaldi@la-ser.com.|Conservatoire national des arts et métiers (CNAM), 292 Rue Saint-Martin, 75003, Paris, France. Lamiae.Grimaldi@la-ser.com.
authors.forename: Lamiae
authors.initials: L
authors.lastname: Grimaldi-Bensouda
authors.affiliation: LA-SER Europe Limited, 66 Chiltern St, London, W1U 4JT, UK.|Department of Epidemiology, London School of Hygiene & Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK.
authors.forename: Lucien
authors.initials: L
authors.lastname: Abenhaim
authors.affiliation: Faculty of Medicine, University of Franche Comté, 9 Rue Ambroise Paré, 25000, Besançon, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Massol
authors.affiliation: Pasteur Institute, 28 rue du Docteur Roux, 75015, Paris, France.|University of Paris-île-de-France-Ouest, 9 boulevard d'Alembert 78280, Guyancourt, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Guillemot
authors.affiliation: LA-SER, 10 place de Catalogne, 75014, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Avouac
authors.affiliation: Cyklad group, 16 Rue André Le Nôtre, 69140, Rillieux-la-Pape, France.
authors.forename: Gerard
authors.initials: G
authors.lastname: Duru
authors.affiliation: INSERM U1018, Centre for Epidemiology and Population Health, Hôpital Paul Brousse, Bât 15/16, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France.
authors.forename: France
authors.initials: F
authors.lastname: Lert
authors.affiliation: Faculty of Medicine, University Pierre and Marie Curie, 4 Place Jussieu, 75005, Paris, France.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Magnier
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Avenue West, Montreal, QC, H3A 1A2, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Rossignol
authors.affiliation: Sainte-Anne Hospital, University of Paris V René Descartes, 100 rue de la Santé, 75674, Paris, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Rouillon
authors.affiliation: INSERM U657, University Victor Segalen Bordeaux 2, 146 rue Léo Saignat, 33076, Bordeaux, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Begaud
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000628:therapy*; D015331:Cohort Studies; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006705:Homeopathy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011619:Psychotropic Drugs / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs
keywords: Anxiety; Depression; Homeopathy; Primary care