The use of CAM providers and psychiatric outpatient services in people with anxiety/depression: a cross-sectional survey.
BACKGROUND
Depression has been identified as one of the most frequent predictors of CAM use. However, limited data exist about the use of CAM providers among people with anxiety/depression in Norway. The aim of this study was to investigate the use of CAM providers, and the use of CAM providers and psychiatric outpatient services in combination, among people with self-reported anxiety and/or depression.


METHODS
We used questionnaire data from 12,982 participants (30-87 years) in the cross-sectional sixth Tromsø Study (conducted in 2007-8). Eligible for analyses in our study were 1685 participants who reported suffering from anxiety and/or depression. By descriptive statistical methods, we estimated the use of CAM providers, psychiatric outpatient services, and the combination of these. By logistic regressions we studied the association between the use of these services and gender, age, income, education, and self-reported degree of anxiety/depression.


RESULTS
During the previous year, 17.8 % of people with anxiety/depression visited a CAM provider once or more, 11.8 % visited psychiatric outpatient services, and 2.5 % visited both. Men with anxiety/depression were less likely to visit CAM providers compared to women (odds ratio [OR] 0.40, confidence interval [CI] 0.30-0.55), whereas higher educated people were more likely to visit compared to the lowest educated (OR 1.47, CI 1.02-2.13). The use of CAM providers was not associated with the degree of anxiety/depression. For those who used both CAM providers and psychiatric specialist services during the previous year, severe anxiety/depression was strongly associated with use compared to moderate disease (OR 7.53, CI 2.75-20.65).


CONCLUSIONS
People with severe anxiety/depression seem to use CAM providers and psychiatric services additionally, whereas those with moderate disease seem to use these services more as alternative pathways. CAM provider treatment might be a substitute for conventional care, particularly in patients with moderate disease.
University Hospital of North Norway, PO box 35, , 9038, Tromsø, Norway. anne.helen.hanzen@gmail.com.|Faculty of Health Sciences, Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway. anne.helen.hanzen@gmail.com.
Anne Helen
http://orcid.org/0000-0001-7396-0879
AH
Hansen
The National Research Center in Complementary and Alternative Medicine (NAFKAM), Faculty of Health Sciences, Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.
Agnete E
AE
Kristoffersen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D011795:Surveys and Questionnaires; D000078329:Workforce
Complementary and alternative medical providers; Cross-sectional study; Health care utilisation; Mental health care; Norway; Psychiatric specialist services