Mental ills attract alternative therapies.

A substantial minority of people suffering from mental ailments seek out alternative therapies, usually without telling their physicians, according to a new analysis of data from a 1996 national survey of the public's choices of medical therapies.

About 12 percent of people contacted had experienced a mental disorder. Of those, nearly 1 in 10 said they had consulted a practitioner of an unconventional therapy, say Benjamin G. Druss and Robert A. Rosenheck, both psychiatrists at Yale University School of Medicine. Patients made about half those visits for psychological problems and the rest for physical complaints.

Unconventional approaches included chiropractic, massage, herbal, spiritual, and nutritional therapies. Such alternatives were much less popular among people without mental disorders, the researchers report in the July ARCHIVES OF GENERAL PSYCHIATRY.

The survey conservatively gauges the popularity of alternative therapies among people with mental conditions, since it focused only on practitioner-guided approaches. Prior surveys of alternative-treatment use in the general population--which didn't separately consider people with mental disorders--indicate that at least as many people self-administer these therapies as go to a practitioner, Druss and Rosenheck assert.

The new analysis comes from interviews with 16,038 adults. Participants also kept diaries of their health-related activities.

People most likely to visit alternative practitioners reported adjustment disorder--a few months of distress sparked by a personal crisis. Individuals with mood or psychotic disorders were least likely to try alternative methods.

The researchers also found that three-quarters of those seeking alternative therapies had not told their physicians about that decision. That raises the potential of harmful interactions between herbal remedies and prescription drugs, Druss and Rosenheck say. What's more, they contend there's no evidence that herbal or other alternative therapies effectively treat adjustment disorder.

Much remains unknown about the impact of alternative therapies on other mental ailments. Two literature reviews in the November 1998 ARCHIVES OF GENERAL PSYCHIATRY--one led by Edzard Ernst of the University of Exeter in England and the other by Albert H.C. Wong of the University of Toronto--recommended only St. John's Wort and physical exercise as alternative treatments for depression.