Evidence map›Paper›PMID 26231014›Full record

ArticleThe Journal of clinical psychiatry2015

Neuropsychiatric symptoms and expenditure on complementary and alternative medicine.

Maulik P Purohit, Ross D Zafonte, Laura M Sherman, Roger B Davis, Michelle Y Giwerc, Martha E Shenton, Gloria Y Yeh

Abstract read
In one paragraph

Article in The Journal of clinical psychiatry, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Trial
  2. Article
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  6. Review
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Maulik P PurohitSpaulding Rehabilitation Hospital Network, 300 First Ave, Charlestown, MA 02129 maulik.p.purohit.civ@mail.mil.
Ross D Zafonte
Laura M Sherman
Roger B Davis
Michelle Y Giwerc
Martha E Shenton
Gloria Y Yeh

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
Research Training in Complementary and Integrative MedicineT32AT000051 · NCCIH · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI GLORIA Y YEH · 1999 to 2026
$10.2M
Improving Outcome Measurement for Medical Rehabilitaiton Clinical TrialsR24HD065688 · NICHD · BOSTON UNIVERSITY MEDICAL CAMPUS · PI JETTE, ALAN MAURICE, ZAFONTE, ROSS DENNIS · 2010 to 2014
$3.9M
Research and Mentorship in Alternative MedicineK24AT000589 · NCCIH · BETH ISRAEL DEACONESS MEDICAL CENTER · PI PHILLIPS, RUSSELL SCOTT · 2001 to 2010
$1.5M
Mentoring and Research in Placebo Studies, Asian Medicine, and CAMK24AT004095 · NCCIH · HARVARD MEDICAL SCHOOL · PI KAPTCHUK, TED · 2007 to 2016
$1.4M
NCCIH NIH HHS K24 AT000589NCCIH NIH HHS K24AT000589NCCIH NIH HHS K24 AT004095NCCIH NIH HHS T32 AT000051NCCIH NIH HHS T32AT000051NCRR NIH HHS UL1 RR 025758NCRR NIH HHS UL1 RR025758NICHD NIH HHS 5R24HD065688-02NICHD NIH HHS R24 HD065688
6 · The paper itself

Abstract

objectiveNeuropsychiatric symptoms affect 37% of US adults. These symptoms are often refractory to standard therapies, and patients may consequently opt for complementary and alternative medicine therapies (CAM). We sought to determine the demand for CAM by those with neuropsychiatric symptoms compared to those without neuropsychiatric symptoms as measured by out-of-pocket expenditure.

methodWe compared CAM expenditure between US adults with and without neuropsychiatric symptoms (n = 23,393) using the 2007 National Health Interview Survey. Symptoms included depression, anxiety, insomnia, attention deficits, headaches, excessive sleepiness, and memory loss. CAM was defined per guidelines from the National Institutes of Health as mind-body therapies, biological therapies, manipulation therapies, or alternative medical systems. Expenditure on CAM by those without neuropsychiatric symptoms was compared to those with neuropsychiatric symptoms.

resultsOf the adults surveyed, 37% had ≥ 1 neuropsychiatric symptom and spent $14.8 billion out-of-pocket on CAM. Those with ≥ 1 neuropsychiatric symptom were more likely than those without neuropsychiatric symptoms to spend on CAM (27.4% vs 20.3%, P < .001). Likelihood to spend on CAM increased with number of symptoms (27.2% with ≥ 3 symptoms, P < .001). After adjustment was made for confounders using logistic regression, those with ≥ 1 neuropsychiatric symptom remained more likely to spend on CAM (odds ratio [OR] = 1.34; 95% CI, 1.22-1.48), and the likelihood increased to 1.55 (95% CI, 1.34-1.79) for ≥ 3 symptoms. Anxiety (OR = 1.40 [95% CI, 1.22-1.60]) and excessive sleepiness (OR = 1.36 [95% CI, 1.21-1.54]) were the most closely associated with CAM expenditure.

conclusionsThose with ≥ 1 neuropsychiatric symptom had disproportionately higher demand for CAM than those without symptoms. Research regarding safety, efficacy, and cost-effectiveness of CAM is limited; therefore, future research should evaluate these issues given the tremendous demand for these treatments.

Indexed as

AdolescentAdultAgedAnxietyAttention Deficit Disorder with HyperactivityComplementary TherapiesDepressionDisorders of Excessive SomnolenceFemaleHeadacheHealth ExpendituresHumansMaleMemory DisordersMiddle AgedSleep Initiation and Maintenance Disorders

Identifiers

PMID26231014
PMCPMC4729567

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.