Use of complementary and integrative medicine for mental disorders–a cross-sectional study in Germany

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Background: Mental disorders pose a substantial global health burden. Complementary and Integrative Medicine (CIM) is widely used; however, data on CIM use in mental disorders are limited. The aim was to investigate CIM prevalence, usage patterns, disclosure, and perceived benefits among individuals with mental disorders in Germany. Methods: A cross-sectional study was conducted among adults with psychiatric disorders in Germany between June 2023 and August 2024. Participants were recruited through a nationwide anonymous online survey and on-site surveys in randomly selected outpatient psychiatric, psychosomatic, and psychotherapeutic settings in Berlin and Brandenburg. The 33-item questionnaire assessed lifetime and current CIM use, diagnostic and sociodemographic characteristics, physician disclosure, recommendation sources, and perceived effectiveness. Associations were analysed using logistic regression. Results: Seven hundred sixty-eight participants (mean age 43.2 years; 77.3% female) completed the questionnaire. Lifetime CIM use was 92.3, and 68.1% reported current use. The most commonly used approaches (lifetime use) were meditation (63.9%), yoga (60.8%), and dietary supplements (59.1%); positive experiences were highest for meditation (76.9%) and yoga (74.6%). Among CIM users, 60.9% informed their physician. Physician awareness was associated with more favourable CIM evaluations (adjusted OR 2.69, 95% CI 1.63-4.49). Recommendations were mainly based on self-directed research (59.9%) and friends' advice (31.2%). Conclusion: CIM use among individuals with mental disorders is highly prevalent and predominantly self-initiated. However, many patients do not disclose their CIM use to clinicians. Physician awareness of patients' CIM use was associated with more positive patient-reported evaluations, suggesting that proactive enquiry and open communication about CIM use may facilitate safer and more coordinated care. Further clinical research is required to evaluate the effectiveness, safety, and potential interactions of commonly used CIM approaches in psychiatric care.

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