Complementary and alternative approaches to treating mental illness,
including yoga, TaiChi, and homeopathy, among many others, are here to stay,
and many patients are using them—whether psychiatrists know it or
So says psychiatrist James Lake, M.D., chair of APA's new Caucus on
Complementary, Alternative, and Integrative Approaches in Mental Health
Lake told Psychiatric News that the caucus, which first met
formally at the 2004 annual meeting in New York, is the result of the shared
interests and efforts of psychiatrists committed to working within APA to
establish expert resources on complex clinical and research issues pertaining
to uses of the wide range of complementary, alternative, and integrative
approaches in mental health care.
Caucus members will advise APA committees, including the Committee on
Research on New Treatments, on significant emerging research findings or
safety considerations pertaining to complementary, alternative, and
Nonconventional treatments include exercise, dietary supplements, Western
herbs, Yoga, Taichi and other mind-body practices, traditional Chinese
medicine, Ayurveda, orthomolecular approaches, massage therapy, guided
imagery, prayer and other spiritual practices, and homeopathy.
"Many psychiatrists have interests outside of conventional
psychopharmacology," Lake said. "While we acknowledge the
usefulness of conventional treatments in psychiatry, it is also important to
consider alternative and integrative approaches. The reasons for doing so are
compelling in view of recent [Food and Drug Administration] disclosures about
safety and limited efficacy of many mainstream pharmacological treatments.
"We believe it is important to add to the armamentarium of
conventional pharmacological treatments and to educate psychiatrists and
mental health professionals about a range of evidence-based complementary,
alternative, and integrative approaches," he said.
Lake added that the formation of the caucus is a step toward APA's
acknowledgement of an important fact: patients are using complementary and
alternative treatments at increasing rates.
"Surveys suggest that two-thirds of patients who are treated for
major depressive disorder and anxiety disorders already self-treat with a
range of alternative approaches and typically do not disclose this to their
psychiatrist or primary care physician, resulting in significant potential
safety issues," Lake said.
At last year's annual meeting, three broad goals for the caucus were
outlined: educating APA members, nonmember psychiatrists, and nonmedically
trained mental health professionals about safe, evidence-based uses of
complementary and alternative treatments in mental health care; conducting a
survey of APA member and nonmember psychiatrists in order to characterize and
quantify their beliefs and practices regarding uses of complementary and
alternative treatments; and establishing a research agenda prioritizing
complementary or alternative modalities of great interest to psychiatrists
that may hold promise as treatments of psychiatric disorders.
Darrel Regier, M.D., M.P.H., director of the American Psychiatric Institute
for Research and Education, noted that the caucus provides an opportunity for
clinicians and researchers within APA to focus on what the evidence is for
various alternative and complementary treatments in psychiatry.
"The use of these treatments is very widespread, so the question is
not whether the American public is using them or not," Regier said."
The question is, what advice psychiatrists can give to their patients
about these treatments."
Information about the new caucus, including a questionnaire and
registration form, is posted online at<APACAM.org>.▪