In addition to the need for a broader range of treatment choices that is inclusive of evidence-based CAM therapies, psychiatry urgently needs a more eclectic research agenda that includes studies on promising CAM and integrative approaches using modern research methods. For decades, conventional psychiatric research has emphasized the development of novel pharmaceuticals and, to a much lesser extent, the role of psychotherapy. Although both treatment modalities are often effective in reducing suffering and disability associated with mental illness, both approaches are resource intensive. Broadening research priorities in psychiatry to include investigations of CAM and integrative approaches will help elucidate the multifactorial causes of psychiatric disorders at the level of social, cultural, psychological, and biological factors. It also will provide a framework for developing individualized treatment protocols addressing complex causes of symptoms on the basis of each unique patient’s response to multimodal treatments. More affordable treatment approaches are also urgently needed. Recent studies have reported positive findings for a variety of nonresource-intensive CAM interventions, including the role of lifestyle changes on mental and emotional well-being, mind-body therapies, and select natural product supplements.

As previously noted, a large percentage of patients with a diagnosed psychiatric disorder receive medications while concurrently using one or more CAM treatments. Recent research findings support that select natural products are safe and effective adjuvants when used in combination with antidepressants or other psychotropic medications. Most studies on conventional biomedical treatments and CAM treatments employ randomized controlled trial designs that examine single interventions in artificial populations that are not representative of the diversity and complex medical and mental health problems of real-world populations. Few rigorously designed, well-powered studies have been done on more complex integrative approaches that combine multiple therapeutic modalities. Important advances will take place in psychiatric research and mental health care delivery when formal research methods are developed that permit rigorous evaluation of complicated patients receiving complex interventions involving multiple therapeutic modalities (which more accurately reflects how patients seek care) to treat real-world clinical populations.

Future clinical trials could examine individually tailored, multiple-component interventions using both quantitative outcome measures (eg, laboratory tests and validated psychometric scales) and qualitative measures (eg, subjective perceptions of improved functioning and placebo and nocebo effects). For example, a controlled trial on patients with diagnosed major depressive disorder could compare “treatment as usual” with a multimodal treatment protocol using a decision-tree algorithm employing specific combinations of evidence-based conventional and CAM modalities. A future research agenda that encompasses CAM treatment modalities will also help clarify the roles of genetic and biochemical individuality, ethnicity, family history, and culture in the pathogenesis of mental illness.

International Journal of Emergency Mental Health and Human Resilience, is a multidisciplinary quarterly designed to be the premier international forum and authority for the discussion of all aspects of emergency mental health.

Authors can submit their manuscript as an email attachment to: mentalhealth@emedscholar.com

Regards,

Journal Coordinator

International Journal of Emergency Mental Health and Human Resilience