Complementary alternative medicine in patients with inflammatory bowel disease: use and attitudes.

BACKGROUND: A widespread increase in the use of complementary alternative medicine (CAM) by patients with inflammatory bowel disease (IBD) has been recognized. The aim of our study was to evaluate both the extent and the determinants of CAM use by outpatients with IBD. METHODS: Outpatients of the IBD centre at the University Hospital of Berne and patients of two gastroenterology private practices in Olten (Switzerland) completed a mailed self-administrated questionnaire regarding alternative medicine. The questionnaire addressed the following topics: demographic variables; disease-related data; the use of 16 types of complementary medicine; comparison between attitudes towards alternative versus conventional medicine and out-of pocket expenses. RESULTS: Alternative medicine has been used by 47% of the patients. Diagnosis, duration and activity of disease, gender, age, previous surgery were not predictive for the use of CAM. The most commonly used CAM methods were: homeopathy, acupuncture and traditional Chinese medicine. Reasons cited for the use of CAM were: lack of satisfaction with and side effects of conventional therapy and the perceived safety of CAM. Sixty-one percent of patients noted that their IBD had improved with the use of CAM. By contrast, 16% noted a flare during CAM therapies. Forty-seven percent of patients paid more than Euro400 per year for CAM. CONCLUSIONS: Complementary medicine use is common in patients with IBD. Frequently cited reasons for the use of complementary therapies were safety of CAM; dissatisfaction with conventional therapies, including their side effects; and that CAM can be used in addition to conventional therapy.

[Is the current legal protection of psychiatric patients sufficient? 179th Decision of the Psychiatric Appeals Commission of the Zurich Canton 1963-74]. / Genügt der heutige Rechtsschutz für Psychischkranke? Die 179 Entscheide der Psychiatrischen Rekurskommission des Kantons Zürich 1963--1974

179 decisions of the Psychiatric Commission of Appeals of the Canton of Zurich in the years 1963 to 1974. Only every 200th patient admitted to 6 psychiatric clinics in the Canton of Zurich appealed against hospitalization to a commission of appeals, although 20 to 40% of all patients deny the need for hospitalization at least in the beginning. More detailed information of the patients as to the possibilities to appeal did not increase the number of appeals. Males, skilled workers, schizophrenic and manic patients are overrepresented, females, unskilled labourers, depressed patients or such with brain-damage are underrepresented among the appealers. The appeals were made on repeated admissions rather than on first hospital stays and after some weeks rather than in the early days after after admission. The majority of appeals (142) was settled in two ways: 1) the clinic authorities agreed to discharge the patient; 2) the commission of appeals was not competent for the complaint in question. 37 appeals led to personal examination of the appealer. The appeal was given suit in 3 cases only. Cases of illegal "dumping" were not observed. Patients under guardianship tend to appeal at least as frequently as those not under tutorage. If the commission of appeals were given competence also for those under guardianship - as demands the European Convention on Human Right - this would satisfy the needs of this group of patients. However, an initial control of all hospitalizations by court or other officials is uncalled for. It would only impair the personal rights of the patients, delay their discharge and foster seemingly but not truly voluntary admissions.