ARTICLE INFO

Article Type

Original Research

Authors

Mahmoudian   SA. (* )
Kheirabadi   GhR. (1 )
Meracy   MR. (2 )






(* ) Social Medicine Department, Medicine Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
(1 ) Psychology Department, Medicine Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
(2 ) Statistics & Epidemiology Department, Hygine Faculty, Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence

Address: Social Medicine Department, Dentistry Faculty, Isfahan University of Medical Sciences, Hezar Jarib Street, Isfahan, Iran
Phone: +98 3137922510
Fax: +98 3137922542
a_mahmoudian@med.mui.ac.ir

Article History

Received:  June  17, 2014
Accepted:  October 25, 2014
ePublished:  February 19, 2015

BRIEF TEXT


Inability to manage stress in the genetic predisposition is the main factor underlying depression [1]. … [2-5] Depression pharmacotherapy has been effective in 20-47% of the cases [6]. … [7, 8] As a severe challenge in psychology, treatment of persons with chronic depression, especially when there are other disorders like post-traumatic stress disorder, has led to complementary therapies used by the psychologists [9]. … [10] The complications of the homeopathic medications have short life spans and they disappear, spontaneously [11-14]. … [15-18]

The results of 8-week homeopathy and Fluoxetine are similar [19]. There are similar results of using homeopathy method and cognitive therapy [20]. … [21-23]

The aim of this study was to investigate the effectiveness of adding homeopathic treatment to the current treatments of depression, on depression severity and quality of life of the depressed veterans.

This is a randomized double-blind clinical trial study.

The depressed veterans under the care of Shahid Rajaie Veterans’ Care Center, Isfahan, Iran, were studied in 2012-13.

The inclusion criteria were age between 18 and 65years, being a veteran, depression, and the symptoms similar to dynamism of Nat. M. 30C. Non-inclusion criteria were drug hypersensitivity history, neurological and rheumatic diseases such as MS, vasculitis, SLE and CVA, cancer or consumption of cytotoxic medications, drug consumption, and treatment via other complementary methods such as medicinal plants or acupuncture in a month to the study. Exclusion criteria were dissatisfied with participation and hypersensitive reactions obstructing administration of homeopathic medication. 100 persons were selected.

The patients randomly divided into “homeopathic group” (55 persons) and “control group” (45 persons) by the medication administrator, without informing the patients and the homeopathic physician. Nat. M. 30C and placebo (tap water) were administrated for homeopathic and control groups, respectively. Therefore, the homeopathic physician, the patient, and the previous physician were unaware of the medication. Both groups were regularly visited by homeopathic physician in 2-4weeks intervals and for 6 months. The medication orders were modified based on the patient’s conditions. As before, both groups, receiving antidepressants and other required treatments, were under the care of previous psychiatrist. All persons received interviews and treatments at least 4 months (about 4 sessions) and maximum of 7 months, totally. Patients, whose data had been analyzed, were investigated by telephone and at attendance, receiving medication. Otherwise, they were excluded. About 20 persons of homeopathic group and 15 persons of control group were excluded. All the participants filled BDI-II and WHOQOL-BREF questionnaires, before study and at the end of the study (after 6 months). BDI-II test allocates 2 items for emotions, 11 items for cognitive issues, 2 items for explicit behaviors, 5 items for somatic symptoms, and 1 item for internal symptoms. All the items are related to the main depression symptoms. 0-9 scores, 10-16 scores, 17-29 scores, and scores more than 30 indicate normality, mild depression, moderate depression, and severe depression, respectively. Its cut-off point in screening studies to diagnose clinical depression is 21. The test has high reliability and credibility [24, 25]. A Persian translation of the test was used after content adaptation with the original version. WHOQOL-BREF questionnaire includes physical health, mental situation, social situation, and life-environment situation domains and 2 general questions about life satisfaction. Each question is scored from 1 to 5. Credibility of the questionnaire is between 0.83 and 0.95. There are 3 negative questions and their answers are reversed. The scores are summed up and computed based on 100. Credibility of a Persian translation of the test is 0.7, using Cronbach’s Alpha Coefficient [26]. Data were analyzed using SPSS 20 software and Mann-Whitney and Covariance Tests. Mann-Whitney Test was used to investigate the equity of the groups in the ground variables such as education level, age, and length of the disease. Covariance Test was used to investigate the difference between depression severity and total mean score of quality of life, after treatment intervention in homeopathic and control groups. The difference between the groups in physical and mental domains of quality of life was investigated using multivariate covariance analysis.

Totally, 65 depressed veterans with/without PTSD were studied in homeopathic group (35 persons) and control group (30 persons). The mean age was 48.6±6.9years. All the persons were male veterans having been affected by shock waves. Some veterans had physical injuries. 4 persons had got divorced. One person was unmarried. Other persons were married. Mean length of their disease was 20.0±10.2years with median equal to 24years and a 3-31year domain. Mean length of consuming antidepressants was 15.3±10.1yeras with median equal to 15years and a 3-to 31-year domain. The number of hospitalization was 5.4±4.7 with median equal to 3 and a 1- to 20-time domain. 56 persons (86.1%) were out of work. 6 persons (9.2%) were illiterate. Education level of 47 persons (72.3%) were under diploma. 12 persons (18.5%) had diploma or a higher education certificate. Regarding education, there was no significant difference between the groups. At the start point of the study, there was a reverse and significant correlation between quality of life and depression severity. In mean score of depression severity after therapeutic intervention (controlling the score of depression severity before intervention, age, education level, and length of consumption of medication), there was no significant difference between homeopathic and control groups. There was no significant difference between homeopathic and control groups in total mean score of quality of life after therapeutic intervention (controlling age, education level, length of consumption of medication, and the score of therapeutic quality of life and depression severity before intervention). There was a significant difference between the groups in physical and mental domains of quality of life (Table 1).

In both groups, depression severity was reduced and quality of life was enhanced. However, regarding the changes, there was no significant difference between the groups. In England, at follow-up of 455 patients, successful treatment of depression has been 81% [27]. In Brazil, as Fluoxetine, homeopathy has been effective on depression [19]. Depression, anxiety, and irritable bowel syndrome are the most therapeutic results [28]. As cognitive therapy, homeopathy has reduced the depression severity [20]. … [21-38]

More and lengthened studies with shorter disease length, as well as different homeopathic medications consumption alongside other depression treatments, ought to be done in order to determine the effectiveness of homeopathy on depression.

Unawareness of homeopathic method and lengthened treatment, which led to leave the treatment by some participants, as well as PTSD and symptoms covered by other dynamisms, were of the limitations of the present study.

6-month homeopathic therapy does not affect depression severity of veterans with chronic depression. However, it affects physical and mental domains of their quality of life.

The researchers feel grateful to Research and Technology Deputy of Isfahan University of Medical Sciences, Janbazan Medical and Engineering Research Center, and Personnel of Shahid Rajaie Hospital (Isfahan).

The researchers had no bias.

The study was approved by Ethics Committee of Janbazan Medical and Engineering Research Center.

The study was funded by Research and Technology Deputy of Isfahan University of Medical Sciences.

TABLES and CHARTS

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