Abstract
INTRODUCTION: Mental health disorders such as depression are a rising issue among university students. Some of them use complementary and alternative medicine (CAM) as self-administered therapy instead of or together with professional care. Defining the scale of the problem, its underlying reasons and possible implications are crucial for addressing it in clinical psychiatry and public health strategies. METHODS: A cross-sectional survey on students from Wrocław universities was conducted between April 2024 and December 2024. The form developed specifically for this study contained questions about demographic status, respondents' mental health history, satisfaction with psychiatric or psychological help and factors affecting it. Survey also assessed experience and attitudes towards various CAM methods, including non-pharmacological like exercise, meditation, yoga and pharmacological such as herbs, e.g., st. John's wort (Hypericum perforatum), supplements, psychedelics, fly agaric (Amanita muscaria), marijuana and other non-conventional therapies. To evaluate current depressive symptoms, questions modelled on the Patient Health Questionnaire (PHQ-10) were used. 493 responses were included in the statistical analysis. RESULTS: 46.5% of respondents had a history of mental disorders, with depression being the most prevalent (74.7%). While 45.3% of all students reported consultations with a psychiatrist and 44.8% usage of antidepressants, 96.1% applied CAM, mainly: physical exercise (81.4%), meditation (60.5%), yoga (39.1%). From herbs, the most popular were Melissa officinalis (53.0%) and Withania somnifera (24.8%), and from other substances: marijuana (31.3%), vitamins (22.5%) and psychedelics (10.4%). The main obstacles we identified in obtaining professional care were cost (80.7%), availability (35.7%) and fear of stigma (30.7%). Acceptance for classic therapies varied from 81.2% for psychotherapy and 75.9% for psychiatric drugs to 16.2% for electroconvulsive therapy (ECT). The factors affecting propensity to use particular CAM modalities included sex and severity of disorder. Females preferred herbs, probiotics and vitamins, while more males reported intake of A. muscaria. We found that among those students who engaged in professional health care services, there was significantly higher usage of marijuana, vitamins and probiotics. What's more, users of marijuana, ashwagandha and st. John's wort presented more intense depressive symptoms, based on PHQ-10. In the case of marijuana, its use is more prevalent among yoga practitioners and students with attention deficit hyperactivity disorder (ADHD). Consumption of psychedelics, marijuana and meditating is also connected to higher acceptance for novel therapies, such as ketamine and psilocybin, and practising yoga-for ketamine alone. CONCLUSION: Prevalence of CAM use among students is high. One of the reasons we identified is limited access to professional psychiatric help. Use of CAM without supervision may potentially lead to adverse events. Psychiatrists treating students should consider those risks. Public health strategies should include educating students about CAM and classic therapies such as ECT, developing clinical guidelines for managing patients who use CAM and improving accessibility to mental health care for students. Future research should focus on studying the issue in other communities and populations, as well as precisely assessing the risks and potential benefits of particular CAM methods.