Prevalence and predictors of herbal medicine use in adults experiencing anxiety : a critical review of the literature

Objective: Anxiety disorders are the most prevalent group of mental health disorders. Having anxiety has been found to predict the use of CAM (including herbal medicines), and anxiety has been identified as one of the most common health problems treated with CAM. This review aims to: determine the prevalence rates of herbal medicine use in adults experiencing anxiety, and to identify and critically discuss the beliefs and attitudes that predict herbal medicine use in this cohort. Method: A critical literature review was conducted. Studies that met the inclusion criteria were identified with a comprehensive search across a range of databases. Results: Eight studies were found across four countries reporting the prevalence of herbal medicine use in people experiencing anxiety — use ranged from 2.39% to 22%. No studies were found that explored attitudes and beliefs as predictors of herbal medicine use in adults with anxiety specifically. Therefore, the criteria were expanded to include other cohorts. Seventeen cross-sectional studies were found, with only one of the studies measuring herbal medicine use specifically, and the remaining studies measuring herbal medicine use within the umbrella of CAM. Three main categories of beliefs and attitudes were identified: belief systems/philosophies, treatment beliefs and attitudes, and control and empowerment beliefs and attitudes. Conclusions: Herbal medicines are being used to treat anxiety symptoms to varying degrees, with people experiencing worse anxiety symptoms using more herbal medicines. Future research on herbal medicine prevalence in adults with anxiety needs to be valid and comparable using standardized definitions and measures. It is hypothesized that personal control over health, satisfaction with the medical encounter and treatment outcome may be important predictors of herbal medicine use in adults with anxiety, and may help explain why those with more severe anxiety are using more herbal medicines. This is an important area for future research.