A critical examination of evidence regarding the use of individualised homeopathy in the treatment of bipolar spectrum disorders

Introduction: Diagnosis of bipolar spectrum disorders (BSD) has substantially expanded in scope due to changing diagnostic criteria. As a result, the societal impact of these disorders has garnered greater public awareness and concern. The aim of this paper is to identify evidence in regards to individualised homeopathic treatment of patients with symptoms of BSD.

Method: A literature review was undertaken to determine published evidence of the effect of individualised homeopathic treatment for bipolar spectrum disorders.

Results: Ten relevant articles were identified. Claims for the effect of homeopathy for BSD exclusively include documentation of single cases presented as informal abbreviated interviews or as summaries. Strengths of single case reports include detailed descriptions of patients’ symptom pictures and length of follow-up periods. Weaknesses include the varied quality of published case reports, lack of diagnostic criteria, lack of triangulation for content validation, and a lack of standardization making cross case comparison unreliable. Case reports are typically retrospective and generally do not include rival explanations for positive changes. To date, no clinical trials have been published.

Conclusion: Documentation of the successful effect of individualised homeopathy in treatment of bipolar spectrum cannot reliably be said to exist at this time. Informal single case reports are a historical backbone of knowledge transfer in the homeopathic community and have provided great depth of insight into practitioners' methodology as well as patient experience. However, lack of consistency in the style and quality of case reporting and in the rigour of analysis limits cross-case comparison and generalizability.

Thompson's (2004) innovative Formal Case Study (FCS) approach offers a viable alternative to the standard case report. FCS is grounded in established practices of qualitative research; it utilizes grounded propositions which are tested by a variety of analytic tools, focusing on identification of deviant cases and rival explanations of outcomes. Although it requires more work on the part of the homeopath-author, the FCS offers the potential for building a clinically useful database of cases amenable to cross-case comparison and generalizability. Whole Systems Research (WSR) offers further research potential into the synergistic effects inherent in complex treatment systems.