{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:58:43Z","timestamp":1790294323717,"version":"4.1.0"},"reference-count":26,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Homeopathy"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Knee osteoarthritis (OA) is frequently accompanied by depression, anxiety and stress, worsening pain, disability and quality of life. Evidence for individualized homeopathic medicines (IHMs) in addressing these co-existing psychological and physical burdens remains limited. This trial aimed to evaluate the efficacy and safety of IHMs compared with placebo in adults with knee OA and co-morbid depression, anxiety and\/or stress.<\/jats:p>\n                  <jats:p>A double-blind, randomized (2:1), placebo-controlled, clinical trial was conducted at a teaching hospital in Kolkata, India. One hundred and ten participants aged between 50 and 70 years with knee OA (American College of Rheumatology [ACR] criteria) and mild-to-moderate depression (DASS-21) were randomized to receive IHMs plus concomitant care (CC) or placebo plus concomitant care for 3 months. Remedies were individualized through standardized homeopathic case-taking. Outcomes (DASS-21, Knee Injury and Osteoarthritis Outcome Score [KOOS], WOMAC, and Measure Yourself Medical Outcome Profile version 2 [MYMOP-2]) were assessed monthly for 3 months. Efficacy was assessed using multivariate linear mixed-effects models (primary test: Intervention\u2009\u00d7\u2009time interaction). Area under the curve analyses, effect sizes, and sensitivity analyses using Generalized Estimating Equations, and responder analyses were performed. Adjusted p-values used the Holm\u2013Bonferroni method.<\/jats:p>\n                  <jats:p>A significant group-by-time interaction favored IHMs for DASS-21 depression (p\u2009&lt;\u20090.001), anxiety, and stress, alongside clinically meaningful improvements in KOOS and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, function, and quality of life (most adjusted p\u2009&lt;\u20090.001). Responder rates were higher with IHMs (59% vs. 11%). Mediation analysis indicated that pain reduction partially explained improvements in depression. No adverse events were reported.<\/jats:p>\n                  <jats:p>IHMs produced significant improvements in both psychological symptoms and physical outcomes related to knee OA compared with placebo, reflecting a holistic therapeutic effect without adverse events.<\/jats:p>\n                  <jats:p>CTRI\/2024\/03\/064632.<\/jats:p>","DOI":"10.1055\/a-2850-9160","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:06:01Z","timestamp":1790291161000},"source":"Crossref","is-referenced-by-count":0,"title":["Individualized Homeopathic Medicines in Treating Depression, Anxiety, and Stress in Adults with Osteoarthritis of the Knee: A Double-Blind, Randomized, Placebo-Controlled Trial"],"prefix":"10.1055","author":[{"given":"Meghamala","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Department of Practice of Medicine, The Calcutta Homoeopathic Medical College and Hospital, Government of West Bengal, affiliated to the West Bengal University of Health Sciences, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajat","family":"Chattapadhyay","sequence":"additional","affiliation":[{"name":"Department of Practice of Medicine, The Calcutta Homoeopathic Medical College and Hospital, Government of West Bengal, affiliated to the West Bengal University of Health Sciences, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhushree","family":"Mondal","sequence":"additional","affiliation":[{"name":"Department of Practice of Medicine, The Calcutta Homoeopathic Medical College and Hospital, Government of West Bengal, affiliated to the West Bengal University of Health Sciences, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayantan","family":"Bhowmick","sequence":"additional","affiliation":[{"name":"Department of Practice of Medicine, The Calcutta Homoeopathic Medical College and Hospital, Government of West Bengal, affiliated to the West Bengal University of Health Sciences, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayba","family":"Khatoon","sequence":"additional","affiliation":[{"name":"Department of Practice of Medicine, The Calcutta Homoeopathic Medical College and Hospital, Government of West Bengal, affiliated to the West Bengal University of Health Sciences, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Practice of Medicine, The Calcutta Homoeopathic Medical College and Hospital, Government of West Bengal, affiliated to the West Bengal University of Health Sciences, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuhina","family":"Parveen","sequence":"additional","affiliation":[{"name":"Department of Repertory, D. N. De Homoeopathic Medical College and Hospital, Government of West Bengal, affiliated to the West Bengal University of Health Science, Tangra, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Repertory, D. N. De Homoeopathic Medical College and Hospital, Government of West Bengal, affiliated to the West Bengal University of Health Science, Tangra, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munmun","family":"Koley","sequence":"additional","affiliation":[{"name":"Department of Homeopathy, East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, under Department of Health & Family Welfare, Government of West Bengal, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2308-5265","authenticated-orcid":false,"given":"Subhranil","family":"Saha","sequence":"additional","affiliation":[{"name":"Department of Repertory, D. N. De Homoeopathic Medical College and Hospital, Government of West Bengal, affiliated to the West Bengal University of Health Science, Tangra, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jphys.2025.06.010","article-title":"Recent highlights and uncertainties in exercise management of knee osteoarthritis","volume":"71","author":"T Haber","year":"2025","journal-title":"J Physiother"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.4103\/jfmpc.jfmpc_1254_24","article-title":"Prevalence of knee osteoarthritis among elderly persons in India: A systematic review and meta-analysis","volume":"14","author":"R A Daniel","year":"2025","journal-title":"J Family Med Prim Care"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1093\/ageing\/afw001","article-title":"Prevalence of depressive symptoms and anxiety in osteoarthritis: a systematic review and meta-analysis","volume":"45","author":"B Stubbs","year":"2016","journal-title":"Age Ageing"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"375","DOI":"10.2147\/NDT.S346183","article-title":"Depression in osteoarthritis: current understanding","volume":"18","author":"S T Wang","year":"2022","journal-title":"Neuropsychiatr Dis Treat"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s12891-020-03875-1","article-title":"Depression in patients with knee osteoarthritis: risk factors and associations with joint symptoms","volume":"22","author":"S Zheng","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"4705","DOI":"10.1097\/MS9.0000000000002258","article-title":"Prevalence of mental health disorders in knee osteoarthritis patients: a systematic review and meta-analysis","volume":"86","author":"B Merry Del Val","year":"2024","journal-title":"Ann Med Surg (Lond)"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"e41335","DOI":"10.1097\/MD.0000000000041335","article-title":"Recent advances in osteoarthritis research: A review of treatment strategies, mechanistic insights, and acupuncture","volume":"104","author":"Z Lou","year":"2025","journal-title":"Medicine (Baltimore)"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1007\/s41669-024-00541-3","article-title":"Economic evaluation of total knee replacement compared with non-surgical management for knee osteoarthritis in India","volume":"9","author":"A S Qadeer","year":"2025","journal-title":"PharmacoEconom Open"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1177\/2156587214568668","article-title":"A double-blind randomized placebo-controlled feasibility study evaluating individualized homeopathy in managing pain of knee osteoarthritis","volume":"20","author":"M Koley","year":"2015","journal-title":"J Evid Based Complementary Altern Med"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1055\/s-0043-1771025","article-title":"Individualized homeopathic medicines in the treatment of knee osteoarthritis: double-blind, randomized, placebo-controlled feasibility trial","volume":"113","author":"S Bhattacharyya","year":"2024","journal-title":"Homeopathy"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4103\/OJMPC.OJMPC_7_26","article-title":"Homeopathy for knee osteoarthritis: Series of three randomized trials and statistical pooling of the results","volume":"32","author":"M Koley","year":"2026","journal-title":"Orthop J MPC"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1186\/s13063-017-2040-2","article-title":"Depressed patients treated by homeopaths: a randomised controlled trial using the \u201ccohort multiple randomised controlled trial\u201d (cmRCT) design","volume":"18","author":"P Viksveen","year":"2017","journal-title":"Trials"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1002\/art.1780290816","article-title":"Development of criteria for the classification and reporting of osteoarthritis. 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