Low vitamin D and depression - Study and meta-analysis, April 2013

The association between low vitamin D and depressive disorders

Molecular Psychiatry , (9 April 2013) | doi:10.1038/mp.2013.36
Y Milaneschi, W Hoogendijk, P Lips, A C Heijboer, R Schoevers, A M van Hemert, A T F Beekman, J H Smit and B W J H Penninx

It has been hypothesized that hypovitaminosis D is associated with depression but epidemiological evidence is limited. We investigated the association between depressive disorders and related clinical characteristics with blood concentrations of 25-hydroxyvitamin D [25(OH)D] in a large cohort.

The sample consisted of participants (aged 18–65 years) from the Netherlands Study of Depression and Anxiety (NESDA) with a current (N=1102) or remitted (N=790) depressive disorder (major depressive disorder, dysthymia) defined according to DSM-IV criteria, and healthy controls (N=494).

Serum levels of 25(OH)D measured and analyzed in multivariate analyses adjusting for sociodemographics, sunlight, urbanization, lifestyle and health. Of the sample, 33.6% had deficient or insufficient serum 25(OH)D (<50 nmol l−1). As compared with controls, lower 25(OH)D levels were found in participants with current depression (P=0.001, Cohen’s d=0.21), particularly in those with the most severe symptoms (P=0.001, Cohen’s d=0.44).

In currently depressed persons, 25(OH)D was inversely associated with symptom severity (β=−0.19, s.e.=0.07, P=0.003) suggesting a dose-response gradient, and with risk (relative risk=0.90, 95% confidence interval=0.82–0.99, P=0.03) of having a depressive disorders at 2-year follow-up.

This large cohort study indicates that low levels of 25(OH)D were associated to the presence and severity of depressive disorder suggesting that hypovitaminosis D may represent an underlying biological vulnerability for depression. Future studies should elucidate whether the highly prevalent hypovitaminosis D could be cost-effectively treated as part of preventive or treatment interventions for depression.

end of free access

CLICK HERE to Rent the article from publisher for $5


8% less likely to be depressed for 10ng higher level of vitamin D - Meta-analysis

Serum 25-hydroxyvitamin d levels and the risk of depression: a systematic review and meta-analysis
J Nutr Health Aging. 2013;17(5):447-55. doi: 10.1007/s12603-012-0418-0.
Ju SY, Lee YJ, Jeong SN.
S.-Y. Ju, Department of Family Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, College of Medicine, 62 Yeouido-dong, Yeongdeungpo-gu, Seoul, Korea, Zip code: 150-713, Tel: +82-2-1377-2247 / Fax; +82-2-1377-1712, E-mail: kolpos@daum.net.

Objective: No quantitative systematic review or meta-analysis of population-based epidemiological studies has been conducted to assess the association between serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of dpression. This study aimed to summarize the current evidence from cross-sectional and prospective cohort studies that have evaluated the association between 25(OH)D levels and the risk of depression.

Methods: Relevant studies were identified by systematically searching the PubMed, EMBASE, Web of Science, and PsycINFO databases through April 2012. Cross-sectional and cohort studies that reported adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association of interest were included. The reported risk estimates for 25(OH)D categories were recalculated, employing a comprehensive trend estimation from summarized dose-response data. A pooled OR was calculated separately for cross-sectional and cohort studies using random-effects models.

Results: In the meta-analysis, 25(OH)D levels were significantly inversely associated with depression in 5 of 11 case-control studies and 2 of 5 cohort studies.
The pooled estimate of the adjusted OR of depression in 11 cross-sectional studies (n = 43,137) was 0.96 (95% CI = 0.94-0.99, I2 = 63%) for a 10 ng/ml increase in 25(OH)D levels.
The 5 included cohort studies comprised 12,648 participants, primarily elderly individuals, whose serum 25(OH)D levels were measured, and 2,663 experienced depression events during follow-up.
The pooled adjusted OR of depression was 0.92 (95% CI = 0.87-0.98, I2 = 50%) for a 10 ng/ml increase in 25(OH)D levels.

Conclusions: Our results indicate an inverse association between serum 25(OH)D levels and the risk of depression.
Further studies are warranted to establish whether this association is causal.

PMID: 23636546

References

  1. Doris A, Ebmeier K, Shajahan P (1999) Depressive illness. Lancet 354:1369–1375. CrossRef
  2. Broadhead WE, Blazer DG, George LK, Tse CK (1990) Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA 264:2524–2528. CrossRef
  3. Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K (1995) Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry 52:11–19. CrossRef
  4. Whooley MA, Browner WS (1998) Association between depressive symptoms and mortality in older women. Study of osteoporotic fractures research group. Arch Intern Med 158:2129–2135. CrossRef
  5. Evans DL, Charney DS, Lewis L, Golden RN, Gorman JM, Krishnan KR, Nemeroff CB, Bremner JD, Carney RM, Coyne JC, Delong MR, Frasure-Smith N, Glassman AH, Gold PW, Grant I, Gwyther L, Ironson G, Johnson RL, Kanner AM, Katon WJ, Kaufmann PG, Keefe FJ, Ketter T, Laughren TP, Leserman J, Lyketsos CG, McDonald WM, McEwen BS, Miller AH, Musselman D, O’Connor C, Petitto JM, Pollock BG, Robinson RG, Roose SP, Rowland J, Sheline Y, Sheps DS, Simon G, Spiegel D, Stunkard A, Sunderland T, Tibbits P, Jr., Valvo WJ (2005) Mood disorders in the medically ill: Scientific review and recommendations. Biol Psychiatry 58:175–189. CrossRef
  6. Fenton WS, Stover ES (2006) Mood disorders: Cardiovascular and diabetes comorbidity. Curr Opin Psychiatry 19:421–427. CrossRef
  7. Jacka FN, Maes M, Pasco JA, Williams LJ, Berk M (2012) Nutrient intakes and the common mental disorders in women. J Affect Disord. doi:10.1016/j.jad.2012.02.018.
  8. Skarupski KA, Tangney C, Li H, Ouyang B, Evans DA, Morris MC (2010) Longitudinal association of vitamin b-6, folate, and vitamin b-12 with depressive symptoms among older adults over time. Am J Clin Nutr 92:330–335. CrossRef
  9. Sarris J, Schoendorfer N, Kavanagh DJ (2009) Major depressive disorder and nutritional medicine: A review of monotherapies and adjuvant treatments. Nutr Rev 67:125–131. CrossRef
  10. Lips P (2006) Vitamin d physiology. Prog Biophys Mol Biol 92:4–8. CrossRef
  11. Garcion E, Wion-Barbot N, Montero-Menei CN, Berger F, Wion D (2002) New clues about vitamin d functions in the nervous system. Trends Endocrinol Metab 13:100–105. CrossRef
  12. Ganji V, Milone C, Cody MM, McCarty F, Wang YT (2010) Serum vitamin d concentrations are related to depression in young adult us population: The third national health and nutrition examination survey. Int Arch Med 3:29. CrossRef
  13. Wilkins CH, Sheline YI, Roe CM, Birge SJ, Morris JC (2006) Vitamin d deficiency is associated with low mood and worse cognitive performance in older adults. Am J Geriatr Psychiatry 14:1032–1040. CrossRef
  14. Hoang MT, Defina LF, Willis BL, Leonard DS, Weiner MF, Brown ES (2011) Association between low serum 25-hydroxyvitamin d and depression in a large sample of healthy adults: The cooper center longitudinal study. Mayo Clin Proc 86:1050–1055. CrossRef
  15. Stewart R, Hirani V (2010) Relationship between vitamin d levels and depressive symptoms in older residents from a national survey population. Psychosom Med 72:608–612. CrossRef
  16. Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis of observational studies in epidemiology (moose) group. JAMA 283:2008–2012. CrossRef
  17. Sanderson S, Tatt ID, Higgins JP (2007) Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: A systematic review and annotated bibliography. Int J Epidemiol 36:666–676. CrossRef
  18. Panagioti M, Gooding PA, Tarrier N (2012) A meta-analysis of the association between posttraumatic stress disorder and suicidality: The role of comorbid depression. Compr Psychiatry.
  19. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188. CrossRef
  20. Greenland S, Longnecker MP (1992) Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol 135:1301–1309.
  21. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560. CrossRef
  22. Jaddou HY, Batieha AM, Khader YS, Kanaan SH, El-Khateeb MS, Ajlouni KM (2012) Depression is associated with low levels of 25-hydroxyvitamin d among jordanian adults: Results from a national population survey. Eur Arch Psychiatry Clin Neurosci 262:321–327. CrossRef
  23. Hauck Jr WW, Donner A (1977) Wald’s test as applied to hypotheses in logit analysis. J Am Stat Assoc: 851–853.
  24. Chan R, Chan D, Woo J, Ohlsson C, Mellstrom D, Kwok T, Leung P (2011) Association between serum 25-hydroxyvitamin d and psychological health in older chinese men in a cohort study. J Affect Disord 130:251–259. CrossRef
  25. Milaneschi Y, Shardell M, Corsi AM, Vazzana R, Bandinelli S, Guralnik JM, Ferrucci L (2010) Serum 25-hydroxyvitamin d and depressive symptoms in older women and men. J Clin Endocrinol Metab 95:3225–3233. CrossRef
  26. Nanri A, Mizoue T, Matsushita Y, Poudel-Tandukar K, Sato M, Ohta M, Mishima N (2009) Association between serum 25-hydroxyvitamin d and depressive symptoms in japanese: Analysis by survey season. Eur J Clin Nutr 63:1444–1447. CrossRef
  27. Kjaergaard M, Joakimsen R, Jorde R (2011) Low serum 25-hydroxyvitamin d levels are associated with depression in an adult norwegian population. Psychiatry Res 190:221–225. CrossRef
  28. Zhao G, Ford ES, Li C, Balluz LS (2010) No associations between serum concentrations of 25-hydroxyvitamin d and parathyroid hormone and depression among us adults. Br J Nutr 104:1696–1702. CrossRef
  29. Pan A, Lu L, Franco OH, Yu Z, Li H, Lin X (2009) Association between depressive symptoms and 25-hydroxyvitamin d in middle-aged and elderly chinese. J Affect Disord 118:240–243. CrossRef
  30. May HT, Bair TL, Lappe DL, Anderson JL, Horne BD, Carlquist JF, Muhlestein JB (2010) Association of vitamin d levels with incident depression among a general cardiovascular population. Am Heart J 159:1037–1043. CrossRef
  31. Lee DM, Tajar A, O’Neill TW, O’Connor DB, Bartfai G, Boonen S, Bouillon R, Casanueva FF, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean ME, Punab M, Silman AJ, Vanderschueren D, Wu FC, Pendleton N, group Es (2011) Lower vitamin d levels are associated with depression among communitydwelling european men. J Psychopharmacol 25:1320–1328. CrossRef
  32. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM, Prince RL, Finkelstein JS (1998) Hypovitaminosis d in medical inpatients. N Engl J Med 338:777–783. CrossRef
  33. Malabanan A, Veronikis IE, Holick MF (1998) Redefining vitamin d insufficiency. Lancet 351:805–806. CrossRef
  34. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin d for multiple health outcomes. Am J Clin Nutr 84:18–28.
  35. Holick MF (2006) High prevalence of vitamin d inadequacy and implications for health. Mayo Clin Proc 81:353–373. CrossRef
  36. Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin d status. Osteoporos Int 16:713–716. CrossRef
  37. Heaney RP, Recker RR, Grote J, Horst RL, Armas LA (2011) Vitamin d(3) is more potent than vitamin d(2) in humans. J Clin Endocrinol Metab 96:E447–452. CrossRef
  38. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin d deficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930. CrossRef
  39. Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ (2003) Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 77:204–210.
  40. Bertone-Johnson ER, Powers SI, Spangler L, Brunner RL, Michael YL, Larson JC, Millen AE, Bueche MN, Salmoirago-Blotcher E, Liu S, Wassertheil-Smoller S, Ockene JK, Ockene I, Manson JE (2011) Vitamin d intake from foods and supplements and depressive symptoms in a diverse population of older women. Am J Clin Nutr 94:1104–1112. CrossRef
  41. Houston DK, Cesari M, Ferrucci L, Cherubini A, Maggio D, Bartali B, Johnson MA, Schwartz GG, Kritchevsky SB (2007) Association between vitamin d status and physical performance: The inchianti study. J Gerontol A Biol Sci Med Sci 62:440–446. CrossRef
  42. Thomas J, Anouti FA, Hasani SA, Abdel-Wareth L, Haq A (2011) Sunshine, sadness and seasonality: 25-hydroxyvitamin d, and depressive symptoms in the united arab emirates (uae). Int J Ment Health Promot 13:23–26. CrossRef
  43. Holick MF (2007) Vitamin d deficiency. N Engl J Med 357:266–281. CrossRef
  44. Humble MB (2010) Vitamin d, light and mental health. J Photochem Photobiol B 101:142–149. CrossRef
  45. McCann JC, Ames BN (2008) Is there convincing biological or behavioral evidence linking vitamin d deficiency to brain dysfunction? FASEB J 22:982–1001. CrossRef
  46. Kuningas M, Mooijaart SP, Jolles J, Slagboom PE, Westendorp RG, van Heemst D (2009) Vdr gene variants associate with cognitive function and depressive symptoms in old age. Neurobiol Aging 30:466–473. CrossRef
  47. Zittermann A (2003) Vitamin d in preventive medicine: Are we ignoring the evidence? Br J Nutr 89:552–572. CrossRef
  48. Mosekilde L (2005) Vitamin d and the elderly. Clin Endocrinol (Oxf) 62:265–281. CrossRef
  49. Kessler RC (2002) The categorical versus dimensional assessment controversy in the sociology of mental illness. J Health Soc Behav 43:171–188. CrossRef
  50. Kraemer HC, Noda A, O’Hara R (2004) Categorical versus dimensional approaches to diagnosis: Methodological challenges. J Psychiatr Res 38:17–25. CrossRef
  51. Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, El-Hajj Fuleihan G, Josse RG, Lips P, Morales-Torres J (2009) Global vitamin d status and determinants of hypovitaminosis d. Osteoporos Int 20:1807–1820. CrossRef
  52. Lee CT, Yeh CJ, Lee MC, Lin HS, Chen VC, Hsieh MH, Yen CH, Lai TJ (2012) Leisure activity, mobility limitation and stress as modifiable risk factors for depressive symptoms in the elderly: Results of a national longitudinal study. Arch Gerontol Geriatr 54:e221–229. CrossRef

See also VitaminDWiki

See also web

  1. Healthy Food Deficiency?
  2. Omega-3 Fatty Acids Deficiency:
  3. Vitamin D Deficiency:
  4. B-Vitamins Deficiency:
  5. Zinc , Folate, Chromium, and Iron Deficiencies:
  6. Iodine Deficiency:
  7. Amino Acids Deficiency:

Note: contrary to the title, they only listed 7 items. Magnesium was added by a reader

Note: Magnesium deficiency is also associated with low vitamin D and poor mental health

Magnesium and Mental Health  see  is.gd/VDMag

13990 visitors, last modified 19 Apr, 2015,
Printer Friendly Follow this page for updates