Effects of vitamin D supplementation on depression and some involved neurotransmitters

Vitamin D deficiency may exacerbate the role of metal exposure in depression: A cross-sectional analysis of NHANES data from 2007 to 2018

People are paying more and more attention to the effects of environmental factors such as heavy metals on depression, and heavy metals may destroy the homeostasis of vitamin D in the body by affecting human metabolism, and the lack of vitamin D will increase the risk of depression. There are few studies on vitamin D deficiency in depression caused by heavy metals, and it is not deep enough. Therefore, this study used logistic regression, restricted cubic spline curve, weighted quantile and Quantile g-computation model to analyze the effects of heavy metal exposure alone and in combination on vitamin D and depression, as well as the potential role of vitamin D deficiency in the process of heavy metal-induced depression. The results showed that cadmium exposure alone or in combination increased the risk of depression (P < 0.05). When Cd increased by 1 unit, the risk of depressive symptoms increased by 1.178 units. Arsenic and its compounds and lead affected vitamin D levels in the body and contributed the second highest or highest weight in the mixture (P < 0.05). It is worth noting that after grouping according to vitamin D deficiency, compared with the normal group, the mixed exposure of heavy metals in the vitamin D deficiency group had more types of metals related to depression and contributed more weight (P < 0.05). This study found that single metal or multi-metal mixed exposure is associated with depression. Vitamin D deficiency may increase the risk of depression. Vitamin D may be a potential factor in the treatment of depression caused by metal, and the specific mechanism of action needs further study.

Vitamin D3 application and factors of its activity in the adrenal cortex of andropausal rats: A functionally-histological study

INTRODUCTION AND AIM

Vitamin D supplementation in aging subjects manifests a positive effect on various health-related parameters. We performed a functionally-histological analysis of the adrenal cortex regarding the factors of vitamin D activity and corticosterone output after vitamin D3 application in a rat model of the andropause.

MATERIAL AND METHODS

Middle-aged Wistar rats were divided into sham operated (SO; n=8), orchidectomized (Orx; n=8) and vitamin D3-treated orchidectomized (Orx+vit. D; n=8) groups. Vitamin D3 (5 μg/kg b.m.) was administered subcutaneously for three weeks, while the SO and Orx groups received the vehicle alone. Set objectives were achieved using histochemistry/immunohistochemistry, stereology, ultrastructural and biochemical analyses.

RESULTS

Orchidectomy (Orx) decreased the adrenal cortex-related volume densities of vascular (p<0,0001), vitamin D receptor (VDR; p<0,0166), cytochrome P450 oxidase 2R1 (CYP 2R1; p<0,0001) and cytochrome P450 oxidase 24 (CYP 24; p<0,0001) depots, but increased the volume density of cytochrome P450 27B1 (CYP 27B1; p<0,0001) depots. In Orx+vit. D rats, increase of the adrenal cortex-related volume densities of collagen (p<0,0001), VDR (p<0,0001) and CYP 2R1 (p<0,0001) depots as well as the lipid-droplet diameter (p<0,0001) in adrenocortical outer zona fasciculata cells was observed, while a decrease of volume densities of the vascular (p<0,0001), CYP 27B1 (p<0,0001) and CYP 24 (p<0,0001) depots was registered, all versus Orx group. Plasma level of ACTH was decreased (p=0,0155) and serum concentrations of 25-hydroxyvitamin D3 and corticosterone were increased (p<0,0001 and p=0,0187, respectively), all after the same treatment.

CONCLUSIONS

Increased corticosterone output after vitamin D3 application to andropausal rats appears not to be related to increased availability of 25-hydroxyvitamin D3 and decreased degradation of 1,25-dihydroxyvitamin D3 in adrenal tissue, but rather involves the central regulatory mechanisms.

Vitamin-D as a multifunctional molecule for overall well-being: An integrative review

Vitamin D is amongst the most important biomolecules to regularize and help in sustainable health, however, based on the studies, deficiency of this multifunctional vitamin is common. Vitamin D, besides playing a role in the form of vitamins, also acts as a multifunctional hormone (steroid). Vitamin D is synthesized inside the body through various steps starting from ultraviolet radiation exposure and comes from limited food sources, however, vitamin D-fortified food products are still among the major sources of vitamin D. Current review, focused on how vitamin D acts as a multifunctional molecule by effecting different functions in the body in normal or specific conditions and how it is important in fortification and how it can be managed from the available literature till date. During the Covid pandemic, people were aware of vitamin D and took supplementation, fortified foods, and sat under sunlight. As COVID prevalence decreases, people start forgetting about vitamin D. Vitamin D is very crucial for overall well-being as it has protective effects against a broad range of diseases as it can reduce inflammation, cancer cell growth and helps in controlling infection, increase metabolism, muscle, and bone strength, neurotransmitter expression, etc. Therefore, the present review is to provoke the population, and fulfillment of the vitamin D recommended dietary allowance daily must be confirmed.

Does vitamin D supplementation impact serotonin levels? A systematic review and meta-analysis

Background and Aims

Vitamin D deficiency impacts a significant proportion of the world's population, and this deficiency has been linked to various conditions characterized by imbalanced serotonin regulation. The objective of this systematic review and meta-analysis was to evaluate the effect of vitamin D supplementation on serum serotonin levels.

Methods

We conducted a comprehensive search of PubMed, Scopus, Cochrane Central for Randomized Clinical Trials, and Web of Science up to September 2022, without any language restrictions. The effect sizes were calculated using the standard mean difference (SMD) and 95% confidence interval (CI).

Results

Six randomized clinical trials involving 356 participants were included in the analysis. Our findings indicated no significant changes in serotonin levels between the intervention and control groups (SMD: 0.24 ng/mL, 95% CI: -0.28, 0.75, p > 0.10). Subgroup analysis also did not reveal any significant changes in serotonin levels among children, participants with autism spectrum disorders, interventions lasting 10 weeks or longer, or those receiving vitamin D doses below 4000 IU/day.

Conclusion

Although the results obtained in this systematic review are inconclusive, they support the need for further well-designed randomized trials to assess the potential role of vitamin D supplementation in regulating serotonin levels and potentially ameliorating depression and related disorders.

Antidepressant-like effects of tomatidine and tomatine, steroidal alkaloids from unripe tomatoes, via activation of mTORC1 in the medial prefrontal cortex in lipopolysaccharide-induced depression model mice

ABSTRACTKetamine, an N-methyl-D-aspartate receptor antagonist, produces rapid antidepressant effects in patients with treatment-resistant depression. However, owing to the undesirable adverse effects of ketamine, there is an urgent need for developing safer and more effective prophylactic and therapeutic interventions for depression. Preclinical studies have demonstrated that activation of the mechanistic target of rapamycin complex 1 (mTORC1) in the medial prefrontal cortex (mPFC) mediates the rapid antidepressant effects of ketamine. The steroidal alkaloid tomatidine and its glycoside α-tomatine (tomatine) can activate mTORC1 signaling in peripheral tissues/cells. We examined whether tomatidine and tomatine exerted prophylactic and therapeutic antidepressant-like actions via mPFC mTORC1 activation using a mouse model of lipopolysaccharide (LPS)-induced depression. Male mice were intraperitoneally (i.p.) administered tomatidine/tomatine before and after the LPS challenge to test their prophylactic and therapeutic effects, respectively. LPS-induced depression-like behaviors in the tail suspension test (TST) and forced swim test (FST) were significantly reversed by prophylactic and therapeutic tomatidine/tomatine administration. LPS-induced anhedonia in the female urine sniffing test was reversed by prophylactic, but not therapeutic, injection of tomatidine, and by prophylactic and therapeutic administration of tomatine. Intra-mPFC infusion of rapamycin, an mTORC1 inhibitor, blocked the prophylactic and therapeutic antidepressant-like effects of tomatidine/tomatine in TST and FST. Moreover, both tomatidine and tomatine produced antidepressant-like effects in ovariectomized female mice, a model of menopause-associated depression. These results indicate that tomatidine and tomatine exert prophylactic and therapeutic antidepressant-like effects via mTORC1 activation in the mPFC and suggest these compounds as promising candidates for novel prophylactic and therapeutic agents for depression.

Preventive and therapeutic effect of vitamin D on depression-like behavior in a mouse adolescent depression model and its association with BDNF protein expression

Introduction

Previous studies in different populations have shown that vitamin D supplementation may reduce depression levels. In adolescents, vitamin D deficiency has been identified as a factor contributing to the onset of depression. This study aimed to establish a model of adolescent depression in mice by using the scientific unpredictable chronic mild stress (UCMS) model and to preliminarily evaluate the effect of vitamin D on the occurrence and development of depression and whether it is related to the protein expression of the BDNF pathway.

Methods

The UCMS method was used to establish a model of adolescent depression in 4-week-old C57BL/6 male mice, randomly divided into five groups: Control group, Stress group, Stress+ low-dose group, Stress+ medium-dose group, Stress+ high-dose group. At the same time as chronic stress, the administration groups were given intramuscular injections of different doses of vitamin D. After 8 weeks, behavioral tests, including the forced swimming test (FST) and open field test (OFT), were performed on each group of mice, along with recording of indicators, blood vitamin D level detection, and brain tissue western blot analysis.

Results

The results showed a significant difference in vitamin D levels among mice in different groups after 8 weeks (P=0.012). The results of behavioral testing showed a significant difference in the static time of forced swimming among the groups (P<0.001). Compared with the UCMS group, the static time of mice with vitamin D injection was significantly reduced (P<0.001). The total number of times mice entered the central area, the total distance of movement, and the time spent in the central area significantly increased after vitamin D injection compared with the UCMS-only group (all P<0.001). There was no significant difference in the expression of BDNF in the brain tissues of experimental mice (P>0.05).

Discussion

In conclusion, in the mouse adolescent depression model, appropriate vitamin D supplementation can reduce the occurrence of stress-induced depression. Furthermore, vitamin D deficiency may also serve as a potential risk factor for depression.

Vitamin D in Central Nervous System: Implications for Neurological Disorders

Vitamin D, obtained from diet or synthesized internally as cholecalciferol and ergocalciferol, influences bodily functions through its most active metabolite and the vitamin D receptor. Recent research has uncovered multiple roles for vitamin D in the central nervous system, impacting neural development and maturation, regulating the dopaminergic system, and controlling the synthesis of neural growth factors. This review thoroughly examines these connections and investigates the consequences of vitamin D deficiency in neurological disorders, particularly neurodegenerative diseases. The potential benefits of vitamin D supplementation in alleviating symptoms of these diseases are evaluated alongside a discussion of the controversial findings from previous intervention studies. The importance of interpreting these results cautiously is emphasised. Furthermore, the article proposes that additional randomised and well-designed trials are essential for gaining a deeper understanding of the potential therapeutic advantages of vitamin D supplementation for neurological disorders. Ultimately, this review highlights the critical role of vitamin D in neurological well-being and highlights the need for further research to enhance our understanding of its function in the brain.

Current Aspects of Selected Factors to Modulate Brain Health and Sports Performance in Athletes

This review offers a comprehensive evaluation of current aspects related to nutritional strategies, brain modulation, and muscle recovery, focusing on their applications and the underlying mechanisms of physiological adaptation for promoting a healthy brain, not only in athletes but also for recreationally active and inactive individuals. We propose that applying the rule, among others, of good sleep, regular exercise, and a properly balanced diet, defined as "SPARKS", will have a beneficial effect on the function and regeneration processes of the gut-brain-muscle axis. However, adopting the formula, among others, of poor sleep, stress, overtraining, and dysbiosis, defined as "SMOULDER", will have a detrimental impact on the function of this axis and consequently on human health as well as on athletes. Understanding these dynamics is crucial for optimizing brain health and cognitive function. This review highlights the significance of these factors for overall well-being, suggesting that adopting the "SPARKS" approach may benefit not only athletes but also older adults and individuals with health conditions.

Combination of vitamin D3 and fructooligosaccharides upregulates colonic vitamin D receptor in C57BL/6J mice and affects anxiety-related behavior in a sex-specific manner

Depression and anxiety disorders are among the most common mental health disorders that affect US adults today, frequently related to vitamin D (VD) insufficiency. Along with VD, growing evidence suggests gut microbiota likely play a role in neuropsychiatric disorders. Here, we investigated if modulation of gut microbiota would disrupt host VD status and promote behaviors related to depression and anxiety in adult mice. Six-week-old male and female C57BL/6J mice (n = 10/mice/group) were randomly assigned to receive (1) control diet (CTR), control diet treated with antibiotics (AB), control diet with total 5000 IU of VD (VD), VD treated with antibiotics (VD + AB), VD supplemented with 5% w/w fructooligosaccharides (FOS; VF), and VF diet treated with antibiotics (VF + AB), respectively, for 8 weeks. Our study demonstrated that VD status was not affected by antibiotic regimen. VD alone ameliorates anxiety-related behavior in female mice, and that combination with FOS (i.e., VF) did not further improve the outcome. Male mice, in contrast, exhibit greater anxiety with VF, but not VD, when compared with CTR mice. Colonic VD receptor was elevated in VF-treated mice in both sexes, compared with CTR, which was positively correlated to colonic TPH1, a rate-limiting enzyme for serotonin synthesis. Taken together, our data indicate that the effect of VF on anxiety-related behavior is sex-specific, which may partially be attributed to the activation of colonic VD signaling and subsequent serotonin synthesis. The synergistic or additive effect of VD and FOS on mood disorders remained to be investigated.

Association between Vitamin D Levels During Pregnancy and Postpartum Depression: A Narrative Reviews

Background

Postpartum Depression (PPD) is a serious depression that develops in the first year, with unknown explained reasons. Many studies evaluated the impact of Vitamin D (VD) levels on depression during pregnancy and postnatal. This narrative review aims to review any association between serum VD levels during pregnancy and the development of PPD.

Materials and Methods

PPD data from published trials and research articles (period from 2012 to 2022) were assessed through PubMed, Scopus, Science Direct, and Google Scholar using the following terms: Depression, pregnancy, 25-hydroxyvitamin D (25OH VD), vitamin D deficiency (VDD) and postpartum (PP). Articles were selected manually and with careful tracking to avoid duplication. Articles that investigated any association between VD levels during pregnancy and PPD in the time frame were included in the study, while articles investigating VD levels of PP without depression were excluded.

Results

In this narrative review, five out of seven studies showed an association between PPD and VDD during pregnancy. Danish National Birth Cohort (DNBC), Edinburgh Postnatal Depression Scale (EPDS) and Center for Epidemiologic Studies Depression Scale (CES-D) enrolled among different studies from 3 days to 1 year PP to assess PPD.

Conclusions

Pregnant women with VDD are significantly associated with PPD. Longitudinal follow-up studies are needed to evaluate the association between VDD with PPD. Screening VD levels among pre-postnatal mothers may be essential for awareness programs that can be implemented to promote remission of postnatal depression.

Nutraceuticals in Psychiatric Disorders: A Systematic Review

Correct nutrition and diet are directly correlated with mental health, functions of the immune system, and gut microbiota composition. Diets with a high content of some nutrients, such as fibers, phytochemicals, and short-chain fatty acids (omega-3 fatty acids), seem to have an anti-inflammatory and protective action on the nervous system. Among nutraceuticals, supplementation of probiotics and omega-3 fatty acids plays a role in improving symptoms of several mental disorders. In this review, we collect data on the efficacy of nutraceuticals in patients with schizophrenia, autism spectrum disorders, major depression, bipolar disorder, and personality disorders. This narrative review aims to provide an overview of recent evidence obtained on this topic, pointing out the direction for future research.

Change in function and homeostasis of HPA axis: The role of vitamin family

With the improvement of living quality, people pay more and more attention to vitamin supplements. The vitamins in the daily diet can meet the needs of the body. Whether additional vitamin supplementation is necessary still needs to be further explored. Many studies have reported that vitamin deficiency and excessive vitamin supplementation could lead to abnormal development in the body or increase the risk of diseases. Here, we summarize the abnormal levels of vitamins can cause the homeostasis imbalance of hypothalamus-pituitary-adrenal (HPA) axis by affecting its development and function. It can lead to abnormal synthesis and secretion of glucocorticoid in the body, which mediates the occurrence and development of metabolic diseases and psychoneurotic diseases. In addition, vitamin has a strong antioxidant effect, which can eliminate oxygen free radicals. Thereby, vitamins can alter HPA axis function and homeostasis maintenance by combating oxidative stress. This review provides a theoretical basis for clarifying the role of abnormal levels of vitamin in the occurrence and development of multiple diseases and its intervention strategy, and also provides reference value and guiding significance for rational use of vitamins.

Revisiting the significance of nano-vitamin D for food fortification and therapeutic application

OBJECTIVE

Vitamin D (a prohormone) is an important micronutrient required by the body for skeletal homeostasis and a range of non-skeletal actions. Calcitriol, the active form of vitamin D, regulates a variety of cellular and metabolic processes through both genomic and nongenomic pathways. Often prescribed for treating rickets and osteoporosis, vitamin D deficiency can exacerbate various other medical conditions.

SIGNIFICANCE, METHODS, AND RESULTS

Despite its multifunctional uses, the sensitivity of vitamin D makes formulating an efficient drug delivery system a challenging task, which is further complicated by its poor aqueous solubility. Enhancing the oral absorption of vitamin D is vital in utilizing its full efficacy. Recent developments in encapsulation and nanotechnology have shown promising results in overcoming these constraints.

CONCLUSION

This review thus offers an insight to adequately comprehend the mechanistic pharmacology of vitamin D, its pathophysiological role, and justification of its medical indications, along with the benefits of utilizing nanotechnology for vitamin D delivery.

The effect of vitamin D supplementation on primary depression: A meta-analysis

BACKGROUND

Previous meta-analyses reported inconsistent results on the effect of vitamin D on depression because of different baseline concentrations of 25-hydroxyvitamin D [25(OH)D], highlighting the need for a more accurate subgroup analysis of previously published findings. The goal of the present study was to evaluate the effect of vitamin D supplementation on depression in adults.

METHODS

A systematic search in numerous databases including PubMed, Embase, and Web of Science was performed. Randomized-controlled trials comparing the effect of vitamin D on depression in adults were selected.

RESULTS

Eighteen studies met the inclusion criteria in the retrieved citations. The meta-analysis showed that vitamin D supplementation had a significant effect on overall reduction in depression symptom scores (SMD = -0.15, 95 % CI [-0.26, -0.04]). Sub-group analysis showed that vitamin D supplementation significantly reduced depressive symptom scores in patients with serum 25(OH)D levels higher than 50 nmol/L (SMD = -0.38, 95 % CI [-0.68, -0.08]).

CONCLUSIONS

Vitamin D supplementation has a benefit on improving depressive symptoms in adults with primary depression and 25(OH)D levels higher than 50 nmol/L but has no effect on improving depressive symptoms in adults with primary depression and 25(OH)D levels lower than 50 nmol/L. Relatively high levels of 25(OH)D maybe required for alleviating depression.

LIMITATIONS

The randomized studies included in this study were designed and completed at different times and countries, the variability in duration and dose of vitamin D supplementation may have introduced significant heterogeneity and have militated against observation of the effects of vitamin D supplementation on depression.

Interplay of Vitamin D, Unfolded Protein Response, and Iron Metabolism in Neuroblastoma Cells: A Therapeutic Approach in Neurodegenerative Conditions

Vitamin D3 (VD) is crucial for various cell functions, including gene regulation, antioxidant defense, and neural health. Neurodegenerative conditions are closely linked to the unfolded protein response (UPR), a mechanism reacting to endoplasmic reticulum (ER) stress. Iron metabolism is intricately associated with UPR and neurodegeneration. This study used SH-SY5Y neuroblastoma cells to investigate the relationship between UPR, iron metabolism, and VD. Different sequences of treatments (pre- and post-treatments) were applied using VD and thapsigargin (Tg), and various methods were used for evaluation, including real-time qPCR, Western blotting, ELISA, and iron content analysis. The findings indicate that VD affects UPR pathways, cytokine release, and iron-related genes, potentially offering anti-inflammatory benefits. It also influences iron transporters and storage proteins, helping to maintain cellular iron balance. Furthermore, pro-inflammatory cytokines like interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα) were impacting UPR activation in cells. VD also influenced fractalkine (CX3CL1) gene expression and secretion, suggesting its potential as a therapeutic agent for addressing neuroinflammation and iron dysregulation. This research provides insights into the intricate connections among VD, UPR, and iron metabolism in SH-SY5Y neuroblastoma cells, with implications for future investigations and potential therapeutic approaches in neurodegenerative diseases characterized by UPR dysregulation and iron accumulation.

Severe Vitamin D Deficiency-A Possible Cause of Resistance to Treatment in Psychiatric Pathology

In the last few years, vitamin D functions have been studied progressively, and along with their main role in regulating calcium homeostasis, the potential function in the nervous system and the link between different psychiatric disorders and vitamin D deficiency have been revealed. The discovery of vitamin D receptors in multiple brain structures, like the hippocampus, led to the hypothesis that vitamin D deficiency could be responsible for treatment resistance in psychiatric diseases. The aim of this study was to analyze the current knowledge in the literature regarding vitamin D deficiency among individuals afflicted with psychiatric disorders and assess the potential therapeutic benefits of vitamin D supplementation. A systematic search was conducted on the PubMed database for articles published in the last five years (2016-2022) in English, focusing on human subjects. Results show that vitamin D deficiency has implications for numerous psychiatric disorders, affecting mood and behavior through its influence on neurotransmitter release, neurotrophic factors, and neuroprotection. It also plays a role in modulating inflammation, which is often elevated in psychiatric disorders. In conclusion, vitamin D deficiency is prevalent and has far-reaching implications for mental health. This review underscores the importance of exploring the therapeutic potential of vitamin D supplementation in individuals with psychiatric disorders and highlights the need for further research in this complex field.

The effect of vitamin D supplementation on depressive symptoms in adults: A systematic review and meta-analysis of randomized controlled trials

Neurosteroid and immunological actions of vitamin D may regulate depression-linked physiology. Meta-analyses investigating the effect of vitamin D on depression have been inconsistent. This meta-analysis investigated the efficacy of vitamin D in reducing depressive symptoms among adults in randomized placebo-controlled trials (RCT). General and clinical populations, and studies of ill individuals with systemic diseases were included. Light therapy, co-supplementation (except calcium) and bipolar disorder were exclusionary. Databases Medline, PsycINFO, CINAHL and The Cochrane Library were searched to identify relevant articles in English published before April 2022. Cochrane risk-of-bias tool (RoB 2) and GRADE were used to appraise studies. Forty-one RCTs (n = 53,235) were included. Analyses based on random-effects models were performed with the Comprehensive Meta-analysis Software. Results for main outcome (n = 53,235) revealed a positive effect of vitamin D on depressive symptoms (Hedges' g = -0.317, 95% CI [-0.405, -0.230], p < 0.001, I2 = 88.16%; GRADE: very low certainty). RoB assessment was concerning in most studies. Notwithstanding high heterogeneity, vitamin D supplementation ≥ 2,000 IU/day appears to reduce depressive symptoms. Future research should investigate possible benefits of augmenting standard treatments with vitamin D in clinical depression. PROSPERO registration number: CRD42020149760. Funding: Finnish Medical Foundation, grant 4120 and Juho Vainio Foundation, grant 202100353.

Body mass index modifies the relationship between dietary iron intake and depressive symptoms among adults: A national population-based cohort

BACKGROUND

Research on the effects of dietary iron intake on depression is limited and controversial. The aim of this study was to explore the association between iron intake and the prevalence of depressive symptoms.

METHODS

The present study used cross-sectional data from people who participated in the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. Logistic regression models and restricted cubic spline models were applied to investigate the relationship between iron intake and depressive symptoms.

RESULTS

A total of 16,098 adults aged 20 years or older were included in this study. Compared with individuals with lowest iron intake Q1 (≤8.31 mg/day), the adjusted OR values for dietary iron intake and depression in Q2 (8.32-11.47 mg/day), Q3 (11.48-15.02 mg/day), Q4 (15.03-20.28 mg/day), and Q5 (≥20.29 mg/day) were 0.69 (95 % CI: 0.52-0.91), 0.68 (95 % CI: 0.50-0.94,), 0.59 (95 % CI: 0.42-0.82,), and 0.63 (95 % CI: 0.40-0.98), respectively. The relationship between iron intake and depressive symptoms exhibited a non-linear. Our findings suggested an interaction between body mass index (BMI) and iron intake (P = 0.03). Additionally, the relationship between dietary iron intake and depressive symptoms in adults with a BMI <25 kg/m2 was U-shaped. And the OR of developing depressive symptoms was 0.93 (95 % CI: 0.87-0.99) in individuals with iron intake ≤19.72 mg/day.

LIMITATIONS

Cross-sectional study and relevant data was based on self-reports.

CONCLUSION

A higher iron intake is significantly associated with a decreased prevalence of depressive symptoms, and different levels of BMI can modify the association between them.

Vitamin D Deficiency (VDD) and Benefits of Supplementation in Veterans with IBS-D

Many veterans deployed to Gulf War areas suffer from persistent chronic diarrhea that is disabling and affects their quality of life. The causes for this condition have eluded investigators until recently and recent literature has shed light on the effect of vitamin D on the brain-gut axis. This study focused on determining clinical causes contributing to diarrhea and assessed whether reversing the identified causes, specifically vitamin D deficiency (VDD), could reduce the incidence of diarrhea in Gulf War veterans (GWVs). All patients completed a workup that included serologies (IBD, celiac), routine laboratory tests (CBC, chemistry panels, TSH, T4, CRP), cultures for enteric pathogens (C diff, bacteria, viruses, small intestinal bacterial overgrowth (SIBO)), and upper and lower endoscopies with histology and a trial of cholestyramine to exclude choleretic diarrhea and rifaximin for dysbiosis. A total of 4221 veterans were screened for chronic diarrhea, yielding 105 GWVs, of which 69 GWVs had irritable bowel syndrome with diarrhea (IBS-D). Paired t-tests demonstrated that all GWVs had VDD (t-11.62, df68 and sig(2-tailed) 0.0001) (defined as a vitamin D level less than 30 ng/mL with normal ranges of 30-100 ng/mL) but no positive serologies, inflammatory markers, abnormal endoscopies, cultures, or histology to explain their persistent diarrhea. There was no correlation with age, BMI, or inflammation. Some zip codes had a higher frequency of GWVs with VDD, but the number of deployments had no impact. Treatment with vitamin D supplementation (3000-5000 units), given in the morning, based on weight, reduced the number of bowel movements per day (p < 0.0001) without causing hypercalcemia. We suggest that VDD is important in the etiology of IBS-D in GWVs and that vitamin D supplementation significantly reduces diarrhea.

Influence of Nutrition on Mental Health: Scoping Review

The aim of this article was to carry out a scoping review of existing research on the influence of food on mental health: (1) Background: nutrition, nutrient levels or an adequate body weight seem to influence the mental health status of individuals. The consumption of psychotropic drugs also seems to contribute to overweight; (2) Methods: fifteen previous research articles were used in the review, which were read in their entirety, following PRISMA methodology and using SPIDER and GRADE tools; (3) Results: there is a relationship between diet and mental health status. Low levels of magnesium, together with high levels of calcium, provoke anxious states, and supplementation with Melissa Officinalis attenuates them. Healthy nutritional habits generally reduce depressive symptoms; while vitamin D supplementation improves mental health status; (4) Conclusion: in general, healthy and appropriate nutrition, such as the Mediterranean diet, improves mental health status. Levels of magnesium, vitamin D, and vitamin B6 also seem to have an influence. As limitations of the present review, "food" was considered any form of nutrient administered as an independent variable, and it may include linguistic and publication bias.

Vitamin D may alleviate irritable bowel syndrome by modulating serotonin synthesis: a hypothesis based on recent literature

A number of studies found that serotonin plays a vital role in the development of depression and irritable bowel syndrome. Recent studies showed that vitamin D was associated with regulating the synthesis of serotonin. This review focuses on the recent progress in the relationship between vitamin D and serotonin synthesis.

Practice and knowledge of dietary supplement consumption among Indonesian adults post-delta wave of the COVID-19 pandemic

Background: Increasing dietary supplement (DS) consumption was observed during the COVID-19 pandemic, including during the post-Delta wave period. This study aimed to measure the practice of DS consumption and respondents' knowledge of DS. Methods: An internet-based survey was distributed from October-December 2021 and obtained 541 valid and completed responses. Descriptive analysis was performed to present the practice of DS consumption, including frequency, duration, aim, preferable dosage form etc. Level of knowledge on DS principles, side effects and regulation were also measured. Inferential analyses were conducted to determine the predictors of the respondents' DS practice and level of knowledge. Results: Data from 541 valid responses showed that 77.63% of respondents consumed DS in the last 3 months, with only 59.52% reporting also consuming DS before the COVID-19 pandemic. One half of the respondents had good knowledge about DS; however, some knowledge regarding side effects and possible drug-supplement interaction needed improvement. Their DS consumption practice was affected by their economic status and history of contracting COVID-19. Nevertheless, the level of knowledge was not affected by the sociodemographic factors and DS supplement experience. Conclusions: Taken together, the practice of self-consumption of DS in Indonesia is increasing; hence, knowledge of DS is necessary to avoid detrimental effects that might occur in the future. Increasing access to information on better labelling and educating consumers about DS are important actions to consider.

Gestational folic acid supplement prevents vitamin D deficiency-induced depression-like behavior by reversing cortical DNA hypomethylation in adult offspring

Depression is a common mental disorder with an increasing incidence. Several studies have demonstrated that cortical DNA hypomethylation is associated with depression-like behaviors. This study aims to investigate whether maternal vitamin D deficiency (VDD) induces depression-like behaviors and to explore the effects of folic acid supplement on VDD-induced cortical DNA hypomethylation in adult offspring. Female mice were fed with a VDD diet, beginning at 5 weeks of age and throughout pregnancy. Depression-like behaviors were evaluated, and cortical 5-methylcytosine (5mC) content was detected in adult offspring. Results showed that depression-like behaviors were observed in adult offspring of the VDD group. Cortical Ache and Oxtr mRNAs were upregulated in female offspring of the VDD group. Cortical Cpt1a and Htr1b mRNAs were increased in male offspring of the VDD group. Moreover, cortical 5mC content was reduced in offspring of VDD-fed dams. The additional experiment showed that serum folate and cortical S-adenosylmethionine (SAM) contents were decreased in the offspring of the VDD group. Folic acid supplement attenuated VDD-induced SAM depletion and reversed cortical DNA methylation. Moreover, folic acid supplement attenuated VDD-induced upregulation of depression-related genes. In addition, folic acid supplement alleviated maternal VDD-induced depression-like behaviors in adult offspring. These results suggest that maternal VDD induces depression-like behavior in adult offspring by reducing cortical DNA methylation. The gestational folic acid supplement prevents VDD-induced depression-like behavior by reversing cortical DNA hypomethylation in adult offspring.

Vitamin D and Restless Legs Syndrome: A Review of Current Literature

This review presents a detailed summary of the current literature regarding RLS and vitamin D deficiency. To our knowledge it is the first review of its kind. We review the prevalence of vitamin D deficiency in RLS as well as the evidence for the use of vitamin D supplementation in RLS management. We further examine the literature for proteomic and genetic evidence of a role for vitamin D in the pathogenesis of RLS. An alteration in vitamin D binding protein in RLS is one of the most consistent findings in the proteomic studies. Furthermore, we examine the interaction of vitamin D with calcium, phosphorus, and parathyroid hormone and the possible role of these connections in RLS. We also explore the possible nexus between RLS and vitamin D in renal disease, cardiovascular and cerebrovascular disease as well as inflammation. In addition, we review the potential interaction between vitamin D and RLS with iron, dopamine and other neurotransmitter systems including the endogenous opiate, serotoninergic, glutamatergic and adenosinergic systems. We also explore the role of vitamin D in RLS Augmentation (i.e., the paradoxical worsening of RLS symptoms when dopaminergic agents are used as a therapy for RLS). Although the literature is not entirely consistent in affirming vitamin D deficiency in RLS or the amelioration of RLS symptoms with vitamin D therapy, the collective studies overall indicate that vitamin D deficiency is common enough in RLS patients to suggest that RLS patients should have their vitamin D levels checked and any deficiency corrected as a standard of care. Highlights  Patients with Restless Legs Syndrome (RLS) may be deficient in vitamin D and therapy with vitamin D may ameliorate RLS. We present the first review dedicated solely to evaluating the relationship between RLS and vitamin D and present a case for the role of vitamin D in RLS pathogenesis.

Vitamin D in Depression: A Potential Bioactive Agent to Reduce Suicide and Suicide Attempt Risk

Suicide is one of the leading causes of death worldwide. According to the World Health Organization (WHO), every year, more than 700 thousand people die from this cause. Therefore, suicide is a public health issue. The complex interaction between different factors causes suicide; however, depression is one of the most frequent factors in people who have attempted suicide. Several studies have reported that vitamin D deficiency may be a relevant risk factor for depression, and vitamin D supplementation has shown promising effects in the adjunctive treatment of this mood disorder. Among the beneficial mechanisms of vitamin D, it has been proposed that it may enhance serotonin synthesis and modulate proinflammatory cytokines since low serotonin levels and systemic inflammation have been associated with depression and suicide. The present narrative review shows the potential pathogenic role of vitamin D deficiency in depression and suicide and the potential benefits of vitamin D supplementation to reduce their risk.

Efficacy and acceptability of vitamin D supplements for depressed patients: A systematic review and meta-analysis of randomized controlled trials

OBJECTIVES

This systematic review and meta-analysis synthesized the evidence from randomized controlled trials comparing vitamin D and placebo in reducing depressive symptoms and contributing to all-cause dropout rates.

METHODS

Inclusion criteria were randomized controlled trials comparing reduced depression between depressed patients receiving vitamin D and those receiving placebo. We searched PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials through January 2022.

RESULTS

Eighteen trials (1980 participants, median age 39 y) were included in the meta-analysis. Vitamin D supplements were significantly superior to placebo in reducing depression (standardized mean difference = -0.49; 95% confidence interval [CI], -0.75 to -0.23; I² = 81%). Depressed adults (standardized mean difference = -0.70; 95% CI, -1.09 to -0.31) responded to vitamin D significantly better than children and adolescents (standardized mean difference = 0.10; 95% CI -0.27 to 0.47). Vitamin D administered as bolus doses (oral intermittent high doses or intramuscular single high dose) appeared to be more effective than that taken daily by the oral route (P < 0.01). Patients with more severe depression tended to respond better than those with less severity (P = 0.053). We found no moderating effect of concurrent antidepressant use, presence of major depressive disorder diagnosis, physical comorbidity, sex, duration and doses of vitamin D supplement, serum 25-hydroxyvitamin D levels at baseline, and changes in serum 25-hydroxyvitamin D levels in the vitamin D group. Dropout rates were indifferent between the groups (17 trials; risk ratio = 0.84; 95% CI, 0.6-1.16; I² = 0).

CONCLUSIONS

Heterogeneous data suggested that vitamin D supplements are effective and safe for depressed patients.

Decreased Levels of Vitamin D in Bipolar Patients

Recently, vitamin D is considered a pleiotropic hormone, and as such, it has also become a topic of renewed interest in neuropsychiatry for its proposed role in the aetiology and pathophysiology of different psychiatric conditions, including mood disorders (MDs). This seems particularly crucial while considering the relatively high and often neglected prevalence of hypovitaminosis D in the general population and in specific groups, such as patients suffering from the most common type of MDs, which are major depression (MDD) and bipolar disorders (BDs). Therefore, in view of the controversial literature and findings on this topic and its potential therapeutic implications, the present study aimed at evaluating vitamin D levels in the plasma of a sample of inpatients fulfilling the DSM-5 criteria for mood episodes within BDs. The clinical picture was assessed by means of specific rating scales. The results showed that the vitamin D levels (mean ± SD, nM/L) of the bipolar patients of our sample were significantly lower (14.58 ± 11.27 nmol/L) than the normative values (>30 nmol/L). Eleven patients had sufficient values and only 4 had optimal, while 19 showed insufficient, 18 critical, and 17 severely critical levels. No differences emerged according to different socio-demographic or clinical features. In our opinion, the present findings strengthen previous research highlighting decreased vitamin D levels in bipolar patients and support the role of this pleiotropic hormone in BDs. Nevertheless, further studies should follow to corroborate the data of this preliminary study and to address the potential benefits of vitamin D supplementation in the treatment of MDs.

The Therapeutic Impact of Plant-Based and Nutritional Supplements on Anxiety, Depressive Symptoms and Sleep Quality among Adults and Elderly: A Systematic Review of the Literature

BACKGROUND

The emerging research in the literature continues to forecast a drastic and alarming increase in negative mental health and sleep health outcomes among populations, especially after the COVID-19 pandemic, which significantly influenced people's way of life. With mental health pharmaceutical interventions continuing to be stigmatized and inaccessible among populations, natural supplements provide an opportunity for intervention.

OBJECTIVE

This study sought to conduct a systematic review of the literature on the most recent comprehensive evidence for which nutritional supplements have the greatest therapeutic impact on symptoms of anxiety, depression, and insomnia.

METHODS

A systematic search of the literature, utilizing several databases, including PubMed and Web of Science, was conducted on 29 April 2022. We used developed keywords and MeSH terms for the search. The study eligibility criteria included (1) a randomized control trial; (2) investigating a plant-based therapeutic or natural supplement as the intervention; (3) measuring at least one health outcome of the following: anxiety symptoms, depressive symptoms, or sleep health outcomes; (4) utilizing validated measurement tools to measure the outcome of interest; (5) written in the English language; (6) peer reviewed; and (7) focused on adults and elderly populations.

MAIN RESULTS

Following the PRISMA guidelines, 76 studies were included in this review. We used the revised Risk of Bias tool (RoB2) to assess the quality of all included randomized control trials. A qualitative data synthesis was conducted. Overall, we found several valuable insights from the evidence in the literature, including evidence that demonstrates the benefits of probiotics and vitamin B complexes on anxiety symptoms, depressive symptoms, and sleep quality. Implication of Key Findings: This review provides the most updated findings in the literature on the topic, including an abundance of research that was published in the past 5 years. Given the expected rise in negative mental and sleep health outcomes following the pandemic, the supplements and therapeutics identified in this study should be the target of intervention measures to increase their accessibility and affordability and allow them to be incorporated into clinical guidelines of treatment. PROSPERO registration number: CRD42022361130.

Effect of low-carbohydrate diet on depression and anxiety: A systematic review and meta-analysis of controlled trials

BACKGROUND

Despite considerable advances in pharmacological and non-pharmacological treatments, mental health illnesses carry many economic and social burdens. Depression and anxiety are known as mental disorders which are highly prevalent worldwide. Previous studies have shown different results. This diet has attracted enormous interest.

OBJECTIVE

This is the first meta-analysis conducted to review systematically all trials to evaluating the effect of a low carbohydrate diet (LCD) on depression, and anxiety.

METHODS

PubMed, Web of Science, and Scopus have been searched until 9 September 2021. In total, 8 RCTs (n = 590) were carried out for evaluation the effects of LCDs on depression and anxiety were included. All the trials included in the analyses evaluated patients without a mood disorder. Random model effects meta-analysis was conducted. To evaluate the heterogeneity among the included studies. The egger test was used. Subgroup analyses performed based on regions, assessment methods, carbohydrate intake and duration of studies.

RESULTS

This study did not show any significant association between a low carbohydrate diet and the of anxiety (SMD = 0.19, 95 % CI -0.10, 0.47; P = 0.20) and also depression (SMD = 0.06, 95 % CI -0.11, 0.24; P = 0.49). If one of the studies is excluded, this diet significantly increases anxiety (SMD = 0.33, 95 % CI 0.12, 0.54; P ≤ 0.001). This study showed that this diet increases anxiety in studies with <26 % carbohydrate intake (SMD = 0.31; 95%CI 0.10, 0.52; P ≤ 0.001; I² = 0.00, P = 0.52), in the Australia (SMD = 0.29; 95%CI 0.08, 0.49; P = 0.01; I² = 0.00, P = 0.42), and in studies that used the Spielberger State Anxiety Inventory (SAI) to assess anxiety (SMD = 0.33; 95%CI 0.11, 0.54; P ≤ 0.001; I² = 0.00, P = 0.54).

LIMITATIONS

One of the limitations of intervention studies examining the effect of diet is that it is difficult to blind people under intervention.

CONCLUSION

The present study did not demonstrate significant association between a low carbohydrate diet and improvement of depression and anxiety. More accurate studies are needed to reach definitive conclusions.

Efficacy of B-vitamins and vitamin D therapy in improving depressive and anxiety disorders: a systematic review of randomized controlled trials

OBJECTIVES

This systematic review aimed to evaluate the efficacy of B vitamins and vitamin D therapy in improving the standard treatment of depression and anxiety disorders. We also aimed to gather the evidence supporting the recommendations for supplementation in clinical practice.

METHODS

Performed between March 2020 and September 2021, the main inclusion criteria were randomized controlled trials (RCTs), with patients ≥ 18 years old, both sexes, fulfilling target diagnoses of major depressive disorder (MDD), generalized anxiety disorder (GAD), or mild to severe depressive and anxiety symptoms. In addition, the RCTs were included if the scales to assess the severity of the symptoms were standardized rating scales in psychiatric. Trials that reported diagnoses of schizophrenia, perinatal depression, bipolar depression, sleep disorders, eating disorders, cancer, and multiple sclerosis in association with any of the mentioned diagnoses were excluded.

RESULTS

We identified 20 RCTs that matched all eligibility criteria, totaling 2,256 subjects, diagnosed with MDD, GAD, and depressive or anxiety symptoms. Supplementation with folic acid or L-methylfolate, B1, B12 or methylcobalamin, and vitamin D (in different doses and study duration) significantly decreased depression score scales by increasing response to standard pharmacological treatment or as monotherapy, including partial or complete remission. As for anxiety symptoms, the availability of results is limited to adjuvant vitamin D therapy.

DISCUSSION

B vitamins and vitamin D associated with other compounds also showed significant results, so the improvement in symptoms cannot be attributed strictly to those. Our results suggest that intervention with B vitamins and/or vitamin D may be an effective and well-tolerated adjuvant strategy for improving the symptoms of depression and anxiety, according to the patient's clinical status and nutritional biomarkers.

Effect of Vitamin D Supplementation on Depression in Adults: A Systematic Review of Randomized Controlled Trials (RCTs)

Vitamin D is a nutrient potentially beneficial in the treatment of depression. The study aimed to carry out a systematic review of the studies assessing the influence of vitamin D supplementation on depression within Randomized Controlled Trials (RCTs). The systematic review was prepared on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020155779). The peer-reviewed studies available within PubMed or Web of Science databases until September 2021 were taken into account. The number of screened records was 8514, and 8 records were included. Two independent researchers conducted screening, including, reporting, and risk of bias assessment using the revised Cochrane risk-of-bias tool for randomized trials. The included studies presented a population of patients with major depressive disorders or general depression, as well as bipolar depression or postpartum depression. The majority of included studies were conducted for 8 weeks or 12 weeks, while one study was conducted for 6 months. Within the large number of included studies, a daily dose of 1500 IU, 1600 IU, or 2800 IU was applied, while within some studies, a vitamin D dose of 50,000 IU was applied weekly or biweekly. Among applied psychological measures of depression, there were various tools. In spite of the fact that the majority of included studies (five studies) supported the positive effect of vitamin D supplementation for the psychological measure of depression, for three studies the positive influence was not supported. A medium risk of bias was indicated for six studies, while a high risk of bias was defined for only two studies, due to deviations from the intended interventions and in measurement of the outcome, as well as for one study, also arising from the randomization process and due to missing outcome data. Based on conducted assessment, it should be emphasized that there are only four studies supporting the positive influence of vitamin D supplementation for the psychological measure of depression of the medium risk of bias, while two studies of a medium risk of bias did not support it. Taking this into account, the conducted systematic review is not a strong confirmation of the effectiveness of vitamin D supplementation in the treatment of depression.

Association of a low vitamin D status with risk of post-stroke depression: A meta-analysis and systematic review

Background

Although post-stroke depression (PSD) affects one-third of patients following an acute stroke, pooled evidence addressing the correlation between a low vitamin D status and the risk of PSD remains inconclusive.

Methods

Comprehensive database search of Medline, EMBASE, Cochrane library, and Google Scholar was performed from inception to December 2022. The primary outcome was the association of PSD risk with a low vitamin D status, while the secondary outcomes included the relationship between PSD and other risk factors.

Results

Analysis of seven observational studies published between 2014 and 2022 with 1,580 patients showed pooled incidences of vitamin D deficiency (defined as 25[OH] D levels < 50 nmol/L) and PSD of 60.1 and 26.1%, respectively. Patients with PSD had a lower circulating vitamin D concentration compared to those without [mean difference (MD) =-13.94 nmol/L, 95% CI: -21.83 to -6.05, p = 0.0005, I ² = 91%, six studies, 1,414 patients]. Meta-analysis also demonstrated a correlation between a low vitamin D level and an increased PSD risk [odd ratio (OR) = 3.25, 95% CI: 1.57-6.69, p = 0.001, I ² = 78.7%, 1,108 patients], the heterogeneity of which was found to be associated with the incidence of vitamin D deficiency but not female proportion on meta-regression. Besides, female gender (OR = 1.78, 95% CI: 1.3-2.44, p = 0.003, I ² = 31%, five studies, 1,220 patients), hyperlipidemia (OR = 1.55, 95% CI: 1.01-2.36, p = 0.04, I ² = 0%, four studies, 976 patients), and high National Institutes of Health Stroke Scale (NIHSS) scores (MD = 1.45, 95% CI: 0.58-2.32, p = 0.001, I ² = 82%, five studies, 1,220 patients) were potential risk factors for PSD. For the primary outcome, the certainty of evidence was very low. Regarding secondary outcomes, the certainty of evidence was low for BMI, female gender, hypertension, diabetes, and stroke history, and very low for age, level of education, hyperlipidemia, cardiovascular disease, and NIHSS scores.

Conclusion

The results suggested an association of a low circulating vitamin D level with an increased risk of PSD. Besides, female gender, hyperlipidemia, high NIHSS score were related to an increased risk or occurrence of PSD. The current study may imply the necessity of routine circulating vitamin D screening in this population.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42022381580.

Dietary intervention in depression - a review

Depression is a mental illness that affects the normal lives of over 300 million people. Unfortunately, about 30% to 40% of patients do not adequately respond to pharmacotherapy and other therapies. This review focuses on exploring the relationship between dietary nutrition and depression, aiming to find safer and efficient ingredients to alleviate depression. Diet can affect depression in numerous ways. These pathways include the regulation of tryptophan metabolism, inflammation, hypothalamic-pituitary-adrenal (HPA) axis, microbe-gut-brain axis, brain-derived neurotrophic factor (BDNF) and epigenetics. Furthermore, probiotics, micronutrients, and other active substances exhibit significant antidepressant effects by regulating the above pathways. These provide insights for developing antidepressant foods.

Effects of vitamin D supplementation on depression and some selected pro-inflammatory biomarkers: a double-blind randomized clinical trial

BACKGROUND

Both augmented inflammatory reaction and low vitamin D status are associated with depression but the magnitude of their relationships is unclear. This study was, therefore, conducted to evaluate the effects of vitamin D supplementation on serum 25(OH)D concentration, depression severity and some pro-inflammatory biomarkers in patients with mild to moderate depression.

METHODS

An 8-week double-blind randomized clinical trial (RCT) was performed on 56 (18-60 yrs) patients with mild to moderate depression, randomly assigned to intervention (50,000 IU cholecalciferol 2wks^-1) and control (placebo) groups. Serum 25(OH)D, intact parathyroid hormone (iPTH), interlukin (IL)-1β, IL-6, high-sensitivity C-reactive protein (hs-CRP) and depression severity (Beck Depression Inventory-II) (BDI-II)) were initially and finally assessed.

RESULTS

At the end point, statistically significant changes were observed only in intervention group as compared with controls including increased 25(OH)D concentration (+ 40.83 ± 28.57 vs. + 5.14 ± 23.44 nmol L^-1, P < 0.001) and decreased depression severity (-11.75 ± 6.40 vs. -3.61 ± 10.40, P = 0.003). No significant within- or between group differences were observed in serum IL-1β, IL-6 and hs-CRP concentrations.

CONCLUSION

Increased circulating 25(OH)D concentrations following 8-week vitamin D supplementation (50,000 IU 2wks^-1) resulted in a significant decrease in BDI-II scores in patients with mild to moderate depression. However, this effect was independent of the serum concentrations of the studied inflammatory biomarkers.

TRIAL REGISTRATION

The clinical trial registration code was obtained from the Iranian Registry of Clinical Trials (date of registration: 17/09/2018, registration number: IRCT20170926036425N1) and ClinicalTrials.gov (date of registration: 04/12/2018, registration number: NCT03766074).

Peripheral oxytocin concentrations in psychiatric disorders - A systematic review and methanalysis: Further evidence

Increased interest in understanding how changes in the oxytocinergic system are associated with the etiology and progression of psychiatric disorders has currently boosted the publication of studies. We present a systematic literature review followed by meta-analyses assessing whether peripheral oxytocin (OXT) levels among psychiatric patients differ from healthy controls, considering the moderating role of methodological aspects and samples' characteristics. The following electronic databases were searched: PubMed, Web of Science, PsycINFO, SciELO, LILACS, and Scopus. Fifty-five papers were included in the analysis, and nine independent meta-analyses were performed according to the different diagnoses. Lower OXT concentrations were found in groups of specific disorders (i.e., schizophrenia, restricting and binge-eating/purging subtypes of anorexia nervosa, and borderline personality disorder) with medium to large effect sizes. Great heterogeneity was found among the studies, so that caution is needed to interpret the results. High OXT levels with an effect size of the same magnitude were found for bipolar disorder - type I and obsessive disorder. In contrast, no differences were found for bulimia, autism spectrum, depression, or social anxiety. No meta-analyses were performed for body dysmorphic disorder, post-traumatic stress disorder, or trichotillomania because only one study was identified for each of these disorders. Altered endogenous OXT concentrations are found in several disorders addressed and must be analyzed according to each disorder's specificities.

Vitamin D: Between the brightness of the sun and the darkness of depression

INTRODUCTION

The scientific literature suggests a relationship between vitamin D (VitD) and the onset, treatment and prognosis of depression. However, this line of research continues to be controversial. The aim of the study was to analyse the relationship between depression and VitD values, controlling for the influence of the season.

MATERIAL AND METHODS

Observational and cross-sectional study. The sample was made up of 150 adult female volunteer participants (aged between 28 and 78 years). The sample was stratified into three groups: a) depression without treatment, b) depression under treatment with antidepressants, and c) without depression (control). VitD values (ng/ml) were compared.

RESULTS

Significant differences were found between the three groups surveyed. The group of participants with depression without treatment obtained the lowest VitD values (mean 18.62ng/ml; SD 8.42), compatible with severe insufficiency. The group of participants with depression in treatment obtained higher values than the previous group, although in an insufficient range (mean 23.80ng/ml; SD 11.30). The third group (control) obtained the highest values and in accordance with the desirable range (mean 30.19ng/ml; SD 10.21). There were no age differences between the groups. When controlling for possible effects of the season, the previous differences in VitD between the three groups were maintained, with an evident decrease of all the mean levels in the winter period.

CONCLUSIONS

Depression is associated with insufficient VitD values. Treatment with antidepressants improves these values, although they continue to be insufficient. The findings of this study reinforce the evidence for an association between depression and VitD.

Molecular Basis Underlying the Therapeutic Potential of Vitamin D for the Treatment of Depression and Anxiety

Major depressive disorder and anxiety disorders are common and disabling conditions that affect millions of people worldwide. Despite being different disorders, symptoms of depression and anxiety frequently overlap in individuals, making them difficult to diagnose and treat adequately. Therefore, compounds capable of exerting beneficial effects against both disorders are of special interest. Noteworthily, vitamin D deficiency has been associated with an increased risk of developing depression and anxiety, and individuals with these psychiatric conditions have low serum levels of this vitamin. Indeed, in the last few years, vitamin D has gained attention for its many functions that go beyond its effects on calcium–phosphorus metabolism. Particularly, antioxidant, anti-inflammatory, pro-neurogenic, and neuromodulatory properties seem to contribute to its antidepressant and anxiolytic effects. Therefore, in this review, we highlight the main mechanisms that may underlie the potential antidepressant and anxiolytic effects of vitamin D. In addition, we discuss preclinical and clinical studies that support the therapeutic potential of this vitamin for the management of these disorders.

Association between Ultraviolet B Exposure Levels and Depression in Taiwanese Adults: A Nested Case-Control Study

Depression is a common mental disorder that affects more than 264 million people worldwide. Anxiety, diabetes, Alzheimer's disease, myocardial infarction, and cancer, among other disorders, are known to increase the risk of depression. Exposure to ultraviolet B (UVB) can cause human serotonin levels to increase. The vitamin D pathway is one mechanism through which ultraviolet light absorbed through the skin can affect mood; however, UVB exposure is known to increase the risk of cancer. In this study, we explored the effects of prolonged exposure to UVB on depression. Data were retrieved from the Taiwan National Health Insurance Research Database for 2008 to 2013. Each patient with depression was matched 1:4 with a comparison patient by sex and age (±5 years); thus, the study included 23,579 patients with depression and 94,316 healthy controls for comparison. The patients had been exposed to UVB for at least 1 year to observe the cumulative effect of UVB exposure. Based on the World Health Organization UV index, we divided the observation period data into five UV levels: low, moderate, high, very high, and extreme. A multivariate Poisson regression model was used to assess the risk of depression according to UVB exposure level, adjusting for sex, age, income, urbanization level, month, and comorbidities. The results revealed that the incidence rate ratio (IRR) for patients with depression was 0.889 for moderate levels (95% CI 0.835-0.947), 1.134 for high levels (95% CI: 1.022-1.260), 1.711 for very high levels (95% CI: 1.505-1.945), and 2.785 for extreme levels (95% CI: 2.439-3.180) when compared to low levels. Moderate levels of UVB lowered the risk of depression, while high levels of UVB gradually increased the risk. We propose that UVB at normal concentrations can effectively improve depression. However, exposure to high concentrations of UVB damage DNA results in physical diseases such as skin cancer, which increase the risk of depression.

Vitamin D supplementation for irritable bowel syndrome: A systematic review and meta-analysis

BACKGROUND AND AIM

Irritable bowel syndrome (IBS) is a prevalent and complex gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits. Observational studies have suggested a relationship between serum vitamin D levels and IBS symptoms. This systematic review and meta-analysis aimed to investigate the clinical effects of vitamin D supplementation on IBS symptom severity and quality of life (QoL) measures.

METHODS

Medline, Embase, Scopus, Web of Science, and The Cochrane Library databases were systematically searched. Data abstraction and quality assessment were conducted by four authors independently, and discrepancies were resolved through consensus from the senior author. Continuous data were pooled with standardized mean difference (SMD) using the DerSimonian and Laird's random-effects model. Sensitivity analysis by risk of bias and potentially "predatory" publication were performed as well.

RESULTS

A total of 685 patients across eight studies were included in the meta-analysis. Vitamin D supplementation significantly improved IBS symptom severity scale scores, with a SMD of -0.77 (95% confidence interval [CI] -1.47 to -0.07, P = 0.04, I²  = 91%). Improvements in IBS-QoL scores were also observed, albeit not statistically significant (SMD 0.54; 95% CI -0.34 to 1.41, P = 0.15, I²  = 87%). However, small sample sizes, a relatively young study population, limited ethnicities, and varied vitamin D dosing strategies across the studies were notable limitations.

CONCLUSIONS

Vitamin D supplementation could be part of our clinical armamentarium when managing IBS patients due to the potential efficacy and good safety profile. Further randomized, controlled trials are required to confirm the therapeutic effects.

Impulsivity and eating disorders: The relationship between serum 25-hydroxyvitamin D and different impulsivity facets in a transdiagnostic sample

OBJECTIVES

Eating disorders (EDs) are severe psychiatric conditions characterised by malnutrition, dysfunctional behaviours, and hypovitaminosis D. In various psychiatric conditions, including EDs, preliminary evidence has correlated impulsivity to a low level of 25-hydroxyvitamin D [25(OH)D]. This study aims to reinforce this evidence by examining different facets, both behavioural and psychological, of the impulsivity construct in patients with ED.

METHODS

A sample of 119 women was evaluated with a validated questionnaire and computerised neuropsychological tasks: the UPPS-P impulsive behaviour scale, a go/no-go task, and the Balloon Analogue Risk Task (BART). A clinical evaluation for EDs and blood sample collection were also performed to assess specific psychopathology and determine the serum level of 25(OH)D.

RESULTS

Significant correlations were found between serum levels of 25(OH)D and BART scores (p = 0.012) and lack of perseverance (p = 0.034). Moreover, regression analyses showed that higher BART scores may be explained by hypovitaminosis D and higher levels of lack of perseverance in patients with EDs.

CONCLUSIONS

The specific aspect of impulsivity linked to goal strategy and behaviours may be explained in patients with EDs by hypovitaminosis D. A possible connection to the brain inflammatory system is also discussed, along with possible directions for future research.

Validation of the five-item version of the Geriatric Depression Scale (GDS-5) in a Turkish elderly population

BACKGROUND

Late-life depression is a geriatric syndrome which should be taken seriously. Many clinical scales have been developed for the screening of geriatric depression. Most of these have been validated at different times and in diverse populations. A five-question version of the Geriatric Depression Scale (GDS-5) was developed in 1997. This test has been validated and used in different populations. In the present study, we plan to validate the GDS-5 for the Turkish elderly population.

METHODS

Patients aged 60 years and older who applied to the Geriatrics Clinic of our hospital between November 2018 and November 2019 were included in the study. We compared the effectiveness of Yesavage Geriatric Depression Scale-30 (YGDS-30) and GDS-5 in screening depression, based on Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) depression criteria.

RESULTS

Four hundred participants were included in the study. A significant positive correlation was found between the DSM-5 scale and the GDS-5 scale (rho = 0.726, P <0.001). According to DSM-5, YGDS-30 and GDS-5, 112 participants (28%), 154 patients (%38.5) and 199 patients (%49.8) were diagnosed with depression respectively. When the cut-off value was taken as ≥2, the sensitivity, specificity, positive predictive and negative predictive values for the GDS-5 scale were determined as 96%, 68%, 54%, and 98%, respectively. We obtained these diagnostic measures with 95% confidence intervals.

CONCLUSION

This study demonstrated the validity and reliability of the GDS-5 for Turkish elderly populations. This five-question scale will be significant in daily use to screen for depression in elderly individuals with multiple problems.

Identification of putative genetic variants in major depressive disorder patients in Pakistan

BACKGROUND

Major depressive disorder (MDD) is a polygenic, and highly prevalent disorder affecting 322 million people globally. It results in several psychological changes which adversely affect different dimensions of life and may lead to suicide.

METHODS

Whole exome sequencing of 15 MDD patients, enrolled at the Dr. A. Q. Khan Institute of Behavioral Sciences, Karachi, was performed using NextSeq500. Different bioinformatics tools and databases like ANNOVAR, ALoFT, and GWAS were used to identify both common and rare variants associated with the pathogenesis of MDD.

RESULTS

A total of 1985 variations were identified in 479 MDD-related genes. Several SNPs including rs1079610, rs11750538, rs1799913, rs1801131, rs2230267, rs2231187, rs3819976, rs4314963, rs56265970, rs587780434, rs6330, rs75111588, rs7596487, and rs9624909 were prioritized due to their deleteriousness and frequency difference between the patients and the South Asian population. A non-synonymous variation rs56265970 (BCR) had 26% frequency in patients and was not found in the South Asian population; a multiallelic UTR-5' insertion rs587780434 (RELN) was present with an allelic frequency of 70% in patients whereas 22% in the SAS population. Genetic alterations in PABPC1 genes, a stress-associated gene also had higher allele frequency in the cases than in the normal population.

CONCLUSION

This present study identifies both common and rare variants in the genes associated with the pathogenesis of MDD in Pakistani patients. Genetic variations in BCR, RELN, and stress-associated PABPC1 suggest potential roles in the pathogenesis of MDD.

Is Vitamin D Important in Anxiety or Depression? What Is the Truth?

PURPOSE OF REVIEW

Depression and anxiety are mood disorders that affect health and therefore quality of life and increase the global burden of disease. One of the possible mechanisms in the pathophysiology of these mood disorders has been reported as oxidative stress and inflammation. In the light of this information, it is important to determine the relationship between antioxidant nutrients (such as vitamin D) and these diseases. There are points where the brain regions involved in the pathophysiology of depression and anxiety and vitamin D metabolism intersect.

RECENT FINDINGS

Low vitamin D levels are associated with increased symptoms of depression and anxiety. For this reason, vitamin D screening should be performed in the prevention and treatment planning of these mood disorders. Vitamin D, which has antioxidant properties and activity in brain tissue, is important for mood disorders preventions or treatments but serum levels must be followed.

The Vitamin D Role in Preventing Primary Headache in Adult and Pediatric Population

Headache is among the main neurological disorders with a great impact on both adults and children. The diagnosis of primary headache and proper management is often delayed with a great impact on work productivity and overall quality of life. Chronic headache often requires prophylactic therapy to reduce the frequency and severity of the attacks and the use of abortive medications. Besides the use of several classes of drugs, another treatment modality is the use of Nutraceuticals. Some studies have suggested a possible role of vitamin D in headache prophylaxis. Indeed, vitamin D is involved in several pathways of brain development, neuroprotection and neurotransmission. Moreover, there is data suggesting a close relationship between primary headache and vitamin D deficiency, both in children and in adults. To date, a few studies have evaluated the effect of vitamin D on headaches. The aim of this review is to summarize the data collected on headache prophylaxis with vitamin D comparing the effects of vitamin D in pediatric and adult populations.

Vitamin D deficiency and depression in obese adults: a comparative observational study

BACKGROUND

Amongst the contributing factors of depression, vitamin D deficiency has increasingly drawn attention in recent years. This paper seeks to examine the association between serum vitamin D level and depression in patients with obesity.

METHODS

In this comparative observational study, serum 25-hydroxyvitamin D [25(OH)D] levels were compared between obese individuals with depression (n = 174) and those without depression considering the effect of potential confounders. Participants were selected from males and females aged 18 to 60 years old visiting the outpatient obesity clinic of Rasoul-e Akram hospital, Tehran, Iran. The diagnosis of depressive disorder was made based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Additional clinical and laboratory data were collected from hospital electronic records. Mann-Whitney U test (nonparametric), Student's t-test (parametric), and Chi-squared test were used to analyze the differences between the two groups. To examine age and gender differences in the relationship between vitamin D deficiency and depression, stratified analyses were conducted by age and gender groups.

RESULTS

The mean 25(OH) D levels were significantly different between depressed and non-depressed groups (20 ± 15 vs. 27 ± 13, P <  0.001). Vitamin D insufficiency/deficiency was detected in 78 and 67% of the depressed and non-depressed groups, respectively, which was significantly different (P = 0.03). The associations between depression and the serum 25(OH) D levels were observed regardless of gender and age. The overall average vitamin D levels were not significantly different between total males and females (22 ± 13 vs. 23 ± 14, P = 0.49). The average level of vitamin D was higher in the older age group (40-60 years) compared to younger participants (18-39 years) (26 ± 15 vs. 21 ± 13, P = 0.004).

CONCLUSION

The present study provides additional evidence for the hypothesis that low vitamin D serum concentration is associated with depression in obese adults, and highlights the need for further research to determine whether this association is causal.

Adverse health outcomes in vitamin D supplementation trials for depression: A systematic review

BACKGROUND

Vitamin D deficiency is a universal risk factor for adverse health outcomes. Since depression is consistently associated with low vitamin D levels as well as several adverse health outcomes, vitamin D supplementation may be especially relevant for depressed persons. This review examines the potential benefits of vitamin D for (somatic) health outcomes in randomised controlled supplementation trials for depression.

METHOD

Systematic literature search to assess whether adverse health outcomes, such as frailty, falls, or cognitive functioning, were included in vitamin D supplementation trials for depression, and whether these outcomes were affected by supplementation. The revised Cochrane tool for assessing risk of bias in randomised trials was used.

RESULTS

Thirty-one trials were included. Adverse health outcomes were considered in five studies. Two studies reported some beneficial effect on an adverse health outcome.

CONCLUSIONS AND IMPLICATIONS

While depressed persons are at increased risk of vitamin D deficiency, supplementation trials hardly addressed the common negative health consequences of low vitamin D levels as secondary outcome measures. Well-designed trials of the effects of vitamin D supplementation in late-life depression should explore whether adverse health outcomes can be prevented or stabilised, and whether depression benefits from this improvement.

Plasma 25-hydroxyvitamin D levels, quality of life, inflammation and depression in older adults: Are they related?

BACKGROUND AND OBJECTIVES

This study aimed to determine whether there is an association between inflammation and depression taking into account the effect of several confounders, but specially plasma 25-hydroxyvitamin D (25[OH]D) levels.

MATERIAL AND METHODS

A cross-sectional study was conducted on adults (n = 346) aged 60 years or older recruited from primary healthcare centres. Depression was assessed by the Geriatric Depression Scale (GDS), while plasma 25(OH)D and inflammatory cytokines were measured following routine biochemical laboratory protocols.

RESULTS

Subjects were divided into two subgroups according to their depression status, and matched in their baseline conditions using random forest-based propensity scores. Both groups were rather similar in regard to most variables, apart from quality of life (p < 0.001) and plasma levels of IL-6 (p = 0.03). The overall prevalence of vitamin D deficiency was 36.3% (95% Confidence Interval [95% CI], 30.2%-42.5%), without a significant difference between depression groups (p = 0.2). A significant association was observed between GDS score and plasma IL-6 levels only among those with SF-6D score between 0.26 and 0.50 (p = 0.001).

CONCLUSIONS

The association between inflammation and depression is more likely to be due to a moderation influence of quality of life rather than plasma 25(OH)D levels. However, further studies are needed to ascertain the effect of a poor quality of life leading to chronic inflammation and poor health upon longer periods of follow-up.

Antenatal Antidepressant Prescription Associated With Reduced Fetal Femur Length but Not Estimated Fetal Weight: A Retrospective Ultrasonographic Study

PURPOSE/BACKGROUND

Antidepressants are among the most frequently prescribed medications during pregnancy and may affect fetal weight. Associations between antenatal antidepressant use and ultrasonographic measures of fetal development have rarely been examined. We hypothesized that the prescription of an antenatal antidepressant would be associated with lower estimated fetal weight (EFW).

METHODS/PROCEDURES

A retrospective analysis of routine ultrasonographic data extracted from electronic medical records was performed on a cohort of pregnant women with psychiatric diagnoses and grouped according to the presence of an antenatal antidepressant prescription (n = 32 antidepressant-prescribed and n = 44 antidepressant prescription-free). After stratifying for gestational age, comparisons included 13 ultrasonographic parameters, frequency of oligohydramnios and polyhydramnios and growth deceleration, and maternal serum protein markers assessed per routine care, including α-fetoprotein, free β-human chorionic gonadotropin, and unconjugated estriol levels, using t tests, nonparametric and Fisher tests, and effect sizes (ESs) were computed.

FINDINGS/RESULTS

No statistically significant EFW differences between groups at any time point were detected (P > 0.05). Antenatal antidepressant prescription was associated with lower femur length at weeks 33 to 40 (P = 0.046, ES = 0.75) and greater left ventricular diameter at weeks 25 to 32 (P = 0.04, ES = 1.18). No differences for frequency of oligohydramnios or polyhydramnios or growth deceleration were observed (P > 0.05). We did not detect group differences for maternal proteins (P > 0.05).

IMPLICATIONS/CONCLUSIONS

Our evidence suggested a lack of association between antenatal antidepressant prescription and lower EFW but indicated an association with lower femur length and greater left ventricular diameter in mid-late gestation. Future research should examine the clinical implications of these findings.

Vitamin D: Between the Brightness of the sun and the Darkness of Depression

INTRODUCTION

The scientific literature suggests a relationship between vitamin D (VitD) and the onset, treatment and prognosis of depression. However, this line of research continues to be controversial. The aim of the study was to analyse the relationship between depression and VitD values, controlling for the influence of the season.

MATERIAL AND METHODS

Observational and cross-sectional study. The sample was made up of 150 adult female volunteer participants (aged between 28 and 78 years). The sample was stratified into three groups: a) depression without treatment, b) depression under treatment with antidepressants, and c) without depression (control). VitD values (ng/ml) were compared.

RESULTS

Significant differences were found between the three groups surveyed. The group of participants with depression without treatment obtained the lowest VitD values (mean 18.62 ng/ml; SD 8.42), compatible with severe insufficiency. The group of participants with depression in treatment obtained higher values than the previous group, although in an insufficient range (mean 23.80 ng/ml; SD 11.30). The third group (control) obtained the highest values and in accordance with the desirable range (mean 30.19 ng/ml; SD 10.21). There were no age differences between the groups. When controlling for possible effects of the season, the previous differences in VitD between the three groups were maintained, with an evident decrease of all the mean levels in the winter period.

CONCLUSIONS

Depression is associated with insufficient VitD values. Treatment with antidepressants improves these values, although they continue to be insufficient. The findings of this study reinforce the evidence for an association between depression and VitD.