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Wu J, Jiang Y, Liang J, Zhou Y, Chai S, Xiong N, Wang Z. Bidirectional causality between micronutrients and mental illness: Mendelian randomization studies. J Affect Disord 2025; 369:718-764. [PMID: 39393463 DOI: 10.1016/j.jad.2024.09.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 09/01/2024] [Accepted: 09/08/2024] [Indexed: 10/13/2024]
Abstract
BACKGROUND Previous observational clinical research has suggested a link between micronutrients and psychiatric conditions. However, the causal relationship between these nutrients and mental health disorders remains uncertain. This study endeavors to fill this knowledge gap by employing a Mendelian randomization (MR) analysis on pooled data from genome-wide association studies (GWAS), aiming to explore the potential causal associations between 20 prevalent micronutrients and 7 common psychiatric disorders. METHODS A collection of single nucleotide polymorphisms (SNPs) associated with 20 micronutrients and seven common psychiatric disorders and extracted from a dataset comprising 7,368,835 individuals. MR analysis, including inverse variance weighting (IVW), Mendelian randomization-egger, weighted median, and sensitivity analysis, was used to evaluate the reliability of the study results. A significance threshold of p < 0.05 was used to identify evidence of potential associations. RESULTS Our forward MR analysis found some commonalities between certain micronutrients and psychiatric disorders. Notably, Vitamin D level is related to the risk of reducing depression and emotional disorders. Carotene levels were associated with an elevated risk of depression, mood disorders, bipolar disorder (BIPO), and post-traumatic stress disorder (PTSD). Additionally, multivitamins ± minerals and retinol were associated with a decreased risk of BIPO, while folate and selenium levels were associated with decreased risks of dementia and schizophrenia, respectively. The study found a significant association between elevated copper levels and an increased likelihood of Bipolar Disorder (BD), while magnesium levels were observed to be positively correlated with a heightened risk of depression. Our sensitivity study confirmed the results of the IVW MR primary analysis. CONCLUSION Our study suggests that carotene, copper, and magnesium are important risk factors for depression, mood disorders, PTSD, phobia, BIPO, and dementia. Elevated levels of these micronutrients are related to an increased likelihood of these disorders.
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Affiliation(s)
- Ji Wu
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, China.
| | - Yongming Jiang
- Department of Neurosurgery, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China; Key Laboratory of Medical Research Basic Guaranteefor Immune-Related Diseases Research of Guangxi (Cultivation), Baise, Guangxi, China
| | - Jing Liang
- Department of pediatric, Xianning Central Hospital, the First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei, China
| | - Yixuan Zhou
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Songshan Chai
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Nanxiang Xiong
- Department of Neurosurgery, Zhongnan Hospital, Wuhan University, Wuhan, China.
| | - Zhihao Wang
- Department of Pathology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Werner E, Le HN, Babineau V, Grubb M. Preventive interventions for perinatal mood and anxiety disorders: A review of selected programs. Semin Perinatol 2024; 48:151944. [PMID: 39048416 DOI: 10.1016/j.semperi.2024.151944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Perinatal mood and anxiety disorders (PMADs) have high prevalence rates and profound deleterious effects on birthing people, families, and society. Counseling interventions have been shown to be effective and carry minimal risk. We review here the protocols and clinical trial data of four preventive counseling interventions that are effective at preventing PMADs. We present the Mothers and Babies (MB) program, a cognitive-behavioral preventive intervention, and Reach Out, Stay Strong, Essentials for mothers of newborns (ROSE), an interpersonal psychotherapy preventive intervention. We also present Mindfulness-Based Cognitive Therapy for Perinatal Depression (MBCT- PD), a preventive intervention that combines a cognitive-behavioral and mindfulness-based approach, and Practical Resources for Effective Postpartum Parenting (PREPP), a parent-infant dyadic intervention with psychodynamic, cognitive-behavioral, mindfulness-based, and psychoeducational elements. We recommend that screening for risk of PMADs (not just current mood symptoms) and providing preventive interventions to those at risk should be included as part of standard obstetrics care.
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Affiliation(s)
- Elizabeth Werner
- Department of Psychiatry, Columbia University Irving Medical Center, USA; Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, USA.
| | - Huynh-Nhu Le
- Department of Psychological and Brain Sciences, George Washington University, USA
| | - Vanessa Babineau
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, USA
| | - Myrriam Grubb
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, USA
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Wang Y, Zhong W, Zhao A, Szeto IMY, Lan H, Zhang J, Li P, Ren Z, Mao S, Jiang H, Wang P, Zhang Y. Perinatal depression and serum vitamin D status: A cross-sectional study in urban China. J Affect Disord 2023; 322:214-220. [PMID: 36395990 DOI: 10.1016/j.jad.2022.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although vitamin D has been found to be associated with perinatal depression, the results are inconsistent. The aim of this cross-sectional study was to examine the association between vitamin D and PND in Chinese pregnant women and lactating women. METHODS A total of 1773 participants were included, including 907 lactating women and 866 pregnant women. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PND, and those with scores ≥13 were considered to have PND. Serum 25-hydroxyvitamin D concentrations were assessed with high-performance liquid chromatography. RESULTS The prevalence of postpartum depression (PPD) and antenatal depression (AD) were 15.9 % and 9.8 %, respectively. Compared with individuals with sufficient vitamin D, those with vitamin D deficiency were associated with a higher prevalence of PPD in lactating women (OR = 1.71, 95%CI: 1.01-2.88, p = 0.044). The serum 25(OH)D of lactating women was inversely associated with the scores of the factor "depressive mood" of the EPDS (ORper 5 ng/mL = -0.10, 95%CI: -0.19 to -0.01, p = 0.032). No significant association between serum 25-hydroxyvitamin D and AD was observed. LIMITATIONS First, this study is a cross-sectional design, which can only determine associations but not causality. Secondly, this study only included participants from urban areas. Thirdly, there are still some possible confounding factors that have not been considered. CONCLUSION In conclusion, this study suggested a significant association between vitamin D status and PPD; however, the association between vitamin D status and AD was not significant.
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Affiliation(s)
- Yanpin Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Wuxian Zhong
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing 100091, China
| | - Ignatius Man-Yau Szeto
- Yili Maternal and Infant Nutrition Institute, Beijing 100071, China; Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010110, China
| | - Hanglian Lan
- Yili Maternal and Infant Nutrition Institute, Beijing 100071, China; Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010110, China.
| | - Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Pin Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Zhongxia Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Shuai Mao
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China
| | - Hua Jiang
- School of Nursing, Peking University, Beijing 100191, China
| | - Peiyu Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing 100191, China.
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4
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Nomura K, Kitagawa K, Tsuji M, Iida M, Aoki M, Miyauchi K, Hirayama J, Nagashima K, Takebayashi T, Tsutsumi A. The quantity and quality of scientific evidence about the health of working women in occupational health of Japan: A scoping review. J Occup Health 2023; 65:e12427. [PMID: 37845837 PMCID: PMC10579630 DOI: 10.1002/1348-9585.12427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE We aim to investigate the quantity and quality of scientific evidence dealing with comprehensive health issues of working women in occupational health. METHODS This scoping review of original articles that investigated comprehensive health issues of working women aged 19-64 years in Japan was published in PubMed (1967-2022) and Igaku Chuo Zasshi (or Ichu-shi, 1982-2022). Using identical broad search terms, we first identified 17 122 English and 6154 Japanese articles. We excluded those with clinically relevant topics, or ethnicity other than Japanese and included 853 English and 855 Japanese articles for review and classified them into nine research areas considered to be critical factors for women in the workforce and five study design groups to investigate the quality of the evidence accumulated. RESULTS Among 853 English-language articles in PubMed, "Mental health" was the most frequent area studied, followed by "Work-related disease" and "Lifestyle-related disease." Among 855 Japanese-language articles from Ichu-shi, "Mental health" was the most frequently studied area followed by "Work and balance," and "Work-related disease." "Infertility, pregnancy, and childbirth" and "Menstruation, menopause, and genital disease" were well studied in Ichu-shi but scarcely published in PubMed. "Harassment and discrimination" were sparsely reported in both databases. As for research designs, many articles in both PubMed and Ichu-shi employed descriptive or cross-sectional study designs. However, a few studies employed cohort/longitudinal or interventional studies. CONCLUSION The results underscored the need for higher-quality study designs with more scientific evidence on working women's health in the field of occupational health.
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Affiliation(s)
- Kyoko Nomura
- Department of Environmental Health Science and Public HealthAkita University Graduate School of MedicineAkitaJapan
| | - Kyoko Kitagawa
- Department of Environmental HealthUniversity of Occupational and Environmental HealthKitakyushuJapan
- Division of Ultrastructural Cell Biology, Department of AnatomyUniversity of MiyazakiMiyazakiJapan
| | - Mayumi Tsuji
- Department of Environmental HealthUniversity of Occupational and Environmental HealthKitakyushuJapan
| | - Miho Iida
- Department of Preventive Medicine and Public HealthKeio University School of MedicineTokyoJapan
| | - Mizuki Aoki
- Department of Environmental Health Science and Public HealthAkita University Graduate School of MedicineAkitaJapan
| | - Kasane Miyauchi
- Department of Environmental Health Science and Public HealthAkita University Graduate School of MedicineAkitaJapan
| | - Junko Hirayama
- Department of Environmental Health Science and Public HealthAkita University Graduate School of MedicineAkitaJapan
| | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research CenterKeio University HospitalTokyoJapan
| | - Toru Takebayashi
- Department of Preventive Medicine and Public HealthKeio University School of MedicineTokyoJapan
| | - Akizumi Tsutsumi
- Department of Public HealthKitasato University School of MedicineSagamiharaJapan
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5
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Miyake Y, Tanaka K, Okubo H, Sasaki S, Arakawa M. Tryptophan intake is related to a lower prevalence of depressive symptoms during pregnancy in Japan: baseline data from the Kyushu Okinawa Maternal and Child Health Study. Eur J Nutr 2022; 61:4215-4222. [PMID: 35895138 DOI: 10.1007/s00394-022-02969-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 07/18/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Tryptophan is an essential amino acid wholly derived from diet. While the majority of tryptophan is degraded through the kynurenine pathway into neuroactive metabolites like quinolinic acid and kynurenic acid, a small proportion of ingested tryptophan is metabolized into the neurotransmitter serotonin. The current cross-sectional study in Japan examined the association between tryptophan intake and depressive symptoms during pregnancy. METHODS Study subjects were 1744 pregnant women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Depressive symptoms were defined as a score ≥ 16 on the Center for Epidemiologic Studies Depression Scale. Adjustment was made for age, gestation, region of residence, number of children, family structure, history of depression, family history of depression, smoking, secondhand smoke exposure at home and at work, employment, household income, education, body mass index, and intake of saturated fatty acids, eicosapentaenoic acid plus docosahexaenoic acid, calcium, vitamin D, and isoflavones. RESULTS The prevalence of depressive symptoms during pregnancy was 19.2%. After adjustment for confounding factors, higher tryptophan intake was independently inversely associated with the prevalence of depressive symptoms during pregnancy: the adjusted prevalence ratios (95% confidence intervals) for depressive symptoms during pregnancy in the first, second, third, and fourth quartiles of tryptophan intake were 1 (reference), 0.99 (0.76-1.28), 0.94 (0.71-1.25), and 0.64 (0.44-0.93), respectively (p for trend = 0.04). CONCLUSIONS Higher estimated tryptophan intake was cross-sectionally independently associated with a lower prevalence of depressive symptoms during pregnancy in Japanese women.
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Affiliation(s)
- Yoshihiro Miyake
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan.
- Integrated Medical and Agricultural School of Public Health, Ehime University, Matsuyama, Ehime, Japan.
- Research Promotion Unit, Translation Research Center, Ehime University Hospital, Toon, Ehime, Japan.
- Center for Data Science, Ehime University, Matsuyama, Ehime, Japan.
| | - Keiko Tanaka
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan
- Integrated Medical and Agricultural School of Public Health, Ehime University, Matsuyama, Ehime, Japan
- Research Promotion Unit, Translation Research Center, Ehime University Hospital, Toon, Ehime, Japan
- Center for Data Science, Ehime University, Matsuyama, Ehime, Japan
| | - Hitomi Okubo
- Department of Epidemiology and Public Health, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan
- Integrated Medical and Agricultural School of Public Health, Ehime University, Matsuyama, Ehime, Japan
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Ibaragi, Japan
- Research Fellow of the Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Bunkyo, Tokyo, Japan
| | - Masashi Arakawa
- Wellness Research Fields, Faculty of Global and Regional Studies, University of the Ryukyus, Nishihara, Okinawa, Japan
- The Department of Cross Cultural Studies, Osaka University of Tourism, Nago, Okinawa, Japan
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6
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A Systematic Review of Vitamin D during Pregnancy and Postnatally and Symptoms of Depression in the Antenatal and Postpartum Period from Randomized Controlled Trials and Observational Studies. Nutrients 2022; 14:nu14112300. [PMID: 35684101 PMCID: PMC9183028 DOI: 10.3390/nu14112300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/18/2022] [Accepted: 05/26/2022] [Indexed: 01/27/2023] Open
Abstract
Depression is a common mood disorder associated with childbirth and is hypothesized to be affected by low vitamin D. This systematic review identified two randomized controlled trials (RCT) of vitamin D supplementation for the treatment or prevention of depressive symptoms in the perinatal period, as well as 18 observational studies of vitamin D exposure and depression in the antenatal and postnatal periods. Both RCTs claimed an improvement in depressive symptoms in the vitamin D group, although the sample sizes were too small to draw firm conclusions. The case-control and cohort studies had mixed findings and were limited by study quality. There were inconsistent results within the few studies with a more robust methodology or within samples restricted to women likely to have depression. The current evidence is inconclusive due to the poor quality and heterogeneity of studies, likely contributing to the contradictory findings. Given there are already numerous RCTs of prenatal vitamin D supplementation, we recommend adding an appropriate measure of depression in the perinatal period to assist in resolving the uncertainty.
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7
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Yu Y, Liang HF, Chen J, Li ZB, Han YS, Chen JX, Li JC. Postpartum Depression: Current Status and Possible Identification Using Biomarkers. Front Psychiatry 2021; 12:620371. [PMID: 34211407 PMCID: PMC8240635 DOI: 10.3389/fpsyt.2021.620371] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 05/19/2021] [Indexed: 12/25/2022] Open
Abstract
Postpartum depression (PPD) is a serious health issue that can affect about 15% of the female population within after giving birth. It often conveys significant negative consequences to the offsprings. The symptoms and risk factors are somewhat similar to those found in non-postpartum depression. The main difference resides in the fact that PPD is triggered by postpartum specific factors, including especially biological changes in the hormone levels. Patients are usually diagnosed using a questionnaire onsite or in a clinic. Treatment of PPD often involves psychotherapy and antidepressant medications. In recent years, there have been more researches on the identification of biological markers for PPD. In this review, we will focus on the current research status of PPD, with an emphasis on the recent progress made on the identification of PPD biomarkers.
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Affiliation(s)
- Yi Yu
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Center for Analyses and Measurements, College of Chemical Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Hong-Feng Liang
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China
| | - Jing Chen
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Zhi-Bin Li
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Yu-Shuai Han
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Jia-Xi Chen
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
| | - Ji-Cheng Li
- Central Laboratory, Yangjiang People's Hospital, Yangjiang, China.,Institute of Cell Biology, Zhejiang University, Hangzhou, China
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8
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Relationship between vitamin D deficiency and both gestational and postpartum depression. NUTR HOSP 2020; 37:1238-1245. [PMID: 33155475 DOI: 10.20960/nh.02953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: vitamin D deficiency (VDD) has been associated with depressive symptoms in pregnancy and postpartum, which can result in increased adverse outcomes in the maternal-infant segment. A possible explanation in the literature is VDD relationship with genetic and neurological mechanisms. Objective: to evaluate VDD relationship with gestational and postpartum depression. Methods: this review followed the recommendations proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Research was conducted in electronic databases, PubMed and LILACS, including studies of the analytical type (cross-sectional and longitudinal), systematic reviews, meta-analyses, and controlled clinical trials carried out in humans; inclusion and exclusion criteria were applied. Results and conclusions: in this systematic review, eight articles were analyzed comprising 8,583 women from seven different countries. Among the selected articles, six found an association between VDD and gestational and postpartum depression. Considering the data collection, it was possible to conclude that there is a probable relationship between VDD and a higher predisposition to gestational and postpartum depression. Also, we concluded that vitamin D supplementation has proven to be a promising strategy for reducing the risk of depressive symptoms.
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Sahasrabudhe N, Lee JS, Scott TM, Punnett L, Tucker KL, Palacios N. Serum Vitamin D and Depressive Symptomatology among Boston-Area Puerto Ricans. J Nutr 2020; 150:3231-3240. [PMID: 33025014 PMCID: PMC7726122 DOI: 10.1093/jn/nxaa253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/08/2020] [Accepted: 07/30/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Low vitamin D status, assessed using serum 25-hydroxyvitamin D [25(OH)D] concentration, has been associated with depression, but research among minority populations, such as Puerto Ricans is limited. We examined the association between serum 25(OH)D and self-reported depressive symptomatology across 3 waves of follow-up in a cohort of Puerto Rican adults residing in Massachusetts. OBJECTIVES We evaluated the cross-sectional and longitudinal associations between serum 25(OH)D and self-reported depressive symptoms in the Boston Puerto Rican Health Study (BPRHS) cohort. METHODS Participants of the BPRHS were evaluated for depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D). Serum 25(OH)D was measured at baseline (n = 1434), year 2 (n = 1218), and year 5 (n = 914). We categorized serum 25(OH)D concentration as sufficient (≥20 ng/mL), insufficient (12 to <20 ng/mL), and deficient (<12 ng/mL). Multivariable linear regression was used for cross-sectional analyses at baseline, and repeated measures mixed effects modeling was used over 3 waves of follow-up for longitudinal analyses. We conducted sensitivity analyses in vitamin D supplement nonusers and participants with complete data on baseline serum 25(OH)D and CES-D at all 3 visits. RESULTS Serum 25(OH)D concentration was not associated with CES-D score in cross-sectional analysis [β = -0.85; 95% CI: -2.80, 1.10 for deficient compared with sufficient 25(OH)D; P-trend = 0.59] or in longitudinal analyses over 5 y [β = -0.41; 95% CI: -1.95, 1.13 for deficient compared with sufficient 25(OH)D; P-trend = 0.93]. Results were similar in sensitivity analyses restricted to vitamin D supplement nonusers (n = 1371) and in analyses conducted in participants with complete measures of baseline serum 25(OH)D and CES-D score at all 3 visits (n = 887) [β = -0.12; 95% CI: -1.98, 1.74 for deficient compared with sufficient 25(OH)D; P-trend = 0.93]. CONCLUSIONS We did not observe a significant association between serum 25(OH)D and depressive symptomatology in the BPRHS cohort.
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Affiliation(s)
- Neha Sahasrabudhe
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Jong Soo Lee
- Department of Mathematical Sciences, University of Massachusetts Lowell, Lowell, MA, USA
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
| | - Tammy M Scott
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Laura Punnett
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Natalia Palacios
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
- Department of Nutrition, Harvard University School of Public Health, Boston, MA, USA
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Hamazaki K, Matsumura K, Tsuchida A, Kasamatsu H, Tanaka T, Ito M, Inadera H, the Japan Environment and Children's Study Group. Dietary intake of fish and n-3 polyunsaturated fatty acids and risk of postpartum depression: a nationwide longitudinal study - the Japan Environment and Children's Study (JECS). Psychol Med 2020; 50:2416-2424. [PMID: 31535610 PMCID: PMC7610183 DOI: 10.1017/s0033291719002587] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/16/2019] [Accepted: 08/30/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pregnant women require increased levels of n-3 polyunsaturated fatty acids (PUFAs) due to the demands of the growing fetus. Although some evidence indicates that maternal intake of fish and n-3 PUFAs is associated with reduced risk of postpartum depression, the results are inconsistent. METHODS We investigated whether dietary consumption of fish and/or n-3 PUFAs during pregnancy is associated with a reduced risk of maternal postpartum depression at 6 months after delivery and of serious mental illness at 1 year in a Japanese population. After exclusion and multiple imputation from a dataset comprising 103 062 pregnancies obtained in the Japan Environment and Children's Study, we evaluated 84 181 and 81 924 women at 6 months and 1 year after delivery, respectively. RESULTS Multivariable logistic regression showed a reduced risk of postpartum depression at 6 months in the second to fifth quintiles v. the lowest quintile for fish and n-3 PUFA intake, with trend tests also revealing a significant linear association. At 1 year after delivery, fish intake was associated with a reduced risk of serious mental illness in the second to fifth quintiles v. the lowest quintile for fish and in the third to fifth quintiles v. the lowest quintile for n-3 PUFA intake, with trend tests also revealing a significant linear association. CONCLUSIONS Women with higher fish and/or n-3 PUFA intake showed reduced risk of postpartum depression at 6 months after delivery and of serious mental illness at 1 year after delivery.
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Affiliation(s)
- Kei Hamazaki
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Kenta Matsumura
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Akiko Tsuchida
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Haruka Kasamatsu
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
| | - Tomomi Tanaka
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Mika Ito
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hidekuni Inadera
- Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan
- Toyama Regional Center for JECS, University of Toyama, Toyama, Japan
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11
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Neshatbini Tehrani A, Farhadnejad H, Salehpour A, Hekmatdoost A. Vitamin D intake and risk of psychological disorders among female adolescents. ACTA ACUST UNITED AC 2020. [DOI: 10.1108/nfs-03-2020-0070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to investigate the association of vitamin D intake and the risk of depression, anxiety and stress among Tehranian female adolescents.
Design/methodology/approach
This cross-sectional analysis included 263 participants. A valid and reliable food frequency questionnaire was used to determine dietary intake of vitamin D. Depression, anxiety and stress scores were characterized by Depression Anxiety Stress Score-21 questionnaire. Multivariable logistic regression was used to estimate the odds ratio (OR) for the occurrence of depression, anxiety and stress according to the tertiles of vitamin D intake.
Findings
The mean ± standard deviation age and body mass index (BMI) of participants were 16.2 ± 1.0 years and 22.2 ± 4.1 kg/m2, respectively. Mean score of depression, anxiety and stress of participants were 9.8 (low-grade depression), 8.4 (low-grade anxiety) and 14.0 (borderline for stress), respectively. In the final model, after adjustment for age, BMI, physical activity, mother/father’s education level, dietary fiber and total energy intake, the OR for depression in the highest compared to the lowest tertile of vitamin D intake was 0.53 (95% confidence interval [CI], 0.24–0.98) (p for trend: 0.040). Moreover, based on the fully adjusted model, participants in the highest tertile of vitamin D intake had lower odds of stress (OR: 0.49; 95% CI: 0.23–0.93), in comparison to those in the lowest one (p for trend: 0.021).
Originality/value
To the best of the authors’ knowledge, this is the first study to assess the association of vitamin D intake and risk of psychological disorders, including depression, stress and anxiety in Middle East and North Africa region’s female adolescents.
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Menon V, Kar SK, Suthar N, Nebhinani N. Vitamin D and Depression: A Critical Appraisal of the Evidence and Future Directions. Indian J Psychol Med 2020; 42:11-21. [PMID: 31997861 PMCID: PMC6970300 DOI: 10.4103/ijpsym.ijpsym_160_19] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Growing evidence points to the role of vitamin D in the pathobiology and treatment of depression. However, the evidence is inconsistent in many aspects. The objectives of this narrative review were to evaluate the state of the evidence, synthesize the knowledge gaps, and formulate recommendations for more enhanced research in this growing area. METHODS Electronic searches of MEDLINE via PubMed, Cochrane Library, and Google Scholar databases were carried out from inception till February 2019 to identify relevant English language peer-reviewed articles. Abstracts generated were systematically screened for eligibility. Included articles were grouped under three broad themes: The association between vitamin D and depression, its biological underpinnings, and trials evaluating the efficacy of vitamin D supplementation in depression. Relevant data were extracted as per a structured proforma. RESULTS A total of 61 articles were included in the present review. Overall findings were that there is a relationship between vitamin D and depression, though the directionality of this association remains unclear. The association appears to be driven by the homeostatic, trophic, and immunomodulatory effects of vitamin D. Evidence from supplementation trials suggest a more robust therapeutic effect on subjects with major depression and concurrent vitamin D deficiency. CONCLUSION Serum vitamin D levels inversely correlate with clinical depression, but the evidence is not strong enough to recommend universal supplementation in depression. Enriching depression treatment trials with subjects having concurrent vitamin D deficiency appears to be a potential step forward in identifying subgroups who may maximally benefit from this approach.
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Affiliation(s)
- Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Dhanvantri Nagar, Puducherry, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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Boulkrane MS, Fedotova J, Kolodyaznaya V, Micale V, Drago F, van den Tol AJM, Baranenko D. Vitamin D and Depression in Women: A Mini-review. Curr Neuropharmacol 2020; 18:288-300. [PMID: 31701847 PMCID: PMC7327938 DOI: 10.2174/1570159x17666191108111120] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/01/2019] [Accepted: 10/31/2019] [Indexed: 12/16/2022] Open
Abstract
Affective-related disorders, including depression, are constantly rising, complicating people's personal lifestyle increasing disqualification and hospital care. Because of the high intensity of urbanization, our lifestyle and food have altered dramatically in the last twenty years. These food modifications have been associated with scores of depression and other affective-related disorders in urbanized countries with high economic levels. Nutrients imbalance is considered as one of the critical causes enabling the pathophysiological mechanisms for the development of psychiatric disorders. The application of additional nutritional interventions for treatment of mood deteriorations can be beneficial for both the prophylaxis and therapy of affective-related disorders. This paper will review recent research on the relation of Vitamin D levels and the epidemiology of depression in women. In this paper, we will provide an overview of the results of a variety of different studies taking into account research which both suggests and refutes an association. Based on these findings we will propose important directions for future research in relation to this topic.
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Affiliation(s)
| | - Julia Fedotova
- Address correspondence to this author at the International Research Centre “Biotechnologies of the Third Millennium”, ITMO University, 9 Lomonosova Str. St. Petersburg 191002, Russia; Laboratory of Neuroendocrinology, I.P. Pavlov Institute of Physiology, Russian Academy of Sciences, 6 Emb. Makarova, St. Petersburg 199034, Russia; Tel: +7 911 287 92 73; Fax: +7 812 328 05 01; E-mail:
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Reza N, Deligiannidis KM, Eustis EH, Battle CL. Complementary Health Practices for Treating Perinatal Depression. Obstet Gynecol Clin North Am 2019; 45:441-454. [PMID: 30092920 DOI: 10.1016/j.ogc.2018.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This article provides a focused review of the evidence for several complementary health approaches (ie, omega-3 fatty acids, folate, vitamin D, selenium, zinc, magnesium, B vitamins, physical activity, yoga) in the treatment of perinatal depression. There is evidence that some of these treatments may be reasonable to consider in women during pregnancy or the postpartum period. However, there are little data on the comparative safety and efficacy of these relative to traditional treatments (eg, psychotherapy, pharmacotherapy). Adequately powered high-quality studies are necessary to determine the role of complementary health practices for treating perinatal depression.
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Affiliation(s)
- Nafisa Reza
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, 75-59 263rd Street, Glen Oaks, NY 11004, USA
| | - Kristina M Deligiannidis
- Department of Psychiatry, Zucker Hillside Hospital, Northwell Health, 75-59 263rd Street, Glen Oaks, NY 11004, USA; Departments of Psychiatry and Obstetrics & Gynecology, Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Boulevard, Hempstead, NY 11549, USA; Feinstein Institute for Medical Research, 300 Community Drive, Manhasset, NY 11030, USA
| | - Elizabeth H Eustis
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Drive, Providence, RI 02903, USA
| | - Cynthia L Battle
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 700 Butler Drive, Providence, RI 02903, USA; Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, USA; Center for Women's Behavioral Health, Women & Infants Hospital of Rhode Island, 2 Dudley Street, Providence, RI 02905, USA.
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15
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Vitamin D deficiency and depressive symptoms in the perinatal period. Arch Womens Ment Health 2018; 21:745-755. [PMID: 29845325 DOI: 10.1007/s00737-018-0852-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 05/09/2018] [Indexed: 01/13/2023]
Abstract
Depression affects 1 in 7 women during the perinatal period. Women with vitamin D deficiency may be at an increased risk for depression. This study investigated the relationship between maternal and cord blood 25-hydroxyvitamin D (25OHD) and maternal depressive symptoms over the perinatal period. Study objectives were to examine variations and relationships between maternal and cord blood vitamin D levels and maternal depressive symptoms over the perinatal period. At a large medical center in southern California, pregnant women (N = 126) were recruited for this longitudinal cohort study. Depressive symptoms (Edinburgh Postnatal Depression Screen, EPDS) and vitamin D status (25OHD) were measured at three time points in the perinatal period: time 1 (T1; N = 125) EPDS and 25OHD were collected in early pregnancy; time 2 (T2; N = 96) EPDS was conducted in the third trimester with blood collected at time of delivery; and time 3 (T3; N = 88) was collected postpartum. A significant inverse relationship between vitamin D status and depressive symptoms was observed between 25OHD and EPDS scores at all time points in this sample (T1 = - 0.18, P = 0.024; T2 = - 0.27, P = 0.009; T3 = - 0.22, P = 0.019). This association remained after controlling for confounders. Low cord blood 25OHD levels were inversely associated with higher EPDS scores in the third trimester (r = - 0.22, P = 0.02). Clinicians may want to consider screening women diagnosed with vitamin D deficiency for depression and vice versa. Vitamin D may represent an important biomarker for pregnant and postpartum women diagnosed with depression. Further studies examining underlying mechanisms and supplementation are needed.
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Aghajafari F, Letourneau N, Mahinpey N, Cosic N, Giesbrecht G. Vitamin D Deficiency and Antenatal and Postpartum Depression: A Systematic Review. Nutrients 2018; 10:E478. [PMID: 29649128 PMCID: PMC5946263 DOI: 10.3390/nu10040478] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/04/2018] [Accepted: 04/10/2018] [Indexed: 01/10/2023] Open
Abstract
Vitamin D has been implicated in antenatal depression (AD) and postpartum depression (PPD) in many studies; however, results have been inconsistent due to the complexity of this association. We searched the MEDLINE, Embase, PsycINFO, and Maternity and Infant Care databases for literature addressing associations between vitamin D and AD and PPD. Two independent authors reviewed titles and abstracts of the search results and selected studies for full review. Data were extracted, and a quality rating was done using the Newcastle-Ottawa Scale (NOS) on the selected studies. A total of 239 studies were identified; 14 were included in the review. The quality assessment of the included studies ranged from moderate to high. Of the studies on PPD, five of nine (55%) showed a significant association between vitamin D and PPD. Five of seven (71%) studies on AD showed a significant association with vitamin D status. As the included studies used different effect estimates and statistical analyses to report the association, it was not possible to transform the existing data into one single effect measure to employ meta-analytic techniques. While results of this systematic review vary, they indicate a significant association between vitamin D status and AD and PD.
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Affiliation(s)
- Fariba Aghajafari
- Department of Family Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Sunridge Family Medicine Teaching Centre, Calgary, AB T2N 1N4, Canada.
| | - Nicole Letourneau
- Faculty of Nursing and Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
| | - Newsha Mahinpey
- Life Science Program, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Nela Cosic
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
| | - Gerald Giesbrecht
- Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
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Dietary intake of fish and n-3 polyunsaturated fatty acids and risks of perinatal depression: The Japan Environment and Children's Study (JECS). J Psychiatr Res 2018; 98:9-16. [PMID: 29253720 DOI: 10.1016/j.jpsychires.2017.11.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/14/2017] [Accepted: 11/27/2017] [Indexed: 11/23/2022]
Abstract
The results of several epidemiological studies and clinical trials investigating the effects of n-3 polyunsaturated fatty acids (PUFAs) on antenatal and postnatal depression remain controversial. We investigated the possible association of dietary intake of fish and n-3 PUFAs with the risks of maternal and paternal psychological distress during pregnancy and of maternal postpartum depression in Japan. From a dataset comprising 104,102 maternal registrations and 52,426 paternal registrations in The Japan Environment and Children's Study, this study analyzed complete data on questionnaires for 75,139, 79,346, and 77,661 women during early pregnancy, mid-late pregnancy, and after pregnancy, respectively, and for 41,506 male partners. Multivariable logistic regression showed reduced risk of psychological distress in the second and third quintiles for fish intake in early pregnancy and in the second to fifth quintile in mid-late pregnancy. No reductions were observed for n-3 PUFA intake in early pregnancy but in the second to fourth quintile in mid-late pregnancy. For postpartum depression, reductions were observed in the second to fourth quintile for fish intake but only in the first quintile for n-3 PUFA intake. As for paternal psychological distress, only the fourth quintile for fish intake showed a significant reduced risk but none were shown for n-3 PUFA intake. In conclusion, fish intake was associated with some reduced risk of psychological distress during pregnancy, even for male partners. The associations were weaker for n-3 PUFA intake than for fish intake.
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Miyake Y, Tanaka K, Okubo H, Sasaki S, Furukawa S, Arakawa M. Dietary patterns and depressive symptoms during pregnancy in Japan: Baseline data from the Kyushu Okinawa Maternal and Child Health Study. J Affect Disord 2018; 225:552-558. [PMID: 28869909 DOI: 10.1016/j.jad.2017.08.073] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 08/21/2017] [Accepted: 08/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Only one Brazilian study has examined the association between dietary patterns and depressive symptoms during pregnancy. The current cross-sectional study examined this issue in Japan. METHODS Study subjects were 1744 pregnant women. Between April 2007 and March 2008, information under study was obtained. Dietary patterns were derived from a factor analysis of 33 predefined food groups based on a self-administered diet history questionnaire. Depressive symptoms were defined as a Center for Epidemiological Studies Depression Scale score ≥ 16. Adjustment was made for age, gestation, region of residence, number of children, family structure, history of depression, family history of depression, smoking, secondhand smoke exposure, employment, household income, education, and body mass index. RESULTS Three dietary patterns were identified: 'healthy', characterized by high intake of green and yellow vegetables, other vegetables, mushrooms, pulses, seaweed, potatoes, fish, sea products, miso soup, sugar, and shellfish; 'Japanese', characterized by high intake of rice and miso soup; and 'Western', characterized by high intake of beef and pork, processed meat, vegetable oil, chicken, eggs, shellfish, and salt-containing seasonings. The healthy and Japanese patterns were independently inversely associated with depressive symptoms during pregnancy: the adjusted prevalence ratios (95% confidence intervals, P for trend) between extreme quartiles were 0.56 (0.43-0.73, < 0.0001) and 0.72 (0.55-0.94, 0.008), respectively. No association was observed between the Western pattern and depressive symptoms during pregnancy. LIMITATIONS Information was obtained between the 5th and 39th week of pregnancy. CONCLUSIONS The healthy and Japanese dietary patterns may be inversely associated with depressive symptoms during pregnancy.
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Affiliation(s)
- Yoshihiro Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.
| | - Keiko Tanaka
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
| | - Hitomi Okubo
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinya Furukawa
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
| | - Masashi Arakawa
- Health Tourism Research Fields, Graduate School of Tourism Sciences, University of the Ryukyus, Okinawa, Japan
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Abstract
The study of perinatal mental health (mental health during pregnancy and postpartum) is a complex field of study that is of major importance both for the mental and physical health of new mothers and for the neurobehavioral development and long-term functioning of the children they bear. In this review, we cover the most recent additions to this rapidly evolving field. Notable advances include further illumination of the epidemiological patterns and clinical manifestations of perinatal mood disruption; new efficacy data on treatment and prevention; clarifications of the respective contributions of maternal mental illness and psychotropic medication to outcomes of pregnancy, birth, and child development; and updated expert guidelines for screening.
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Affiliation(s)
- Thalia Robakis
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Eugenia Jernick
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Katherine Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
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Miyake Y, Tanaka K, Okubo H, Sasaki S, Furukawa S, Arakawa M. Manganese intake is inversely associated with depressive symptoms during pregnancy in Japan: Baseline data from the Kyushu Okinawa Maternal and Child Health Study. J Affect Disord 2017; 211:124-129. [PMID: 28110159 DOI: 10.1016/j.jad.2017.01.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/05/2017] [Accepted: 01/14/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND One epidemiological study in Canada has addressed the association between zinc intake and depressive symptoms during pregnancy while another epidemiological study in Korea has examined the association between iron intake and depressive symptoms during pregnancy. The present cross-sectional study in Japan examined the association between intake of zinc, magnesium, iron, copper, and manganese and depressive symptoms during pregnancy. METHODS Study subjects were 1745 pregnant women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Depressive symptoms were defined as a score ≥16 on the Center for Epidemiologic Studies Depression Scale. Adjustment was made for age, gestation, region of residence, number of children, family structure, history of depression, family history of depression, smoking, secondhand smoke exposure at home and at work, employment, household income, education, body mass index, and intake of saturated fatty acids, eicosapentaenoic acid plus docosahexaenoic acid, calcium, vitamin D, and isoflavones. RESULTS In crude analysis, significant inverse associations were observed between intake levels of zinc, magnesium, iron, copper, and manganese and the prevalence of depressive symptoms during pregnancy. After adjustment for confounding factors, only manganese intake was independently inversely associated with depressive symptoms during pregnancy: the adjusted prevalence ratio between extreme quartiles was 0.74 (95% confidence interval:0.56-0.97, P for trend=0.046). LIMITATIONS Information was obtained between the 5th and 39th week of pregnancy. CONCLUSIONS The current cross-sectional study of Japanese women demonstrated higher manganese intake to be independently associated with a lower prevalence of depressive symptoms during pregnancy.
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Affiliation(s)
- Yoshihiro Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.
| | - Keiko Tanaka
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
| | - Hitomi Okubo
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinya Furukawa
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
| | - Masashi Arakawa
- Health Tourism Research Fields, Graduate School of Tourism Sciences, University of the Ryukyus, Okinawa, Japan
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Sparling TM, Henschke N, Nesbitt RC, Gabrysch S. The role of diet and nutritional supplementation in perinatal depression: a systematic review. MATERNAL & CHILD NUTRITION 2017; 13:10.1111/mcn.12235. [PMID: 26840379 PMCID: PMC6865932 DOI: 10.1111/mcn.12235] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 09/28/2015] [Accepted: 09/30/2015] [Indexed: 12/21/2022]
Abstract
This article presents a systematic literature review on whether dietary intake influences the risk for perinatal depression, i.e. depression during pregnancy or post-partum. Such a link has been hypothesized given that certain nutrients are important in the neurotransmission system and pregnancy depletes essential nutrients. PubMed, EMBASE and CINAHL databases were searched for relevant articles until 30 May 2015. We included peer-reviewed studies of any design that evaluated whether perinatal depression is related to dietary intake, which was defined as adherence to certain diets, food-derived intake of essential nutrients or supplements. We identified 4808 studies, of which 35 fulfilled inclusion criteria: six randomized controlled trials, 12 cohort, one case-control and 16 cross-sectional studies, representing 88 051 distinct subjects. Studies were grouped into four main categories based on the analysis of dietary intake: adherence to dietary patterns (nine studies); full panel of essential nutrients (six studies); specific nutrients (including B vitamins, Vitamin D, calcium and zinc; eight studies); and intake of fish or polyunsaturated fatty acids (PUFAs; 12 studies). While 13 studies, including three PUFA supplementation trials, found no evidence of an association, 22 studies showed protective effects from healthy dietary patterns, multivitamin supplementation, fish and PUFA intake, calcium, Vitamin D, zinc and possibly selenium. Given the methodological limitations of existing studies and inconsistencies in findings across studies, the evidence on whether nutritional factors influence the risk of perinatal depression is still inconclusive. Further longitudinal studies are needed, with robust and consistent measurement of dietary intake and depressive symptoms, ideally starting before pregnancy.
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Affiliation(s)
- Thalia M. Sparling
- Institute of Public Health, Im Neuenheimer Feld 324Ruprecht‐Karls‐UniversitätHeidelbergGermany
| | - Nicholas Henschke
- Institute of Public Health, Im Neuenheimer Feld 324Ruprecht‐Karls‐UniversitätHeidelbergGermany
| | - Robin C. Nesbitt
- Institute of Public Health, Im Neuenheimer Feld 324Ruprecht‐Karls‐UniversitätHeidelbergGermany
| | - Sabine Gabrysch
- Institute of Public Health, Im Neuenheimer Feld 324Ruprecht‐Karls‐UniversitätHeidelbergGermany
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22
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Gomes CDB, Malta MB, Corrente JE, Benício MHD, Carvalhaes MADBL. [High prevalence of inadequate calcium and vitamin D dietary intake in two cohorts of pregnant women]. CAD SAUDE PUBLICA 2016; 32:e00127815. [PMID: 27992038 DOI: 10.1590/0102-311x00127815] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 04/06/2016] [Indexed: 11/22/2022] Open
Abstract
This study aimed to identify the prevalence of inadequate calcium and vitamin D dietary intake and related factors in two cohorts of pregnant women according to trimester of pregnancy. Two 24-hour dietary recall tests were taken in each trimester, one pertaining to weekends. Variables significantly correlated with intake of these nutrients were included in a multivariate linear regression model, adjusted for energy. Prevalence of inadequate intake was estimated according to the National Cancer Institute method (United States). In cohort A, inadequate vitamin D did not differ between trimesters; in B there was a reduction: from 99.7% in the first trimester to 97.1% in the third. In cohorts A and B, inadequate calcium intake exceeded 70%, falling slightly from the first (89.2% and 81.4%) to the second (79.7% and 69.1%) and third trimesters (82.7% and 72.6%). There was no correlation between maternal variables and the intake of these micronutrients. In conclusion, intake of vitamin D and calcium is seriously inadequate and distributed homogeneously among pregnant women in the primary healthcare network.
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Affiliation(s)
- Caroline de Barros Gomes
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho". Botucatu, Brasil
| | | | - José Eduardo Corrente
- Instituto de Biociências de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, Brasil
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Miyake Y, Tanaka K, Okubo H, Sasaki S, Furukawa S, Arakawa M. Soy isoflavone intake and prevalence of depressive symptoms during pregnancy in Japan: baseline data from the Kyushu Okinawa Maternal and Child Health Study. Eur J Nutr 2016; 57:441-450. [PMID: 27744546 DOI: 10.1007/s00394-016-1327-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 10/10/2016] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Several observational studies and trials examined the relationship between isoflavones or soybeans and depressive symptoms among peri- and postmenopausal women. We cross-sectionally evaluated the associations between intake of soy products and isoflavones and depressive symptoms during pregnancy in Japan. METHODS Study subjects were 1745 pregnant women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Depressive symptoms were defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale. RESULTS Higher intake of total soy products, tofu, tofu products, fermented soybeans, boiled soybeans, miso soup, and isoflavones was independently related to a lower prevalence of depressive symptoms during pregnancy: The adjusted prevalence ratios (95 % confidence intervals, P for trend) between extreme quartiles were 0.63 (0.47-0.85, 0.002), 0.72 (0.54-0.96, 0.007), 0.74 (0.56-0.98, 0.04), 0.57 (0.42-0.76, <0.0001), 0.73 (0.55-0.98, 0.03), 0.65 (0.49-0.87, 0.003), and 0.63 (0.46-0.86, 0.002), respectively. A significant positive exposure-response relationship was found between miso intake and depressive symptoms during pregnancy. No material relationship was observed between soymilk intake and depressive symptoms during pregnancy. CONCLUSIONS Our study is the first to show independent inverse relationships between intake of total soy products, tofu, tofu products, fermented soybeans, boiled soybeans, miso soup, and isoflavones and depressive symptoms during pregnancy.
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Affiliation(s)
- Yoshihiro Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, 791-0295, Japan. .,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.
| | - Keiko Tanaka
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, 791-0295, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
| | - Hitomi Okubo
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Shinya Furukawa
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, 791-0295, Japan.,Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
| | - Masashi Arakawa
- Health Tourism Research Fields, Graduate School of Tourism Sciences, University of the Ryukyus, Okinawa, Japan
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Vaziri F, Nasiri S, Tavana Z, Dabbaghmanesh MH, Sharif F, Jafari P. A randomized controlled trial of vitamin D supplementation on perinatal depression: in Iranian pregnant mothers. BMC Pregnancy Childbirth 2016; 16:239. [PMID: 27544544 PMCID: PMC4992225 DOI: 10.1186/s12884-016-1024-7] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 08/11/2016] [Indexed: 02/06/2023] Open
Abstract
Background Mood disorders in pregnancy and post-partum period are common and considered as a public health issue. Researchers have studied the relationship between low serum vitamin D concentration and perinatal depression, although no clinical trial has been conducted on vitamin D’s effects on depression related to childbirth. This study evaluated the effect of vitamin D3 supplementation on perinatal depression scores. Methods This randomized clinical trial was done in pregnant women who were under prenatal care in a teaching hospital in Shiraz, Iran. The inclusion criteria were: being 18 years or older, no history of mental illness and internal diseases, a singleton live fetus, without any pregnancy complications, gestational age of 26–28 weeks upon enrollment, and depression score of 0 to 13. The Edinburgh Postnatal Depression scale was used to evaluate depression scores. A total of 169 participants were assigned to the two groups of placebo and vitamin D through block randomization design. Vitamin D group received 2000 IU vitamin D3 daily from 26 to 28 weeks of gestation until childbirth. Maternal serum 25-hydroxyvitamin D concentrations were measured at baseline and childbirth. Besides, depression scores were evaluated four times: at 26–28 and 38–40 weeks of gestation, and finally at 4 and 8 weeks after birth. Results The two groups were similar in relation to baseline 25-hydroxyvitamin D concentrations. However, at childbirth, the vitamin D group had significantly higher 25-hydroxyvitamin D concentration in comparison to the control group (p < 0.001). At baseline, no correlation was observed between 25-hydroxyvitamin D concentration and depression score (r = 0.13, p = 0.09). There was no significant difference between the two study groups in relation to the baseline depression score. While, the vitamin D group had greater reduction in depression scores than the control group at 38–40 weeks of gestation (p = 0.01) also, at 4 and 8 weeks after birth (p < 0.001). Conclusions The present trial showed that consuming 2000 IU vitamin D3 daily during late pregnancy was effective in decreasing perinatal depression levels. We suggest further clinical trial in pregnant mothers who are at risk for postnatal depression. Trial registration Iranian Registry of Clinical Trials IRCT2015020310327N11. Date of registration: March 9th 2015. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-1024-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Farideh Vaziri
- Department of midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samira Nasiri
- Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zohreh Tavana
- Department of Obstetrics and Gynecology, Medical school, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Farkhondeh Sharif
- Community Based Psychiatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Jafari
- Biostatics Department, School of medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Williams JA, Romero VC, Clinton CM, Vazquez DM, Marcus SM, Chilimigras JL, Hamilton SE, Allbaugh LJ, Vahratian AM, Schrader RM, Mozurkewich EL. Vitamin D levels and perinatal depressive symptoms in women at risk: a secondary analysis of the mothers, omega-3, and mental health study. BMC Pregnancy Childbirth 2016; 16:203. [PMID: 27485050 PMCID: PMC4971719 DOI: 10.1186/s12884-016-0988-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 07/23/2016] [Indexed: 11/17/2022] Open
Abstract
Background Vitamin D insufficiency may be associated with depressive symptoms in non-pregnant adults. We performed this study to evaluate whether low maternal vitamin D levels are associated with depressive symptoms in pregnancy. Methods This study was a secondary analysis of a randomized trial designed to assess whether prenatal omega-3 fatty acid supplementation would prevent depressive symptoms. Pregnant women from Michigan who were at risk for depression based on Edinburgh Postnatal Depression Scale Score or history of depression were enrolled. Participants completed the Beck Depression Inventory (BDI) and Mini International Neuropsychiatric Interview at 12–20 weeks, 26–28 weeks, 34–36 weeks, and 6–8 weeks postpartum. Vitamin D levels were measured at 12–20 weeks (N = 117) and 34–36 weeks (N = 112). Complete datasets were available on 105 subjects. Using regression analyses, we evaluated the relationship between vitamin D levels with BDI scores as well as with MINI diagnoses of major depressive disorder and generalized anxiety disorder. Our primary outcome measure was the association of maternal vitamin D levels with BDI scores during early and late pregnancy and postpartum. Results We found that vitamin D levels at 12–20 weeks were inversely associated with BDI scores both at 12—20 and at 34–36 weeks’ gestation (P < 0.05, both). For every one unit increase in vitamin D in early pregnancy, the average decrease in the mean BDI score was .14 units. Vitamin D levels were not associated with diagnoses of major depressive disorder or generalized anxiety disorder. Conclusions In women at risk for depression, early pregnancy low vitamin D levels are associated with higher depressive symptom scores in early and late pregnancy. Future investigations should study whether vitamin D supplementation in early pregnancy may prevent perinatal depressive symptoms. Trial registration https://clinicaltrials.gov/ Registration Number: NCT00711971
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Affiliation(s)
- Jennifer Anne Williams
- Department of Obstetrics and Gynecology, St. Joseph Mercy Health System, Ypsilanti, MI, USA
| | - Vivian C Romero
- Spectrum Health Maternal Fetal Medicine, Grand Rapids, MI, USA.,Department of Obstetrics and Gynecology, Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Chelsea M Clinton
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Delia M Vazquez
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Sheila M Marcus
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Julie L Chilimigras
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Susan E Hamilton
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Lucy J Allbaugh
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Anjel M Vahratian
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Ronald M Schrader
- Clinical and Translational Science Center, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Ellen L Mozurkewich
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA. .,Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, NM, 87131, USA.
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26
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Miyake Y, Tanaka K, Okubo H, Sasaki S, Furukawa S, Arakawa M. Milk intake during pregnancy is inversely associated with the risk of postpartum depressive symptoms in Japan: the Kyushu Okinawa Maternal and Child Health Study. Nutr Res 2016; 36:907-913. [PMID: 27632910 DOI: 10.1016/j.nutres.2016.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/19/2016] [Accepted: 06/01/2016] [Indexed: 12/22/2022]
Abstract
Only one epidemiologic study has investigated the association between dairy product intake during pregnancy and postpartum depressive symptoms. Epidemiologic evidence on the relationships between calcium and vitamin D intake during pregnancy and postpartum depressive symptoms is also lacking. The present prospective study examined these issues in Japan. Study subjects were 1319 women. During pregnancy, dietary intake during the preceding month was assessed using a self-administered diet history questionnaire in the baseline survey. Postpartum depressive symptoms were defined as present when subjects had an Edinburgh Postnatal Depression Scale score of 9 or higher between 3 and 4 months postpartum. Adjustment was made for age, gestation at baseline, region of residence, number of children, family structure, history of depression, family history of depression, job type, education, body mass index, having smoked during pregnancy, cesarean delivery, baby's sex, baby's birth weight, and total energy intake. After adjustment for the confounding factors, compared with milk intake in the lowest quartile, intake levels in the second and fourth quartiles were independently associated with a reduced risk of postpartum depressive symptoms, although the inverse exposure-response relationship was not significant: the adjusted odds ratio between extreme quartiles was 0.51 (95% confidence interval, 0.28-0.93; P for trend = .12). No material relationships were observed between intake of total dairy products, yogurt, cheese, calcium, or vitamin D and the risk of postpartum depressive symptoms. The present prospective cohort study in Japan suggests that higher milk intake during pregnancy is associated with a reduced risk of postpartum depressive symptoms.
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Affiliation(s)
- Yoshihiro Miyake
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan.
| | - Keiko Tanaka
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
| | - Hitomi Okubo
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinya Furukawa
- Department of Epidemiology and Preventive Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Epidemiology and Medical Statistics Unit, Translational Research Center, Ehime University Hospital, Ehime, Japan
| | - Masashi Arakawa
- Health Tourism Research Fields, Graduate School of Tourism Sciences, University of the Ryukyus, Okinawa, Japan
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27
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Serati M, Redaelli M, Buoli M, Altamura AC. Perinatal Major Depression Biomarkers: A systematic review. J Affect Disord 2016; 193:391-404. [PMID: 26802316 DOI: 10.1016/j.jad.2016.01.027] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/04/2015] [Accepted: 01/12/2016] [Indexed: 12/20/2022]
Abstract
Postpartum depression, now termed perinatal depression by the DSM-5, is a clinically relevant disorder reaching 15% of incidence. Although it is quite frequent and associated with high social dysfunction, only recently its underpinning biological pathways have been explored, while multiple and concomitant risk factors have been identified (e.g. psychosocial stress). Peripartum depression usually has its onset during the third trimester of pregnancy or in the postpartum, being one of the most common medical complications in new mothers. Purpose of the present review is to summarize the state of art of biological biomarkers involved in the pathogenesis of perinatal depression, in view of the fact that suboptimal prenatal milieu can induce permanent damage in subsequent offspring life and have a negative impact on mother-child relationship. Furthermore, parents' biological changes due to medical/psychiatric disorders or stress exposure could influence offspring life: a concept known as 'intergenerational transmission', acting by variations into gametes and the gestational uterine environment. Given the evidence that perinatal mental disorders involve risks for the mother and offspring, the search for reliable biomarkers in high-risk mothers actually represents a medical priority to prevent perinatal depression.
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Affiliation(s)
- M Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy.
| | - M Redaelli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - M Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - A C Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
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