Sunshine, Sadness and Seasonality: 25-Hydroxyvitamin D, and Depressive Symptoms in the United Arab Emirates (UAE)

Outdoor Activity in the Daytime, but Not the Nighttime, Predicts Better Mental Health Status During the COVID-19 Curfew in the United Arab Emirates

Background

The COVID-19 pandemic and the associated infection prevention and control measures had a negative impact on the mental health of many people. In the United Arab Emirates (UAE), infection control measures implemented after March 24th, 2020, placed necessary restrictions on people's freedom of movement.

Aim

This study aimed to assess the association between levels of daytime vs. nighttime outdoor activity and mental health among a sample of UAE residents during the lockdown period.

Method

An opportunity sample of 245 participants completed an online survey assessing levels of depression, somatic symptoms, daytime and nighttime activity levels.

Results

Multivariate logistic regression revealed that daytime activity, but not nighttime activity, was associated with a lower risk of clinically significant depressive and somatic symptomatology.

Conclusion

The association of better mental health with daytime not nighttime outdoor activity could be possibly attributed to vitamin D, but further studies are needed to confirm this speculation.

Sun Exposure and Behavioral Activation for Hypovitaminosis D and Depression: A Controlled Pilot Study

Several independent meta-analytic reviews suggest a relationship between vitamin D (VTD) deficiency and depressive symptoms. Theoretically, behavioural withdrawal (staying home, discontinuing outdoor activities etc.) is likely to exacerbate VTD deficiency. This pilot study assessed the efficacy of a modified form of behavioral therapy designed to simultaneously target VTD deficiency and depressive symptoms. College women (N = 114), all citizens of the United Arab Emirates, were screened for depressive symptoms and VTD deficiency. Those participants who were severely VTD deficient and experiencing clinically significant depressive symptoms, were randomly allocated to either a 12-week program of behavioral activation, emphasizing safe-sun exposure (N = 10), or a waiting list control group (N = 10). At time 2 the sun exposure and behavioral activation (SEBA) group showed a significant increases in 25-hydroxyvitamin D and were, on average, no longer VTD deficient, whereas the control group deteriorated in terms of VTD. Similarly positive results were observed for depressive symptoms. Sun exposure and behavioral activation (SEBA) may be an effective approach to improving VTD status and alleviating depressive symptoms.

Serum 25-hydroxyvitamin D levels and the risk of depression: a systematic review and meta-analysis

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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