Guowei Li1, Lawrence Mbuagbaw, Zainab Samaan, Maicon Falavigna, Shiyuan Zhang, Jonathan D Adachi, Ji Cheng, Alexandra Papaioannou, Lehana Thabane. 1. Department of Clinical Epidemiology and Biostatistics (G.L., L.M., S.Z., J.C., L.T.), and Department of Psychiatry and Behavioural Neurosciences (Z.S.), Division of Geriatric Medicine, Department of Medicine (A.P.), McMaster University, Hamilton, Ontario, Canada L8S 4L8; Post Graduate Program in Epidemiology (M.F.), Universidade Federal do Rio Grande do Sul, Porto Alegre 90040-060, Brazil; and St Joseph's Hospital (J.D.A., J.C., L.T.), McMaster University, Hamilton, Ontario, Canada L8N 4A6.
Abstract
CONTEXT: Randomized controlled trials (RCTs) investigating the efficacy of vitamin D (Vit D) in depression provided inconsistent results. OBJECTIVE: We aim to summarize the evidence of RCTs to assess the efficacy of oral Vit D supplementation in depression compared to placebo. DATA SOURCES: We searched electronic databases, two conference proceedings, and gray literature by contacting authors of included studies. STUDY SELECTION: We selected parallel RCTs investigating the effect of oral Vit D supplementation compared with placebo on depression in adults at risk of depression, with depression symptoms or a primary diagnosis of depression. DATA EXTRACTION: Two reviewers independently extracted data from relevant literature. DATA SYNTHESIS: Classical and Bayesian random-effects meta-analyses were used to pool relative risk, odds ratio, and standardized mean difference. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS: Six RCTs were identified with 1203 participants (72% females) including 71 depressed patients; five of the studies involved adults at risk of depression, and one trial used depressed patients. Results of the classical meta-analysis showed no significant effect of Vit D supplementation on postintervention depression scores (standardized mean difference = -0.14, 95% confidence interval = -0.41 to 0.13, P = .32; odds ratio = 0.93, 95% confidence interval = 0.54 to 1.59, P = .79). The quality of evidence was low. No significant differences were demonstrated in subgroup or sensitivity analyses. Similar results were found when Bayesian meta-analyses were applied. CONCLUSIONS: There is insufficient evidence to support the efficacy of Vit D supplementation in depression symptoms, and more RCTs using depressed patients are warranted.
CONTEXT: Randomized controlled trials (RCTs) investigating the efficacy of vitamin D (Vit D) in depression provided inconsistent results. OBJECTIVE: We aim to summarize the evidence of RCTs to assess the efficacy of oral Vit D supplementation in depression compared to placebo. DATA SOURCES: We searched electronic databases, two conference proceedings, and gray literature by contacting authors of included studies. STUDY SELECTION: We selected parallel RCTs investigating the effect of oral Vit D supplementation compared with placebo on depression in adults at risk of depression, with depression symptoms or a primary diagnosis of depression. DATA EXTRACTION: Two reviewers independently extracted data from relevant literature. DATA SYNTHESIS: Classical and Bayesian random-effects meta-analyses were used to pool relative risk, odds ratio, and standardized mean difference. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool. RESULTS: Six RCTs were identified with 1203 participants (72% females) including 71 depressedpatients; five of the studies involved adults at risk of depression, and one trial used depressedpatients. Results of the classical meta-analysis showed no significant effect of Vit D supplementation on postintervention depression scores (standardized mean difference = -0.14, 95% confidence interval = -0.41 to 0.13, P = .32; odds ratio = 0.93, 95% confidence interval = 0.54 to 1.59, P = .79). The quality of evidence was low. No significant differences were demonstrated in subgroup or sensitivity analyses. Similar results were found when Bayesian meta-analyses were applied. CONCLUSIONS: There is insufficient evidence to support the efficacy of Vit D supplementation in depression symptoms, and more RCTs using depressedpatients are warranted.
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