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Meng Y, Liu S, Yu M, Liang H, Tong Y, Song J, Shi J, Cai W, Wu Q, Wen Z, Wang J, Guo F. The Changes of Blood and CSF Ion Levels in Depressed Patients: a Systematic Review and Meta-analysis. Mol Neurobiol 2024; 61:5369-5403. [PMID: 38191692 DOI: 10.1007/s12035-023-03891-x] [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: 05/17/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024]
Abstract
Micronutrient deficiencies and excesses are closely related to developing and treating depression. Traditional and effective antidepressants include tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and lithium. There is no consensus on the fluctuation of zinc (Zn2+), magnesium (Mg2+), calcium (Ca2+), copper (Cu2+), iron (Fe2+), and manganese (Mn2+) ion levels in depressed individuals before and after therapy. In order to determine whether there were changes in blood and cerebrospinal fluid (CSF) levels of these ions in depressed patients compared with healthy controls and depressed patients treated with TCAs, SSRIs, or lithium, we applied a systematic review and meta-analysis. Using the Stata 17.0 software, we performed a systematic review and meta-analysis of the changes in ion levels in human samples from healthy controls, depressive patients, and patients treated with TCAs, SSRIs, and lithium, respectively. By searching the PubMed, EMBASE, Google Scholar, Web of Science, China National Knowledge Infrastructure (CNKI), and WAN FANG databases, 75 published analyzable papers were chosen. In the blood, the levels of Zn2+ and Mg2+ in depressed patients had decreased while the Ca2+ and Cu2+ levels had increased compared to healthy controls, Fe2+ and Mn2+ levels have not significantly changed. After treatment with SSRIs, the levels of Zn2+ and Ca2+ in depressed patients increased while Cu2+ levels decreased. Mg2+ and Ca2+ levels were increased in depressed patients after Lithium treatment. The findings of the meta-analysis revealed that micronutrient levels were closely associated with the onset of depression and prompted more research into the underlying mechanisms as well as the pathophysiological and therapeutic implications.
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Affiliation(s)
- Yulu Meng
- Department of Pharmacy, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Shuangshuang Liu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Miao Yu
- Science Experiment Center, China Medical University, Shenyang, 110122, China
| | - Hongyue Liang
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Yu Tong
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Ji Song
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Jian Shi
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Wen Cai
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China
| | - Qiong Wu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Zhifeng Wen
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, China.
| | - Jialu Wang
- Department of Neurology, The First Hospital of China Medical University, Shenyang, Liaoning, 110001, China.
| | - Feng Guo
- Department of Pharmacy, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, China.
- Department of Pharmaceutical Toxicology, School of Pharmacy, China Medical University, Shenyang, 110122, China.
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Guo L, Li J, White H, Xu Z, Ren J, Huang X, Chen Y, Yang K. PROTOCOL: Treatment for depressive disorder among adults: An evidence and gap map of systematic reviews. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1308. [PMID: 36911856 PMCID: PMC9985796 DOI: 10.1002/cl2.1308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This is the protocol for a Campbell evidence and gap map. The objective of the map is to map available systematic reviews on the effectiveness of treatments for depressive disorders among adults. Specifically, this EGM includes studies on the effectiveness of treatments across a range of outcome domains.
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Affiliation(s)
- Liping Guo
- Evidence‐Based Medicine Center, The Centre of Evidence‐based Social Science, School of Basic MedicineLanzhou UniversityLanzhouChina
| | - Jieyun Li
- Evidence‐Based Medicine Center, The Centre of Evidence‐based Social Science, School of Basic MedicineLanzhou UniversityLanzhouChina
| | - Howard White
- Evidence‐Based Medicine Center, The Centre of Evidence‐based Social Science, School of Basic MedicineLanzhou UniversityLanzhouChina
| | - Zheng Xu
- Evidence‐Based Medicine Center, The Centre of Evidence‐based Social Science, School of Basic MedicineLanzhou UniversityLanzhouChina
| | - Junjie Ren
- The Centre of Evidence‐based Social Science, School of Public healthLanzhou UniversityLanzhouChina
| | - Xinyu Huang
- The Centre of Evidence‐based Social Science, School of Public healthLanzhou UniversityLanzhouChina
| | - Yaogeng Chen
- School of Basic MedicineNingxia Medical UniversityNingxiaChina
| | - Kehu Yang
- Evidence‐Based Medicine Center, The Centre of Evidence‐based Social Science, School of Basic MedicineLanzhou UniversityLanzhouChina
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Tarikere Satyanarayana P, Suryanarayana R, Theophilus Yesupatham S, Reddy S, Reddy N. Is Sunshine Vitamin Related to Adolescent Depression? A Cross-Sectional Study of Vitamin D Status and Depression Among Rural Adolescents. Cureus 2023; 15:e34639. [PMID: 36895546 PMCID: PMC9989901 DOI: 10.7759/cureus.34639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Adolescence is the phase of rapid transition of the body. The requirement of all minerals and vitamins changes in this phase of life so does Vitamin D. Despite Vitamin D being abundantly available, its deficiency, which can cause innumerable side effects on the body, is extremely common among the general population. Material and methods: The present study was a cross-sectional study carried out from January 2021 to July 2022 for two years at various government rural high schools in Kolar, Karnataka, India. All adolescents who were aged 11-18 years and studying in 9th and 10th standards were included in the study after consent and assent. Adolescent boys and girls with any pre-existing mental health illness were excluded from the study. To assess depression, Beck's Depression Inventory (BDI-II) was used. Vitamin D3 levels were assessed by using VITROS Immunodiagnostic products using a 25-OH Total reagent pack. All data were entered in a Microsoft Excel sheet (Redmond, USA) and analyzed using IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. To check for the association between factors, Chi-square was applied with a level of significance defined as a p-value less than 0.05. RESULTS Out of 451 students, 272 (60.3%) belonged to the 15-year age group, 224 (49.7%) were boys, 235 (52.1%) were studying in 10th standard, 323 (71.6 %) belonged to nuclear families, 379 (84%) were non-vegetarian by diet, 222 (49.2%) had sun exposure in the afternoon, and 156 (34.6%) had a sun exposure of fewer than 60 minutes, 133 (29.5%) had severe depression according to Beck's Depression Inventory-II. One hundred sixty-two (35.9%) had insufficient Vitamin D3 levels (12-20 ng/ml), and 66 (14.6%) had deficient levels of Vitamin D3 (less than 12 ng/dl). There was a statistically significant association between depression and Vitamin D3 levels. CONCLUSION There are innumerable causes of adolescent depression. The present study shows Vitamin D levels were statistically associated with depression among adolescents. Vitamin D supplementation of at least 600 international units, which is the recommended dietary allowance (RDA), could be beneficial in tackling Vitamin D to sufficiency status (20-100 ng/ml) and also indirectly address Adolescent Depression. Better study designs, like randomized control trials showing Vitamin D intervention and its possible curative role in adolescent depression, are required to establish the causal association.
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Affiliation(s)
- Pradeep Tarikere Satyanarayana
- Community Medicine, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar, IND
| | - Ravishankar Suryanarayana
- Biostatistics, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar, IND
| | - Susanna Theophilus Yesupatham
- Biochemistry, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar, IND
| | - Sudha Reddy
- Pediatrics, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar, IND
| | - Navya Reddy
- Psychiatry, Sri Devaraj Urs Medical College (SDUMC) Sri Devaraj Urs Academy of Higher Education and Research (SDUAHER), Kolar, IND
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Environmental Influences on the Behavioural and Emotional Outcomes of Children: A Network Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148479. [PMID: 35886325 PMCID: PMC9320434 DOI: 10.3390/ijerph19148479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/19/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022]
Abstract
Background: Intellectual developmental disorders are a serious source of health morbidity with negative consequences for adults as well as children. However, there is limited evidence on the environmental, trace element, behavioural, and emotional outcomes in children. Here, we investigated whether there is any association between child behaviour and emotional outcomes and micronutrients using network analysis. Methods: A cross-sectional study was conducted in 9-year-old children within a Pacific Island Families study birth cohort. Elemental concentration was determined in children’s toenails after acid digestion and analysed using inductively coupled plasma mass spectrometry. We used network analysis to identify closely associated trace elements and tested the directions and strength of these trace elements. MANCOVA were used to identify the significant associations between individual elements and the behavioural/emotional function of the children using the children behaviour checklist (CBCL). At the final step, quantile regression analysis was used to assess and quantify the identified associations between CBCL function scores and manganese, adjusted by sex, ethnicity, and standardized BMI. Results: Three major nutrient networks were identified. In the Mn network, Mn was strongly positively associated with Al (0.63) and Fe (r = 0.65) and moderately associated with Pb (r = 0.45) and Sb (r = 0.42). Al was also strongly associated with Fe (r = 0.9). Children in the second or third clinical group, with an elevated externalized CBCL score, had a much higher mean and median level of Mn as compared to the normal range group. The aggression score was significantly associated with Mn concentration and sex. Higher Mn concentrations were associated with a higher aggression score. A 1 ug/g unit increase in Mn was associated with a 2.44-fold increase (95% confidence interval: 1.55–4.21) in aggression score, and boys had higher median aggression score than girls (difference: 1.7, 95% CI: 0.9–2.8). Attention and rule breaking scores were both significantly associated with Mn concentration. Higher Mn concentrations were associated with higher attention behaviour problem and rule breaking scores. A 1 ug/g unit increase in Mn was found to be associated with a 1.80-fold increase (95% confidence interval: 1.37–2.82) in attention score, and a 1.46-fold increase (95% confidence interval: 1.01–1.74) in the rule breaking score. Thought score was not significantly associated with Mn concentration (p = 0.13) but was significantly lower in boys (p = 0.004). Conclusions: Exceeding Mn levels is potentially toxic and has been identified to be associated with worse externalized children’s behavioural health and emotional well-being. Future studies are necessary to find the exposure paths so that advice shall be provided to family and care providers in public health and environmental protection.
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He W, Ruan Y. Poor sleep quality, vitamin D deficiency and depression in the stroke population: A cohort study. J Affect Disord 2022; 308:199-204. [PMID: 35429540 DOI: 10.1016/j.jad.2022.04.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 04/02/2022] [Accepted: 04/09/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Depression is a common psychiatric complication after stroke. However, the relationships among sleep quality, vitamin D status and depression are unclear in stroke patients. The aim of this study was to explore the impact of poor sleep quality and vitamin D status on post-stroke depression (PSD). METHODS In the present study, 233 stroke patients completed the one-month follow-up. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) both at admission and 1 month after stroke. Depressive symptom was measured by the Hamilton Depression Scale (HAMD) at 1 month after stroke. Serum vitamin D levels were measured at admission. Multivariable logistic regression and mediation analysis were used to examine the mediating and moderating effects of sleep quality and vitamin D status on PSD. RESULTS The incidence of PSD was higher in patients with poor sleep quality than those with good sleep quality. Vitamin D levels were negatively correlated with HAMD score (r = -0.244, P < 0.001). Prestroke poor sleep quality was associated with an increased risk of PSD in the vitamin D deficiency group after adjustment for potential confounders (OR = 4.047, 95%CI = 1.300-12.600, P = 0.016), while this association was not significant in the vitamin D sufficiency group. In mediation analysis, the relationship between vitamin D deficiency and PSD was mediated by poststroke sleep quality. LIMITATIONS Vitamin D levels were measured only at admission. CONCLUSIONS The combination of poor sleep quality and vitamin D deficiency is associated with a substantially increased risk of PSD.
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Affiliation(s)
- Weilei He
- Department of Nuclear Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
| | - Yiting Ruan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
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Zarate-Ortiz AG, Verhoef H, Melse-Boonstra A, Woods BJ, Lee-Bazaldúa EE, Feskens EJ, Quiroga-Garza A, Cepeda-Lopez AC. Depressive symptoms among Mexican adolescent girls in relation to iron status, anaemia, body weight and pubertal status: results from a latent class analysis. Public Health Nutr 2022; 26:1-8. [PMID: 35583048 DOI: 10.1017/s1368980022001203] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The study examined the association between depressive symptoms and iron status, anaemia, body weight and pubertal status among Mexican adolescent girls. DESIGN In this cross-sectional study, depressive symptoms were assessed by the 6-item Kutcher Adolescent Depression Scale, and latent class analysis (LCA) was used to identify and characterise groups of girls based on depressive symptoms. Iron status and inflammation were assessed using ferritin and soluble transferrin receptor, C-reactive protein and alpha-1-acid glycoprotein, respectively. Multiple logistic and linear regressions were applied to model class membership as a function of iron status, anaemia, body weight and pubertal status. PARTICIPANTS We collected data from 408 girls aged 12-20 years. SETTING Public schools in northern Mexico. RESULTS LCA yielded three classes of depressive symptoms: 44·4 % of the adolescents were 'unlikely to be depressed', 41·5 % were 'likely to be depressed' and 14·1 % were 'highly likely to be depressed'. Our analyses demonstrated that iron-deficient girls had greater odds of being 'likely depressed' (OR 2·01, 95 % CI 1·01, 3·00) or 'highly likely depressed' (OR 2·80, 95 % CI 1·76, 3·84). Linear regression analyses revealed that lower Hb concentrations and higher body weight increased the probability of being 'likely depressed'. There was no evidence that depressive symptoms were associated with age at menarche and years since menstruation. CONCLUSIONS This study shows that iron-deficient adolescent girls are more likely to suffer from depressive symptoms and that lower concentrations of Hb and higher body weight increased the probability of experiencing depressive symptoms.
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Affiliation(s)
- Arli Guadalupe Zarate-Ortiz
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen6700 AK, The Netherlands
| | - Hans Verhoef
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen6700 AK, The Netherlands
- Medical Research Council (MCR) Unit, The Gambia at London School of Hygiene & Tropical Medicine, Serrekunda, Gambia
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen6700 AK, The Netherlands
| | - Bo-Jane Woods
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen6700 AK, The Netherlands
- Access to Nutrition Initiative, Utrecht, The Netherlands
| | | | - Edith Jm Feskens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen6700 AK, The Netherlands
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Portnoy J, Wang J, Wang F, Um P, Irving SY, Hackl L, Liu J. Lower serum selenium concentration associated with anxiety in children. J Pediatr Nurs 2022; 63:e121-e126. [PMID: 34686396 PMCID: PMC10002467 DOI: 10.1016/j.pedn.2021.09.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/26/2021] [Accepted: 09/28/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Few studies have examined the role of selenium in anxiety. This study aimed to evaluate the association between serum selenium concentrations and anxiety disorders and symptoms in children. DESIGN AND METHODS This study utilized data from 831 children participating in the China Jintan Child Cohort Study (mean age = 12.67 years; 46.1% female). Serum selenium samples were collected and anxiety was assessed using the Chinese version of the Screen for Child Anxiety Related Disorders. Six types of anxiety scores were calculated, including total anxiety, panic/somatic, generalized anxiety, separation anxiety, social anxiety, and school phobia. RESULTS Controlling for covariates, children with lower serum selenium concentrations were more likely to meet clinical cutoffs for total anxiety (OR = 0.992, p < 0.01), panic/somatic disorder (OR = 0.993, p < 0.05), generalized anxiety disorder (OR = 0.990, p < 0.05), social anxiety disorder (OR = 0.991, p < 0.01), and school phobia (OR = 0.989, p < 0.01), but not separation anxiety (OR = 1.000, p > 0.05). Controlling for covariates, lower serum selenium concentrations were also associated with higher continuous total anxiety, generalized anxiety, and school phobia scores (p < 0.05). CONCLUSIONS Lower serum selenium concentrations were associated with higher anxiety. To our knowledge, this was the first study to examine the relationship between serum selenium and anxiety disorders in a sample of children. Results indicate an association between children's micronutrient levels and anxiety disorders. PRACTICE IMPLICATIONS Improving child nutrition may be a promising strategy to help reduce childhood anxiety.
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Affiliation(s)
- Jill Portnoy
- University of Massachusetts Lowell, Lowell, MA, USA
| | - Jessica Wang
- School of Nursing, University of Pennsylvania, Philadelphia PA, USA
| | - Fenfen Wang
- School of Nursing, University of Pennsylvania, Philadelphia PA, USA
| | - Phoebe Um
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sharon Y Irving
- School of Nursing, University of Pennsylvania, Philadelphia PA, USA
| | | | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia PA, USA.
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Campisi SC, Zasowski C, Shah S, Bradley-Ridout G, Madigan S, Szatmari P, Korczak DJ. Do Healthy Dietary Interventions Improve Pediatric Depressive Symptoms? A Systematic Review and Meta-Analysis. Adv Nutr 2021; 12:2495-2507. [PMID: 34302170 PMCID: PMC8634309 DOI: 10.1093/advances/nmab088] [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: 02/05/2021] [Revised: 04/05/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Dietary recommendations have been proposed as a way of impacting current and future mental health. There exists a limited body of conflicting literature related to pediatric nutritional interventions and depression. This meta-analysis aims to determine the efficacy of child and adolescent dietary interventions on depression. Systematic searches in electronic databases and gray literature were conducted. After screening 6725 citations, 17 studies were included in this systematic review. Quality assessment was performed using the Cochrane risk-of-bias tool and the Joanna Briggs Institute Critical Appraisal Tool for Quasi-Experimental Studies. A meta-analysis of Hedges g values was calculated using the Hartung-Knapp-Sidik-Jonkman method. Publication bias was assessed with funnel plots and the Egger test. The results of the meta-analysis of the RCTs (k = 7) demonstrated a nonsignificant effect of dietary intervention (g = 0.05; 95% CI: -0.25, 0.35; P = 0.70) whereas the results of the pre-post intervention studies (k = 9) demonstrated a significant small-to-medium effect favoring dietary intervention for reducing depression (g = -0.45; 95% CI: -0.64, -0.27; P = 0.001). Publication bias was not detected by the Egger test or by funnel plot asymmetry. The current meta-analysis demonstrates that "healthy" dietary interventions for children or adolescents in the community have little impact on nonclinical depression. Confusion will persist until better-designed studies in pediatric nutritional psychiatry research focusing on adolescents with depressive illness are conducted.
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Affiliation(s)
- Susan C Campisi
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Clare Zasowski
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Shailja Shah
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | | | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Peter Szatmari
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Campisi SC, Krause KR, Chan BWC, Courtney DB, Bennett K, Korczak DJ, Szatmari P. Eating, sleeping and moving recommendations in clinical practice guidelines for paediatric depression: umbrella review. BJPsych Open 2021; 7:e185. [PMID: 34607616 PMCID: PMC8503910 DOI: 10.1192/bjo.2021.1020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Current first-line treatments for paediatric depression demonstrate mild-to-moderate effectiveness. This has spurred a growing body of literature on lifestyle recommendations pertaining to nutrition, sleep and exercise for treating paediatric depression. AIMS Paediatric depression clinical practice guidelines (CPGs) were reviewed for quality and to catalogue recommendations on nutrition, sleep and exercise made by higher-quality CPGs. METHOD Searches were conducted in Medline, EMBASE, PsycINFO, Web of Science and CINAHL, and grey literature CPGs databases for relevant CPGs. Eligible CPGs with a minimum or high-quality level, as determined by the Appraisal of Guidelines for Research and Evaluation, Second Edition instrument, were included if they were (a) paediatric; (b) CPGs, practice parameter or consensus or expert committee recommendations; (c) for depression; (d) the latest version and (e) lifestyle recommendations for nutrition, sleep or exercise. Key information extracted included author(s), language, year of publication, country, the institutional body issuing the CPG, target disorder, age group, lifestyle recommendation and the methods used to determine CPG lifestyle recommendations. RESULTS Ten paediatric CPGs for depression with a minimum or high-quality level contained recommendations on nutrition, sleep or exercise. Lifestyle recommendations were predominately qualitative, with quantitative details only outlined in two CPGs for exercise. Most recommendations were brief general statements, with 50% lacking supporting evidence from the literature. CONCLUSIONS Interest in lifestyle interventions for treatment in child and youth depression is growing. However, current CPG lifestyle recommendations for nutrition, sleep or exercise are based on expert opinion rather than clinical trials.
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Affiliation(s)
- Susan C Campisi
- Department of Psychiatry, Hospital for Sick Children, Canada
| | - Karolin R Krause
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Canada; Evidence-Based Practice Unit, University College London, UK; and Evidence-Based Practice Unit, Anna Freud National Centre for Children and Families, UK
| | | | - Darren B Courtney
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Canada; and Department of Psychiatry, University of Toronto, Canada
| | - Kathryn Bennett
- Department of Health Research Methods, Evidence and Impact, McMaster University, Canada
| | - Daphne J Korczak
- Department of Psychiatry, Hospital for Sick Children, Canada; and Department of Psychiatry, University of Toronto, Canada
| | - Peter Szatmari
- Department of Psychiatry, Hospital for Sick Children, Canada; Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Canada; and Department of Psychiatry, University of Toronto, Canada
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Campisi SC, Zasowski C, Shah S, Shah A, Bradley-Ridout G, Korczak DJ, Szatmari P. Assessing the Evidence of Micronutrients on Depression among Children and Adolescents: An Evidence Gap Map. Adv Nutr 2020; 11:908-927. [PMID: 32193537 PMCID: PMC7360446 DOI: 10.1093/advances/nmaa021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 01/13/2020] [Accepted: 02/12/2020] [Indexed: 12/15/2022] Open
Abstract
There is some evidence indicating that nutrition may have the ability to prevent, treat, and/or influence the severity of depression. The aims of this evidence gap map (EGM) are to provide an overview and to determine evidence gaps in the existing research on micronutrients and their impact on depression among children and adolescents. We conducted a comprehensive search in multiple databases of primary and secondary literature assessing the impact of micronutrients on depression-related outcomes such as unipolar depression, major depressive disorders, dysthymia, acute depression, and mood disorders. Abstracts and full-text articles were dual-screened based on predefined eligibility criteria. A total of 30 primary research publications were included in the EGM. About 47% of included studies focused on late adolescents (15-19 y), ∼40% on early adolescents (10-14 y), and ∼13% on children aged 6-9 y. Among the included studies, 8 studies examined a single micronutrient intervention and 22 studies examined micronutrient concentrations (either intake or serum), and their impact on depression. The most frequently studied micronutrients were vitamin D (n = 8), zinc (n = 8), iron (n = 6), folate (n = 7), and vitamin B-12 (n = 5). More longitudinal studies and trials are needed to determine the role of micronutrients in the etiology and treatment of depression among children and adolescents.
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Affiliation(s)
- Susan C Campisi
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Canada
| | - Clare Zasowski
- School of Nutrition, Ryerson University, Faculty of Community Service, Toronto, Canada
| | - Shailja Shah
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health Toronto, Canada
| | - Ashka Shah
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Daphne J Korczak
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada
- Department of Psychiatry, Hospital for Sick Children, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Canada
- Department of Psychiatry, Hospital for Sick Children, Canada
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