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Review
. 2014 Apr;76(3):190-6.
doi: 10.1097/PSY.0000000000000044.

Vitamin D supplementation for depressive symptoms: a systematic review and meta-analysis of randomized controlled trials

Jonathan A Shaffer  1 , Donald Edmondson, Lauren Taggart Wasson, Louise Falzon, Kirsten Homma, Nchedcochukwu Ezeokoli, Peter Li, Karina W Davidson
Affiliations
Review

Vitamin D supplementation for depressive symptoms: a systematic review and meta-analysis of randomized controlled trials

Jonathan A Shaffer et al. Psychosom Med. 2014 Apr.

Abstract

Objective: The aim of this study was to review the effects of vitamin D supplementation on depressive symptoms in randomized controlled trials. Although low vitamin D levels have been observationally associated with depressive symptoms, the effect of vitamin D supplementation as an antidepressant remains uncertain.

Methods: MEDLINE, CINAHL, AMED, PsycINFO, Scopus, The Cochrane Library, and references of included reports (through May 2013) were searched. Two independent reviewers identified and extracted data from randomized trials that compared the effect of vitamin D supplementation on depressive symptoms to a control condition. Two additional reviewers assessed study quality using The Cochrane Risk of Bias Tool. Seven trials (3191 participants) were included.

Results: Vitamin D supplementation had no overall effect on depressive symptoms (standardized mean difference [SMD], 0.14; 95% confidence interval [CI], -0.33 to 0.05, p = .16), although considerable heterogeneity was observed. Subgroup analysis showed that vitamin D supplementation for participants with clinically significant depressive symptoms or depressive disorder had a moderate, statistically significant effect (2 studies: SMD, -0.60; 95% CI, -1.19 to -0.01; p = .046), but a small, nonsignificant effect for those without clinically significant depression (5 studies: SMD, -0.04; 95% CI, -0.20 to 0.12; p = .61). Most trials had unclear or high risk of bias. Studies varied in the amount, frequency, duration, and mode of delivery of vitamin D supplementation.

Conclusions: Vitamin D supplementation may be effective for reducing depressive symptoms in patients with clinically significant depression; however, further high-quality research is needed.

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Figures

Figure 1
Figure 1
Forest plots of randomized controlled trials investigating the effect of vitamin D supplementation on depressive symptoms, overall and by depression and vitamin D status. Five weighted pooled intervention effect estimates (diamonds) are shown: one for the full set of 7 trials (overall) and one each for nondepressed participants, depressed participants, participants with sufficient vitamin D, and participants with insufficient vitamin D. Data are expressed as standardized mean differences with 95% CI, using the inverse-variance method and random-effects models. Trials categorized as “nondepressed” did not specifically recruit participants with depression or included participants whose baseline depressive symptom scores were indicative of no or mild depression; trials categorized as “depressed” included participants with clinically significant depressive symptoms and/or major depressive disorder. Categorization of trials as “sufficient vitamin D” or “insufficient vitamin D” was based on participants’ baseline concentrations of 25-hydroxyvitamin D and established cutpoints for interpreting these concentrations (7).
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