Vitamin D and Mood Disorders Among Women: An Integrative Review

Pamela K. Murphy, CNM, MS, IBCLC; Carol L. Wagner, MD

J Midwifery Womens Health. 2008;53(5):440-446.

Physiology of Vitamin D

Vitamin D is either absorbed by dietary intake or manufactured when epidermal 7-dehydrocholesterol converts UVB rays in the range of 290 nm to 310 nm hitting the skin into previtamin D₃.^[1,6,10,23] A thermal reaction causes previtamin D₃ to convert into vitamin D₃, also named cholecalciferol, within the epidermis. Vitamin D₃ is transported via vitamin D binding proteins to the liver, where it metabolizes into 25(OH)D, also named calcifediol, the inert form of vitamin D. Tightly regulated by parathyroid hormone, 25(OH)D converts to 1, 25-dihydroxy-vitamin D (1,25[OH]₂D), also named calcitriol, the active hormonal form of vitamin D, in the kidneys and other extra-renal tissues. 1,25(OH)₂D binds to vitamin D receptors to regulate cellular function in several tissues located in the body, including brain neurons.^[24]

Obradovic et al.^[25] demonstrated a relationship between vitamin D receptors and the regulation of glucocorticoid signaling in rat models, an important finding because dysfunctional glucocorticoid signaling has been implicated in disorders such as major depressive disorder. Glucocorticoids, a type of cortisol, are increased in the presence of major depressive disorder while bone mineral density (BMD) is decreased.^[26] Decreased BMD occurs when bone formation decreases and bone reabsorption increases, which also occurs in vitamin D deficiency.^[6] While the exact mechanisms for the link between glucocorticoids, vitamin D receptors, and mood disorders have yet to be determined, evidence exists to support future research exploring these associations.

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Cite this: Vitamin D and Mood Disorders Among Women: An Integrative Review - Medscape - Sep 01, 2008.

Abstract and Introduction
Sources of Vitamin D
Vitamin D Status
Physiology of Vitamin D
Overview of Vitamin D and Its Effects on Disease Processes
Integrative Review of the Literature
Discussion
Implications for Practice
Calls for Future Research
Conclusion
References

Research Studies Evaluating the Association of Vitamin D and Mood Disorders
Type of Mood Disorder	Author, Year	Type of Study	Sample	Measurement Instrument	Key Findings	USPSTF Rating
Major depressive disorder	Eskandari et al., 2007	Comparative descriptive	n=131; 21–45 years old; 121 white F, 10 nonspecified race	DSM-IV	25(OH)D significantly lower in women with MDD compared to controls (27±10.1 ng/mL vs. 34±14.4 ng/mL; P<.002)	Fair
Mood disorder	Wilkins et al., 2006	Comparative descriptive	n=80; =60 years old; 50 F, 30 M; 70 white, 10 AA; 40 with mild Alzheimer's, 40 non-demented	Depressive Features Battery; Depressive Symptoms Inventory	Vitamin D deficiency significantly associated with mood disorder (Wald X₂=7.66; df=2; P=.022)	Fair
Major depression	Schneider et al., 2000	Comparative descriptive	n=56; 18–85 years old, healthy; 12 F, 19 M; major depression: 14 F, 11 M*	DSM-III-R	25(OH)D serum levels not correlated to participants with major depression	Fair
SAD	Gloth, Alam, and Hollis, 1999	Randomized clinical trial	n=15; 15–61 years old; 14 F, 1 M; all white; all diagnosed with SAD	Hamilton Depression Score; SIGH-SAD; SAD-8	Increase in 25(OH)D significantly associated with improvement in depression scale scores (r²=0.26; P=.05)	Fair
PMS	Thys-Jacobs et al., 1995	Comparative descriptive	n=46; 28–42 years old; all white F	Self-recorded diary of PMS-related symptoms	PMS group had significantly lower 25(OH)D levels than controls (19.5±7.5 vs. 25.3±8.3 ng/mL; P<.02)	Fair
Seasonal mood changes	Harris and Dawson-Hughes, 1993	Randomized clinical trial	n=250, 43–72 years old, all white F	POMS questionnaire	POMS scores were not correlated with 25(OH)D serum levels	Fair

25(OH)D = 25-hydroxyvitamin D; AA = African American; DSM = Diagnostic and Statistical Manual of Mental Disorders; F = female; M = male; PMS = premenstrual syndrome; POMS = profile of mood states; SAD = seasonal affective disorder; USPSTF = U.S. Preventative Services Task Force.
*Study included because half of participants with major depression were female and therefore the study met the inclusion criteria.

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Vitamin D and Mood Disorders Among Women: An Integrative Review

Physiology of Vitamin D

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