Integrative Review of the Literature
An integrative review includes studies using both experimental and non-experimental methodologies and thus was the chosen method to compile the findings of six quantitative research studies completed in the past 37 years (1971–2008). This timeframe was chosen because the research article premiering the assay to evaluate serum 25(OH)D was first published in 1971 by Haddad and Chyu. These six research articles were selected because each study conducted compared serum 25(OH)D and mood disorders that affect women, including SAD, PMS, major depressive disorder, and other mood disorders.
Peer-reviewed research studies were located using the CINAHL, PsycINFO, MEDLINE, and PubMed databases, as well as ancestry searching of reference lists from selected articles, using the following keywords: vitamin D; 25-hydroxyvitamin D (25[OH]D); depression; seasonal affective disorder; premenstrual syndrome; postpartum depression; perinatal depression; depressive disorder; mood disorder; and women. Studies were included if the sample consisted of at least 50% women; if the focus was on subjects with major depressive disorder, SAD, PMS, postpartum depression, perinatal depression, or other mood disorders; and if serum 25(OH)D was measured.
Of 11 studies initially identified, five were eliminated because they did not meet the inclusion criteria.[44,45,46,47,48] The final six studies consist of one focused on SAD; one on seasonal mood changes (not defined as SAD); one on PMS; one on major depressive disorder; one on major depression; and one on mood disorders. No studies focusing on postpartum or perinatal depression were identified.
The six studies were critiqued using the U.S. Preventative Services Task Force (USPSTF) rating system to evaluate the strength of the research. The USPSTF uses specific guidelines to evaluate the quality of the evidence pertaining to a specific topic in order to develop evidence-based clinical practice guidelines. These ratings are then used to determine the strength of the evidence.
Each study is given a rating of good, fair, or poor based on the evaluation of specific criteria of each type of study design. The criteria evaluated for randomized clinical trials (RCT) include: randomization of groups; distribution of confounders equally among groups; minimization of participant's loss to follow-up; equal, valid, and reliable measurements; clearly defined interventions; and consideration of all important outcomes. For descriptive studies, the criteria include: the evaluation of valid evidence for the setting and population under study, the evaluation of generalizable findings and application to other populations, and the determination of logical findings. The key findings of the studies evaluated are presented in Table 1 . Findings are limited to results that address mood disorders and serum 25(OH)D.
J Midwifery Womens Health. 2008;53(5):440-446. © 2008 Elsevier Science, Inc.
Cite this: Vitamin D and Mood Disorders Among Women: An Integrative Review - Medscape - Sep 01, 2008.