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.

Calls for Future Research

Further research of the effects of vitamin D deficiency on mood disorders in women (including perinatal and postpartum depression, because no studies were found on either of these topics) is warranted and must incorporate rigorous methods focusing on a specific mood disorder. In addition, it is important to incorporate sufficient sample sizes of females of white, African American, Hispanic, and other ethnicities, and of ages appropriate to the mood disorder grouped according to phase of menstruation (pre-, peri-, or postmenopausal or, if experiencing their menstrual cycle, the time the depressive symptoms and 25[OH]D levels are assessed). A comparison between geographic location and season should be considered. Variables should be clearly defined and instruments should be validated and proven reliable. Analyses should incorporate not only serum 25(OH)D levels but also standardized classification of these levels into deficient, optimal, and toxic states. Close attention should be paid to ensure that 25(OH)D levels are drawn at least 3 months after a stable regimen of vitamin D intake is confirmed, because this is how long it takes for 25(OH)D levels to stabilize depending on sun exposure and dietary intake.^[19] Confounding variables should be controlled, including ethnicity/race, degree of skin pigmentation, study location (if multicentered), season of data collection, dietary intake, and daily sun exposure if supplementation with vitamin D is used as an intervention.

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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

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