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Meta-Analysis
. 2014 Apr 11;6(4):1501-18.
doi: 10.3390/nu6041501.

Vitamin D and depression: a systematic review and meta-analysis comparing studies with and without biological flaws

Affiliations
Meta-Analysis

Vitamin D and depression: a systematic review and meta-analysis comparing studies with and without biological flaws

Simon Spedding. Nutrients. .

Abstract

Efficacy of Vitamin D supplements in depression is controversial, awaiting further literature analysis. Biological flaws in primary studies is a possible reason meta-analyses of Vitamin D have failed to demonstrate efficacy. This systematic review and meta-analysis of Vitamin D and depression compared studies with and without biological flaws. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was undertaken through four databases for randomized controlled trials (RCTs). Studies were critically appraised for methodological quality and biological flaws, in relation to the hypothesis and study design. Meta-analyses were performed for studies according to the presence of biological flaws. The 15 RCTs identified provide a more comprehensive evidence-base than previous systematic reviews; methodological quality of studies was generally good and methodology was diverse. A meta-analysis of all studies without flaws demonstrated a statistically significant improvement in depression with Vitamin D supplements (+0.78 CI +0.24, +1.27). Studies with biological flaws were mainly inconclusive, with the meta-analysis demonstrating a statistically significant worsening in depression by taking Vitamin D supplements (-1.1 CI -0.7, -1.5). Vitamin D supplementation (≥800 I.U. daily) was somewhat favorable in the management of depression in studies that demonstrate a change in vitamin levels, and the effect size was comparable to that of anti-depressant medication.

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Figures

Figure 1
Figure 1
Daily dose of Vitamin D per study. This shows the range of equivalent daily doses. (These were calculated after estimating the actual dose rather than using the dose shown in their published papers).
Figure 2
Figure 2
The figures show the meta-analysis of studies from the systematic review.

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