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Adherence to the Mediterranean diet and risk of depression: a systematic review and updated meta-analysis of observational studies.
Shafiei, F, Salari-Moghaddam, A, Larijani, B, Esmaillzadeh, A
Nutrition reviews. 2019;(4):230-239
Abstract
CONTEXT More than 300 million people worldwide have been diagnosed with depression, which is a leading cause of disability and disease burden. Elucidating dietary patterns that may reduce the risk of depression could help reduce the incidence of other diseases. DATA SOURCES PubMed/MEDLINE, ISI Web of Science, Scopus, Embase, and Google Scholar databases were searched to identify relevant publications up to May 2018. STUDY SELECTION All observational studies that considered the Mediterranean diet as the exposure variable and depression as the main outcome or as one of the outcome variables were included in this systematic review and meta-analysis. Two authors independently screened 3229 publications. A total of 14 observational studies were included in the meta-analysis. DATA EXTRACTION Two authors independently extracted the data and assessed the risk of bias. RESULTS The studies in the meta-analysis included a total of 56 043 participants. When 5 effect sizes from 4 cohort studies were combined, no significant association was observed between adherence to the Mediterranean diet and risk of depression (overall hazard ratio = 0.95; 95%CI, 0.79-1.16). When 3 effect sizes from 3 cohort studies that reported β coefficients were combined, again no significant association was found (β = -0.00; 95%CI, -0.12, 0.12). However, when 9 effect sizes from 9 cross-sectional studies were combined, an inverse significant association was found between adherence to the Mediterranean diet and risk of depression (overall odds ratio = 0.72; 95%CI, 0.60-0.87). CONCLUSIONS The analysis of cohort studies revealed no significant association was found between adherence to the Mediterranean diet and risk of depression. However, an inverse significant association between adherence to the Mediterranean diet and odds of depression in cross-sectional studies.
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Prebiotics and probiotics for depression and anxiety: A systematic review and meta-analysis of controlled clinical trials.
Liu, RT, Walsh, RFL, Sheehan, AE
Neuroscience and biobehavioral reviews. 2019;:13-23
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Abstract
With growing interest in the gut microbiome, prebiotics and probiotics have received considerable attention as potential treatments for depression and anxiety. We conducted a random-effects meta-analysis of 34 controlled clinical trials evaluating the effects of prebiotics and probiotics on depression and anxiety. Prebiotics did not differ from placebo for depression (d = -.08, p = .51) or anxiety (d = .12, p = .11). Probiotics yielded small but significant effects for depression (d = -.24, p < .01) and anxiety (d = -.10, p = .03). Sample type was a moderator for probiotics and depression, with a larger effect observed for clinical/medical samples (d = -.45, p < .001) than community ones. This effect increased to medium-to-large in a preliminary analysis restricted to psychiatric samples (d = -.73, p < .001). There is general support for antidepressant and anxiolytic effects of probiotics, but the pooled effects were reduced by the paucity of trials with clinical samples. Additional randomized clinical trials with psychiatric samples are necessary fully to evaluate their therapeutic potential.
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The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis.
Wang, X, Li, Y, Fan, H
BMC public health. 2019;(1):1524
Abstract
BACKGROUND The use of computers/TV has become increasingly common worldwide after entering the twenty-first century and depression represents a growing public health burden. Understanding the association between screen time-based sedentary behavior (ST-SB) and the risk of depression is important to the development of prevention and intervention strategies. METHODS We searched the electronic databases of Medline, Embase and the Cochrane Library. The odds ratio (OR) with corresponding 95% confidence intervals (CIs) was adopted as the pooled measurement. Subgroup analyses were investigated by stratified meta-analyses based on age, gender and reference group (reference category of screen time, e.g. 2 h/day, 4 h/day). RESULTS There were 12 cross-sectional studies and 7 longitudinal studies met the inclusion criteria. Overall, the pooled OR was 1.28 with high heterogeneity (I2 = 89%). Compared to those who reported less SB, persons reporting more SB had a significantly higher risk of depression. When the gender was stratified, the pooled OR was 1.18 in female groups while no significant association was observed in males. Among the 19 studies, 5 studies used a reference group with ST = 2 h/days (pooled OR = 1.46), 9 studies used ≥4 h as a reference group (pooled OR = 1.38), 2 studies used 1 h as a reference group (pooled OR = 1.07) and for the remaining 3 studies, hours of ST were calculated as a continuous variable (pooled OR = 1.04). CONCLUSIONS ST-SB is associated with depression risk and the effects vary in different populations. In addition, valid objective measures of SB should be developed in future studies.
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Systematic review and meta-analysis of omega-3-fatty acids in elderly patients with depression.
Bae, JH, Kim, G
Nutrition research (New York, N.Y.). 2018;:1-9
Abstract
One of the typical symptoms of a psychological crisis is depression, an increasing concern in the elderly population. Although omega-3-polyunsaturated fatty acids (PUFAs) are reported to be promising nutrients for treating depression, currently, there are no systematic reviews or meta-analyses of randomized control trials that provide critical evidence regarding the potential benefits of omega-3 fatty acids in elderly patients with depression. This analysis was conducted to provide evidence for the clinical application of omega-3 fatty acids in the treatment of depressive symptoms of elderly subjects older than 65 years. Seven databases were searched from their inception date until September 2016. Following this search, 6 studies were selected, which included 4605 patients (mean age, 76.97 years; male-female ratio=3752:853; mean dose of omega 3 intake, 1.3 g/d). These results were divided into 2 categories: well-being mental health group and depressive group. In the well-being mental health group, the Hedges g was 0.12 (95% confidence interval, -0.05 to 0.29), which indicated no significant effect of n-3 PUFA supplementation on depressed mood compared with placebo. In the depressive group, the pooled Hedges g was -0.94 (95% CI, -1.37 to -0.50]) for the random-effects model, which indicated a large effect of n-3 PUFA supplementation on those with depressed mood compared with placebo. Although this review shows that omega-3 fatty acids are effective in the treatment of elderly depressed patients, the benefits of omega-3 fatty acid supplementation were significant only in the elderly patients with mild to moderate depression.
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Efficacy and Safety of Xiaoyao Formula as an Adjuvant Treatment for Post-Stroke Depression: A Meta-Analysis.
Jin, X, Jiang, M, Gong, D, Chen, Y, Fan, Y
Explore (New York, N.Y.). 2018;(3):224-229
Abstract
OBJECTIVE To systematically evaluate the efficacy and safety of Xiaoyao formula (XYF) as an adjuvant treatment of post-stroke depression (PSD) by conducting a meta-analysis. METHODS Pubmed, Embase, Cochrane Library, CNKI, VIP, and Wanfang databases were searched up to May 2016. Randomized controlled trials investigating XYF plus antidepressants versus antidepressants alone for patients with PSD were considered. RESULTS A total of 607 PSD patients were identified from 7 trials. Adjuvant treatment with XYF had additional benefits in terms of improved total response rates (risk ratio [RR] 1.21; 95% confidence interval [CI]: 1.12-1.30), reduced Hamilton's depressive scale (weighted mean difference [WMD] -5.21; 95% CI: -7.48 to -2.95), and decreased Scandinavian Stroke Scale (WMD -6.35; 95% CI: -8.27 to -4.43). No serious adverse events were observed in any of the included trials. CONCLUSIONS Adjuvant treatment with XYF appears to have additional benefits in the treatment of PSD, without increasing serious adverse events.
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Maternal depression and childhood obesity: a systematic review.
Lampard, AM, Franckle, RL, Davison, KK
Preventive medicine. 2014;:60-7
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Abstract
OBJECTIVE Maternal depression is prevalent and has been associated with parenting practices that influence child weight. In this systematic review we aimed to examine the prospective association between maternal depression and child overweight. METHODS We searched four databases (PsycINFO, PubMed, Embase, and Academic Search Premier) to identify studies for inclusion. We included studies with a prospective design with at least one year follow-up, measuring maternal depression at any stage after childbirth, and examining child overweight or obesity status, body mass index z-score or percentile, or adiposity. Two authors extracted data independently and findings were qualitatively synthesized. RESULTS We identified nine prospective studies for inclusion. Results were examined separately for episodic depression (depression at a single measurement occasion) and chronic depression (depression on multiple measurement occasions). Mixed results were observed for the relationship between episodic depression and indicators of child adiposity. Chronic depression, but not episodic depression, was associated with greater risk for child overweight. CONCLUSIONS While chronic depression may be associated with child overweight, further research is needed. Research is also needed to determine whether maternal depression influences child weight outcomes in adolescence and to investigate elements of the family ecology that may moderate the effect of maternal depression on child overweight.
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Investigating the possible causal association of smoking with depression and anxiety using Mendelian randomisation meta-analysis: the CARTA consortium.
Taylor, AE, Fluharty, ME, Bjørngaard, JH, Gabrielsen, ME, Skorpen, F, Marioni, RE, Campbell, A, Engmann, J, Mirza, SS, Loukola, A, et al
BMJ open. 2014;(10):e006141
Abstract
OBJECTIVES To investigate whether associations of smoking with depression and anxiety are likely to be causal, using a Mendelian randomisation approach. DESIGN Mendelian randomisation meta-analyses using a genetic variant (rs16969968/rs1051730) as a proxy for smoking heaviness, and observational meta-analyses of the associations of smoking status and smoking heaviness with depression, anxiety and psychological distress. PARTICIPANTS Current, former and never smokers of European ancestry aged ≥16 years from 25 studies in the Consortium for Causal Analysis Research in Tobacco and Alcohol (CARTA). PRIMARY OUTCOME MEASURES Binary definitions of depression, anxiety and psychological distress assessed by clinical interview, symptom scales or self-reported recall of clinician diagnosis. RESULTS The analytic sample included up to 58 176 never smokers, 37 428 former smokers and 32 028 current smokers (total N=127 632). In observational analyses, current smokers had 1.85 times greater odds of depression (95% CI 1.65 to 2.07), 1.71 times greater odds of anxiety (95% CI 1.54 to 1.90) and 1.69 times greater odds of psychological distress (95% CI 1.56 to 1.83) than never smokers. Former smokers also had greater odds of depression, anxiety and psychological distress than never smokers. There was evidence for positive associations of smoking heaviness with depression, anxiety and psychological distress (ORs per cigarette per day: 1.03 (95% CI 1.02 to 1.04), 1.03 (95% CI 1.02 to 1.04) and 1.02 (95% CI 1.02 to 1.03) respectively). In Mendelian randomisation analyses, there was no strong evidence that the minor allele of rs16969968/rs1051730 was associated with depression (OR=1.00, 95% CI 0.95 to 1.05), anxiety (OR=1.02, 95% CI 0.97 to 1.07) or psychological distress (OR=1.02, 95% CI 0.98 to 1.06) in current smokers. Results were similar for former smokers. CONCLUSIONS Findings from Mendelian randomisation analyses do not support a causal role of smoking heaviness in the development of depression and anxiety.
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Depression and risk of stroke: a meta-analysis of prospective studies.
Dong, JY, Zhang, YH, Tong, J, Qin, LQ
Stroke. 2012;(1):32-7
Abstract
BACKGROUND AND PURPOSE A history of depression may be associated with an increased risk of stroke. We aimed to determine the association between depression and risk of stroke by performing a meta-analysis of prospective studies. METHODS Relevant studies were identified by a PubMed database search through May 2011 without restrictions and by reviewing reference lists of obtained articles. Community-based or population-based prospective studies that reported relative risk estimates with 95% confidence intervals for the association between depression and stroke were selected. Studies that enrolled participants with preexisting stroke at baseline were excluded. A random-effects model was used to compute the pooled risk estimate. RESULTS Random-effects meta-analysis of 17 prospective studies involving 206 641 participants and 6086 cases demonstrated a significant positive association between depression and subsequent risk of stroke (pooled relative risk, 1.34; 95% confidence interval, 1.17-1.54) after adjustment for potential confounding factors. The associations were similar between men and women. Potential publication bias may exist, but correction for this bias using a formal statistical method did not materially alter the combined risk estimate. CONCLUSIONS Depression significantly increased the risk of development of stroke, and this increase was probably independent of other risk factors, including hypertension and diabetes.
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No association with the 5,10-methylenetetrahydrofolate reductase gene and major depressive disorder: results of the depression case control (DeCC) study and a meta-analysis.
Gaysina, D, Cohen, S, Craddock, N, Farmer, A, Hoda, F, Korszun, A, Owen, MJ, Craig, IW, McGuffin, P
American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics. 2008;(6):699-706
Abstract
Unipolar major depressive disorder (MDD) is a complex disorder thought to result from multiple genes in combination with environmental and developmental components. The 5,10-methylenetetrahydrofolate reductase gene (MTHFR) has been implicated in MDD in a meta-analysis of association studies and is within a linkage region suggested by a recent study of affected sib pairs. A single base mutation in the MTHFR gene (C677T) results in the production of a mildly dysfunctional thermolabile enzyme. The MTHFR 677TT genotype, and to a lesser extent the 677CT genotype, is associated with a significant elevation in the circulating concentrations of homocysteine and a decrease in serum folate concentrations. This may parallel a similar reduction in 5-methyltetrahydrofolate in the CNS, leading to a potential reduction in monoamine neurotransmitter function and an elevated risk of depressive disorder. To test the hypothesis that the MTHFR C677T polymorphism is involved in the predisposition to MDD, we conducted an association study of 1,222 patients with recurrent MDD and 835 control subjects. This allows 99% power to detect an effect of the size reported in the study of Bjelland et al. 2003, however no significant differences in genotype or allele frequencies between depressive patients and controls were observed. This was the case in the sample as a whole, and when females and males were considered separately. Our findings suggest that the MTHFR C677T polymorphism is not involved in the etiology of clinically significant recurrent MDD.
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Excess mortality in depression: a meta-analysis of community studies.
Cuijpers, P, Smit, F
Journal of affective disorders. 2002;(3):227-36
Abstract
BACKGROUND Although most studies examining the relationship between depression and mortality indicate that there is excess mortality in depressed subjects, this is not confirmed in all studies. Furthermore, it has been hypothesized that mortality rates in depressed men are higher than in depressed women. Finally, it is not clear if the increased mortality rates exist only in major depression or also in subclinical depression. METHODS A meta-analysis was conducted to examine these questions. A total of 25 studies with 106,628 subjects, of whom 6416 were depressed, were examined. Both univariate and multivariate analyses were conducted. RESULTS The overall relative risk (RR) of dying in depressed subjects was 1.81 (95% CI: 1.58-2.07) compared to non-depressed subjects. No major differences were found between men and women, although the RR was somewhat larger in men. The RR in subclinical depression was no smaller than the RR in clinical depression. LIMITATIONS Only RRs of mortality were examined, which were not corrected for important confounding variables, such as chronic illnesses, or life-style. In the selected studies important differences existed between study characteristics and populations. The number of comparisons was relatively small. CONCLUSIONS There is an increased risk of mortality in depression. An important finding of this study is that the increased risk not only exists in major depression, but also in subclinical forms of depression. In many cases, depression should be considered as a life-threatening disorder.