Journal Article

Effect of vitamin D deficiency on depressive symptoms in child and adolescent psychiatric patients: results of a randomized controlled trial

Hahn, Denise, Grasemann, Corinna, Timmesfeld, Nina, Ring, Stefanie, Antel, Jochen, Hinney, Anke, Libuda, Lars, Föcker, Manuel, Bühlmeier, Judith, Öztürk, Dana, Führer, Dagmar, Hirtz, Raphael, Langenbach, Gina, Peters, Triinu, Hebebrand, Johannes, Bauer, Jens, Zwanziger, Denise

2020

Overview

Purpose While observational studies revealed inverse associations between serum vitamin D levels [25(OH)D] and depression, randomized controlled trials (RCT) in children and adolescents are lacking. This RCT examined the effect of an untreated vitamin D deficiency compared to an immediate vitamin D 3 supplementation on depression scores in children and adolescents during standard day and in-patient psychiatric treatment. Methods Patients with vitamin D deficiency [25(OH)D ≤ 30 nmol/l] and at least mild depression [Beck Depression Inventory II (BDI-II) > 13] ( n  = 113) were 1:1 randomized into verum (VG; 2640 IU vitamin D 3 /d) or placebo group (PG) in a double-blind manner. During the intervention period of 28 days, both groups additionally received treatment as usual. BDI-II scores were assessed as primary outcome, DISYPS-II (Diagnostic System for Mental Disorders in Childhood and Adolescence, Self- and Parent Rating) and serum total 25(OH)D were secondary outcomes. Results At admission, 49.3% of the screened patients ( n  = 280) had vitamin D deficiency. Although the intervention led to a higher increase of 25(OH)D levels in the VG than in the PG (treatment difference: + 14 ng/ml; 95% CI 4.86–23.77; p  = 0.003), the change in BDI-II scores did not differ (+ 1.3; 95% CI − 2.22 to 4.81; p  = 0.466). In contrast, DISYPS parental ratings revealed pronounced improvements of depressive symptoms in the VG (− 0.68; 95% CI − 1.23 to − 0.13; p  = 0.016). Conclusion Whereas this study failed to show a vitamin D supplementation effect on self-rated depression in adolescent in- or daycare patients, parents reported less depressive symptoms in VG at the end of our study. Future trials should consider clinician-rated depressive symptoms as primary outcome. Trial registration “German Clinical Trials Register” ( https://www.drks.de ), registration number: DRKS00009758

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Adolescence / Adolescent / Adolescents / blood serum / Chemistry / Chemistry and Materials Science / Child / Child & adolescent psychiatry / childhood / Children / Childrens health / Cholecalciferol / Clinical trials / Daycare / Depression / Dietary Supplements / Double-Blind Method / Humans / inventories / Mental depression / Mental disorders / Nutrition / Original Contribution / Patients / placebos / randomized clinical trials / Supplements / Teenagers / Vitamin D / Vitamin D Deficiency - complications / Vitamin D Deficiency - drug therapy / Vitamin D3 / Vitamin deficiency / Vitamins