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The association between low vitamin D and depressive disorders

Molecular Psychiatry volume 19, pages 444–451 (2014)Cite this article

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Abstract

It has been hypothesized that hypovitaminosis D is associated with depression but epidemiological evidence is limited. We investigated the association between depressive disorders and related clinical characteristics with blood concentrations of 25-hydroxyvitamin D [25(OH)D] in a large cohort. The sample consisted of participants (aged 18–65 years) from the Netherlands Study of Depression and Anxiety (NESDA) with a current (N=1102) or remitted (N=790) depressive disorder (major depressive disorder, dysthymia) defined according to DSM-IV criteria, and healthy controls (N=494). Serum levels of 25(OH)D measured and analyzed in multivariate analyses adjusting for sociodemographics, sunlight, urbanization, lifestyle and health. Of the sample, 33.6% had deficient or insufficient serum 25(OH)D (<50 nmol l−1). As compared with controls, lower 25(OH)D levels were found in participants with current depression (P=0.001, Cohen’s d=0.21), particularly in those with the most severe symptoms (P=0.001, Cohen’s d=0.44). In currently depressed persons, 25(OH)D was inversely associated with symptom severity (β=−0.19, s.e.=0.07, P=0.003) suggesting a dose-response gradient, and with risk (relative risk=0.90, 95% confidence interval=0.82–0.99, P=0.03) of having a depressive disorders at 2-year follow-up. This large cohort study indicates that low levels of 25(OH)D were associated to the presence and severity of depressive disorder suggesting that hypovitaminosis D may represent an underlying biological vulnerability for depression. Future studies should elucidate whether—the highly prevalent—hypovitaminosis D could be cost-effectively treated as part of preventive or treatment interventions for depression.

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Acknowledgements

The infrastructure for the NESDA study (www.nesda.nl) is funded through the Geestkracht program of the Netherlands Organization for Health Research and Development (Zon-Mw, grant number 10-000-1002) and is supported by participating universities and mental health care organizations (VU University Medical Center, GGZ inGeest, Arkin, Leiden University Medical Center, GGZ Rivierduinen, University Medical Center Groningen, Lentis, GGZ Friesland, GGZ Drenthe, Institute for Quality of Health Care (IQ Healthcare), Netherlands Institute for Health Services Research (NIVEL) and Netherlands Institute of Mental Health and Addiction (Trimbos). Assaying of vitamin D and PTH was supported by the Neuroscience Campus Amsterdam and the Dutch Brain Foundation.

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Authors and Affiliations

  1. Department of Psychiatry, and EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands

    Y Milaneschi, A T F Beekman, J H Smit & B W J H Penninx

  2. Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands

    W Hoogendijk

  3. Department of Internal Medicine, Endocrine Section, VU University Medical Center, Amsterdam, The Netherlands

    P Lips

  4. Department of Clinical Chemistry, VU University Medical Center, The Netherlands

    A C Heijboer

  5. Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands

    R Schoevers & B W J H Penninx

  6. Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands

    A M van Hemert & B W J H Penninx

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Milaneschi, Y., Hoogendijk, W., Lips, P. et al. The association between low vitamin D and depressive disorders. Mol Psychiatry 19, 444–451 (2014). https://doi.org/10.1038/mp.2013.36

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