Swainson Jennifer, Reeson Matthew, Malik Usama, Stefanuk Ian, Cummins Mary, Sivapalan Sudhakar
Dept of Psychiatry, University of Alberta. Edmonton, AB, Canada.
Dept of Psychiatry, University of Alberta. Edmonton, AB, Canada.
J Affect Disord. 2023 Apr 14;327:270-278. doi: 10.1016/j.jad.2023.01.094. Epub 2023 Feb 3.
BACKGROUND & RATIONALE: Depression is a common mental illness that afflicts over 300 million individuals worldwide. Despite a variety of therapeutic options available, a significant number of depressed patients fail to respond to treatment. Current guidelines for treating depression suggest that supplementation of essential nutrients may be an appropriate adjunctive to treatment, but research investigating full dietary interventions for depressed patients is scarce.
The primary aim of this study was to systematically review published scientific literature investigating full dietary interventions as treatment for individuals with a diagnosis of depression. In doing so, we assessed existing evidence for recommendation of a dietary intervention and reviewed theory of how diet may be important in this context.
A systematic search was conducted using OVID to search Medline, PsychINFO, and EMBASE, and PubMed for relevant publications. Only studies including full dietary interventions for patients with Major Depressive Episode, Major Depressive Disorder, Persistent Depressive Disorder, Seasonal Affective Disorder, or Dysthymia, as diagnosed using criteria defined in the chapter of "Depressive Disorders" in the DSM, were included.
Only five studies met the inclusion criteria for this review. All five studies included in this review reported improvements in mood following dietary intervention as compared to the comparison group. However, heterogeneity in both the dietary intervention and the outcome(s) measured made it difficult to compare these studies against each other and to generalize them to larger populations.
The findings of this review provide preliminary evidence for the positive impact of dietary interventions in the treatment of depressed patients. However, the mechanism by which particular diets induce positive changes in mood, be it through anti-inflammatory mechanisms or via weight loss in overweight patients, is unclear. Future research investigating the impact of dietary interventions on a large-scale is warranted and needed.
抑郁症是一种常见的精神疾病，全球有超过3亿人受其困扰。尽管有多种治疗选择，但仍有相当数量的抑郁症患者对治疗无反应。当前抑郁症治疗指南表明，补充必需营养素可能是一种合适的辅助治疗方法，但针对抑郁症患者进行全面饮食干预的研究却很少。
本研究的主要目的是系统回顾已发表的科学文献，这些文献研究了全面饮食干预作为抑郁症患者治疗方法的情况。在此过程中，我们评估了推荐饮食干预的现有证据，并回顾了饮食在这种情况下可能重要的理论。
使用OVID系统检索Medline、PsychINFO和EMBASE以及PubMed以获取相关出版物。仅纳入了根据《精神疾病诊断与统计手册》“抑郁障碍”章节中定义的标准诊断为重度抑郁发作、重度抑郁障碍、持续性抑郁障碍、季节性情感障碍或恶劣心境的患者进行全面饮食干预的研究。
只有五项研究符合本综述的纳入标准。本综述纳入的所有五项研究均报告称，与对照组相比，饮食干预后情绪有所改善。然而，饮食干预和所测量的结果的异质性使得难以将这些研究相互比较并推广到更大的人群。
本综述的结果为饮食干预对抑郁症患者治疗的积极影响提供了初步证据。然而，特定饮食通过抗炎机制或超重患者体重减轻导致情绪产生积极变化的机制尚不清楚。未来有必要且需要开展大规模研究来调查饮食干预的影响。
