The Relationship Between Vitamin D Levels and the Severity of Anxiety and Depression in Patients Under Methadone Maintenance Treatment
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 11 No. 3 (2021),
18 July 2021
,
Page 34968
https://doi.org/10.32598/ijmtfm.v11i3.34968
Abstract
Background: Hypovitaminosis D, low bone mineral density, non-specific musculoskeletal pain, increased risk of fracture, and periodontal disease were reported in most subjects recruited from the Methadone Maintenance Treatment (MMT) program. This study aimed to determine the relationship between vitamin D levels and the severity of anxiety and depression in patients under MMT.
Methods: In a cross-sectional study, serum vitamin D levels were measured among 500 patients under MMT from Kashan Province, Iran. Correlation tests were used to assess the association of vitamin D levels with the severity of anxiety and depression in the explored patients.
Results: We found that serum vitamin D levels were positively correlated with the scores of the Beck Depression Inventory (BDI) (r=0.107, P=0.017) and the Beck Anxiety Inventory (BAI) (r=0.129, P=0.004). Additionally, there was a negative correlation between serum vitamin D levels, MMT dosage (r=-0.011, P=0.8), and the duration of MMT (r=-0.017, P=0.7).
Conclusion: Our findings demonstrated that serum vitamin D levels were independently correlated with the BDI and BAI scores. Further studies are required to confirm our findings.
- Vitamin D
- Anxiety
- Depression
- Methadone
How to Cite
References
Forouzanfar MH, Sepanlou SG, Shahraz S, Dicker D, Naghavi P, Pourmalek F, et al. Evaluating causes of death and morbidity in Iran, global burden of diseases, injuries, and risk factors study 2010. Arch Iran Med. 2014; 17(5):304-20. [PMID]
United Nations Office on Drugs Crime. World drug report. New York: United Nations Publications; 2016. https://books.google.com/books/about/World_Drug_Report_2016.html?id=zyWWDwAAQBAJ&source=kp_book_description
Amin-Esmaeili M, Rahimi-Movaghar A, Sharifi V, Hajebi A, Radgoodarzi R, Mojtabai R, et al. Epidemiology of illicit drug use disorders in Iran: Prevalence, correlates, comorbidity and service utilization results from the Iranian Mental Health Survey. Addiction (Abingdon, England). 2016; 111(10):1836-47. [DOI:10.1111/add.13453] [PMID]
Kourounis G, Richards BD, Kyprianou E, Symeonidou E, Malliori MM, Samartzis L. Opioid substitution therapy: Lowering the treatment thresholds. Drug Alcohol Depend. 2016; 161:1-8. [DOI:10.1016/j.drugalcdep.2015.12.021] [PMID]
Lankarani KB, Afshari R. Alcohol consumption in Iran. Lancet. 2014; 384(9958):1927-8. [DOI:10.1016/S0140-6736(14)62279-0]
Lankarani KB, Alavian SM, Peymani P. Health in the Islamic republic of Iran, challenges and progresses. Med J Islam Repub Iran. 2013; 27(1):42-9. [PMCID]
Callaly T, Trauer T, Munro L, Whelan G. Prevalence of psychiatric disorder in a methadone maintenance population. Aust N Z J Psychiatry. 2001; 35(5):601-5. [DOI:10.1080/0004867010060507] [PMID]
Heaney RP, Dowell MS, Hale CA, Bendich A. Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr. 2003; 22(2):142-6. [DOI:10.1080/07315724.2003.10719287] [PMID]
Holick MF, Chen TC. Vitamin D deficiency: A worldwide problem with health consequences. Am J Clin Nutr. 2008; 87(4):1080s-6. [DOI:10.1093/ajcn/87.4.1080S] [PMID]
Tabrizi R, Moosazadeh M, Akbari M, Dabbaghmanesh MH, Mohamadkhani M, Asemi Z, et al. High prevalence of vitamin d deficiency among Iranian population: A systematic review and meta-analysis. Iran J Med Sci. 2018; 43(2):125-39. [PMCID]
Hagenau T, Vest R, Gissel TN, Poulsen CS, Erlandsen M, Mosekilde L, et al. Global vitamin D levels in relation to age, gender, skin pigmentation and latitude: An ecologic meta-regression analysis. Osteoporos Int. 2009; 20(1):133-40. [DOI:10.1007/s00198-008-0626-y] [PMID]
Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004; 80(6 S):1678s-88. [DOI:10.1093/ajcn/80.6.1678S] [PMID]
Holick MF. Vitamin D: Importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am J Clin Nutr. 2004; 79(3):362-71. [DOI:10.1093/ajcn/79.3.362] [PMID]
Kim TW, Alford DP, Malabanan A, Holick MF, Samet JH. Low bone density in patients receiving methadone maintenance treatment. Drug Alcohol Depend. 2006; 85(3):258-62. [DOI:10.1016/j.drugalcdep.2006.05.027] [PMID] [PMCID]
Kim TW, Alford DP, Holick MF, Malabanan AO, Samet JH. Low vitamin d status of patients in methadone maintenance treatment. J Addict Med. 2009; 3(3):134-8. [DOI:10.1097/ADM.0b013e31819b736d] [PMID] [PMCID]
Ghaderi A, Banafshe HR, Motmaen M, Rasouli-Azad M, Bahmani F, Asemi Z. Clinical trial of the effects of vitamin D supplementation on psychological symptoms and metabolic profiles in maintenance methadone treatment patients. Prog Neuropsychopharmacol Biol Psychiatry. 2017; 79(Pt B):84-9. [DOI:10.1016/j.pnpbp.2017.06.016] [PMID]
Hoogendijk WJ, Lips P, Dik MG, Deeg DJ, Beekman AT, Penninx BW. Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults. Arch Gen Psychiatry. 2008; 65(5):508-12. [DOI:10.1001/archpsyc.65.5.508] [PMID]
Lee DM, Tajar A, O’Neill TW, O’Connor DB, Bartfai G, Boonen S, et al. Lower vitamin D levels are associated with depression among community-dwelling European men. J Psychopharmacol. 2011; 25(10):1320-8. [DOI:10.1177/0269881110379287] [PMID]
Bicikova M, Duskova M, Vitku J, Kalvachova B, Ripova D, Mohr P, et al. Vitamin D in anxiety and affective disorders. Physiol Res. 2015; 64(S2):S101-3. [DOI:10.33549/physiolres.933082] [PMID]
Zhao G, Ford ES, Li C, Balluz LS. No associations between serum concentrations of 25-hydroxyvitamin D and parathyroid hormone and depression among U.S. adults. Br J Nutr. 2010; 104(11):1696-702. [DOI:10.1017/S0007114510002588] [PMID]
Can MS, Baykan H, Baykan O, Erensoy N, Karlidere T. Vitamin D levels and vitamin D receptor gene polymorphism in major depression. Psychiatr Danub. 2017; 29(2):179-85. [DOI:10.24869/psyd.2017.179] [PMID]
Fernandes de Abreu DA, Eyles D, Feron F. Vitamin D, a neuro-immunomodulator: Implications for neurodegenerative and autoimmune diseases. Psychoneuroendocrinology. 2009; 34(S1):S265-77. [DOI:10.1016/j.psyneuen.2009.05.023] [PMID]
Sassi F, Tamone C, D’Amelio P. Vitamin D: Nutrient, hormone, and immunomodulator. Nutrients. 2018; 10(11):1656. [DOI:10.3390/nu10111656] [PMID] [PMCID]
Kesby JP, Turner KM, Alexander S, Eyles DW, McGrath JJ, Burne THJ. Developmental vitamin D deficiency alters multiple neurotransmitter systems in the neonatal rat brain. Int J Dev Neurosci. 2017; 62:1-7. [DOI:10.1016/j.ijdevneu.2017.07.002] [PMID]
Eyles DW, Smith S, Kinobe R, Hewison M, McGrath JJ. Distribution of the vitamin D receptor and 1 alpha-hydroxylase in human brain. J Chem Neuroanat. 2005; 29(1):21-30. [DOI:10.1016/j.jchemneu.2004.08.006] [PMID]
Zhou Q, Shao YC, Gan ZQ, Fang LS. Lower vitamin D levels are associated with depression in patients with gout. Neuropsychiatr Dis Treat. 2019; 15:227-31. [DOI:10.2147/NDT.S193114] [PMID] [PMCID]
Kim SH, Seok H, Kim DS. Relationship between serum vitamin D levels and symptoms of depression in stroke patients. Ann Rehabil Med. 2016; 40(1):120-5. [DOI:10.5535/arm.2016.40.1.120] [PMID] [PMCID]
Fond G, Godin O, Schurhoff F, Berna F, Bulzacka E, Andrianarisoa M, et al. Hypovitaminosis D is associated with depression and anxiety in schizophrenia: Results from the national FACE-SZ cohort. Psychiatry Res. 2018; 270:104-10. [DOI:10.1016/j.psychres.2018.09.024] [PMID]
Yao Y, Fu S, Zhang H, Li N, Zhu Q, Zhang F, et al. The prevalence of depressive symptoms in Chinese longevous persons and its correlation with vitamin D status. BMC Geriatr. 2018; 18(1):198. [DOI:10.1186/s12877-018-0886-0] [PMID] [PMCID]
Han B, Zhu FX, Yu HF, Liu S, Zhou JL. Low serum levels of vitamin D are associated with anxiety in children and adolescents with dialysis. Sci Rep. 2018; 8(1):5956. [DOI:10.1038/s41598-018-24451-7] [PMID] [PMCID]
Ju SY, Lee YJ, Jeong SN. Serum 25-hydroxyvitamin D levels and the risk of depression: A systematic review and meta-analysis. J Nutr Health Aging. 2013; 17(5):447-55. [DOI:10.1007/s12603-012-0418-0] [PMID]
Casseb GAS, Ambrosio G, Rodrigues ALS, Kaster MP. Levels of 25-hydroxyvitamin D3, biochemical parameters and symptoms of depression and anxiety in healthy individuals. Metab Brain Dis. 2019; 34(2):527-35. [DOI:10.1007/s11011-018-0371-7] [PMID]
Ulusoy H, Sarica N, Arslan S, Ozyurt H, Cetin I, Birgul Ozer E, et al. Serum vitamin D status and bone mineral density in fibromyalgia. Bratisl Lek Listy. 2010; 111(11):604-9. [PMID]
Kwasky AN, Groh CJ. Vitamin D and depression: Is there a relationship in young women? J Am Psychiatr Nurses Assoc. 2012; 18(4):236-43. [DOI:10.1177/1078390312452451] [PMID]
Macova L, Bicikova M, Ostatnikova D, Hill M, Starka L. Vitamin D, neurosteroids and autism. Physiol Res. 2017; 66(S3):S333-40. [DOI:10.33549/physiolres.933721] [PMID]
Humble MB. Vitamin D, light and mental health. J Photochem Photobiol B. 2010; 101(2):142-9. [DOI:10.1016/j.jphotobiol.2010.08.003] [PMID]
Pertile RA, Cui X, Eyles DW. Vitamin D signaling and the differentiation of developing dopamine systems. Neuroscience. 2016; 333:193-203. [DOI:10.1016/j.neuroscience.2016.07.020] [PMID]
Stockmeier CA. Involvement of serotonin in depression: evidence from postmortem and imaging studies of serotonin receptors and the serotonin transporter. J Psychiatr Res. 2003; 37(5):357-73. [DOI:10.1016/S0022-3956(03)00050-5]
Mansournia MA, Ostadmohammadi V, Doosti-Irani A, Ghayour-Mobarhan M, Ferns G, Akbari H, et al. The effects of vitamin D supplementation on biomarkers of inflammation and oxidative stress in diabetic patients: A systematic review and meta-analysis of randomized controlled trials. Horm Metab Res. 2018; 50(6):429-40. [DOI:10.1055/a-0630-1303] [PMID]
Akbari M, Ostadmohammadi V, Lankarani KB, Tabrizi R, Kolahdooz F, Heydari ST, et al. The effects of vitamin D supplementation on biomarkers of inflammation and oxidative stress among women with polycystic ovary syndrome: A systematic review and meta-analysis of randomized controlled trials. Horm Metab Res. 2018; 50(4):271-9. [DOI:10.1055/s-0044-101355] [PMID]
Jamilian H, Amirani E, Milajerdi A, Kolahdooz F, Mirzaei H, Zaroudi M, et al. The effects of vitamin D supplementation on mental health, and biomarkers of inflammation and oxidative stress in patients with psychiatric disorders: A systematic review and meta-analysis of randomized controlled trials. Prog Neuropsychopharmacol Biol Psychiatry. 2019; 94:109651. [DOI:10.1016/j.pnpbp.2019.109651] [PMID]
Alrefaie Z, Alhayani A. Vitamin D(3) improves decline in cognitive function and cholinergic transmission in prefrontal cortex of streptozotocin-induced diabetic rats. Behav Brain Res. 2015; 287:156-62. [DOI:10.1016/j.bbr.2015.03.050] [PMID]
Larson MJ, Paasche-Orlow M, Cheng DM, Lloyd-Travaglini C, Saitz R, Samet JH. Persistent pain is associated with substance use after detoxification: A prospective cohort analysis. Addiction. 2007; 102(5):752-60. [DOI:10.1111/j.1360-0443.2007.01759.x] [PMID]
Rosenblum A, Joseph H, Fong C, Kipnis S, Cleland C, Portenoy RK. Prevalence and characteristics of chronic pain among chemically dependent patients in methadone maintenance and residential treatment facilities. JAMA. 2003; 289(18):2370-8. [DOI:10.1001/jama.289.18.2370] [PMID]
Karasz A, Zallman L, Berg K, Gourevitch M, Selwyn P, Arnsten JH. The experience of chronic severe pain in patients undergoing methadone maintenance treatment. J Pain Symptom Manage. 2004; 28(5):517-25. [DOI:10.1016/j.jpainsymman.2004.02.025] [PMID]
Reginato AJ, Falasca GF, Pappu R, McKnight B, Agha A. Musculoskeletal manifestations of osteomalacia: Report of 26 cases and literature review. Semin Arthritis Rheum. 1999; 28(5):287-304. [DOI:10.1016/S0049-0172(99)80013-4]
Plotnikoff GA, Quigley JM. Prevalence of severe hypovitaminosis D in patients with persistent, non-specific musculoskeletal pain. Mayo Clin Procs. 2003; 78(12):1463-70. [DOI:10.4065/78.12.1463] [PMID]
Black PN, Scragg R. Relationship between serum 25-hydroxyvitamin d and pulmonary function in the third national health and nutrition examination survey. Chest. 2005; 128(6):3792-8. [DOI:10.1378/chest.128.6.3792] [PMID]
Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP. A higher dose of vitamin d reduces the risk of falls in nursing home residents: A randomized, multiple-dose study. J Am Geriatr Soc. 2007; 55(2):234-9. [DOI:10.1111/j.1532-5415.2007.01048.x] [PMID]
Ford ES, Ajani UA, McGuire LC, Liu S. Concentrations of serum vitamin D and the metabolic syndrome among U.S. adults. Diabetes Care. 2005; 28(5):1228-30. [DOI:10.2337/diacare.28.5.1228] [PMID]
Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008; 117(4):503-11. [DOI:10.1161/CIRCULATIONAHA.107.706127] [PMID] [PMCID]
- Abstract Viewed: 262 times
- pdf Downloaded: 362 times