TY - JOUR
T1 - Multinutrients for the treatment of psychiatric symptoms in clinical samples
T2 - A systematic review and meta-analysis of randomized controlled trials
AU - Johnstone, Jeanette M.
AU - Hughes, Andrew
AU - Goldenberg, Joshua Z.
AU - Romijn, Amy R.
AU - Rucklidge, Julia J.
N1 - Funding Information:
We gratefully acknowledge that this work was supported by the National Institutes of Health (NIH) NCCIH under grants 5R90AT00892403 and T32 AT002688 (Johnstone); the Foundation for Excellence in Mental Health Care, including individual philanthropic support; and The Gratis Foundation; School of Psychology, Speech and Hearing, University of Canterbury (Rucklidge).
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/11
Y1 - 2020/11
N2 - This systematic review and meta-analysis focused on randomized controlled trials (RCT) of multinutrients consisting of at least four vitamins and/or minerals as interventions for participants with psychiatric symptoms. A systematic search identified 16 RCTs that fit the inclusion criteria (n = 1719 participants) in six psychiatric categories: depression, post-disaster stress, antisocial behavior, behavioral deficits in dementia, attention-deficit/hyperactivity disorder, and autism. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to rate the evidence base. Significant clinical benefit was assessed using minimal clinically important differences (MIDs). Due to heterogeneity in participants, multinutrient formulas, outcome measures, and absence of complete data, only the Attention-Deficit/Hyperactivity Disorder (ADHD) category was eligible for meta-analyses. In ADHD populations, statistically and clinically significant improvements were found in global functioning, Mean Difference (MD)-3.3, p = 0.001, MID-3.26; Standardized Mean Difference (SMD)-0.49 p = 0.001 MD-0.5), clinician ratings of global improvement (MD-0.58, p = 0.001, MID-0.5) and ADHD improvement (MD-0.54, p = 0.002, MID-0.5), and clinician (but not observer) measures of ADHD inattentive symptoms (MD-1.53, p = 0.05, MID-0.5). Narrative synthesis also revealed a pattern of benefit for global measures of improvement, for example: in autism, and in participants with behavioral deficits in dementia. Post-natural disaster anxiety and the number of violent incidents in prison populations also improved. Broad-spectrum formulas (vitamins + minerals) demonstrated more robust effects than formulas with fewer ingredients. This review highlights the need for robust methodology-RCTs that report full data, including means and standard deviations for all outcomes-in order to further elucidate the effects of multinutrients for psychiatric symptoms.
AB - This systematic review and meta-analysis focused on randomized controlled trials (RCT) of multinutrients consisting of at least four vitamins and/or minerals as interventions for participants with psychiatric symptoms. A systematic search identified 16 RCTs that fit the inclusion criteria (n = 1719 participants) in six psychiatric categories: depression, post-disaster stress, antisocial behavior, behavioral deficits in dementia, attention-deficit/hyperactivity disorder, and autism. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to rate the evidence base. Significant clinical benefit was assessed using minimal clinically important differences (MIDs). Due to heterogeneity in participants, multinutrient formulas, outcome measures, and absence of complete data, only the Attention-Deficit/Hyperactivity Disorder (ADHD) category was eligible for meta-analyses. In ADHD populations, statistically and clinically significant improvements were found in global functioning, Mean Difference (MD)-3.3, p = 0.001, MID-3.26; Standardized Mean Difference (SMD)-0.49 p = 0.001 MD-0.5), clinician ratings of global improvement (MD-0.58, p = 0.001, MID-0.5) and ADHD improvement (MD-0.54, p = 0.002, MID-0.5), and clinician (but not observer) measures of ADHD inattentive symptoms (MD-1.53, p = 0.05, MID-0.5). Narrative synthesis also revealed a pattern of benefit for global measures of improvement, for example: in autism, and in participants with behavioral deficits in dementia. Post-natural disaster anxiety and the number of violent incidents in prison populations also improved. Broad-spectrum formulas (vitamins + minerals) demonstrated more robust effects than formulas with fewer ingredients. This review highlights the need for robust methodology-RCTs that report full data, including means and standard deviations for all outcomes-in order to further elucidate the effects of multinutrients for psychiatric symptoms.
KW - ADHD
KW - Autism
KW - Depression
KW - Meta-analysis
KW - Minerals
KW - Mood
KW - Multinutrients
KW - Psychiatric symptoms
KW - Systematic review
KW - Vitamins
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U2 - 10.3390/nu12113394
DO - 10.3390/nu12113394
M3 - Article
C2 - 33158241
AN - SCOPUS:85095750911
SN - 2072-6643
VL - 12
SP - 1
EP - 35
JO - Nutrients
JF - Nutrients
IS - 11
M1 - 3394
ER -