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Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Jeanette M. Johnstone, Andrew Hughes, Joshua Z. Goldenberg, Amy Romijn Orcid Logo, Julia J. Rucklidge

Nutrients, Volume: 12, Issue: 11, Start page: 3394

Swansea University Author: Amy Romijn Orcid Logo

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DOI (Published version): 10.3390/nu12113394

Abstract

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...

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Published in: Nutrients
ISSN: 2072-6643
Published: MDPI AG 2020
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URI: https://cronfa.swan.ac.uk/Record/cronfa57938
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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) &#x2212;3.3, p = 0.001, MID &#x2212;3.26; Standardized Mean Difference (SMD) &#x2212;0.49 p = 0.001 MD &#x2212;0.5), clinician ratings of global improvement (MD &#x2212;0.58, p = 0.001, MID &#x2212;0.5) and ADHD improvement (MD &#x2212;0.54, p = 0.002, MID &#x2212;0.5), and clinician (but not observer) measures of ADHD inattentive symptoms (MD &#x2212;1.53, p = 0.05, MID &#x2212;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. 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spelling 2021-10-18T13:21:11.9694433 v2 57938 2021-09-17 Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials e360b00b12b720c52e38c94a539e6555 0000-0001-5014-1539 Amy Romijn Amy Romijn true false 2021-09-17 HPS 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. Journal Article Nutrients 12 11 3394 MDPI AG 2072-6643 systematic review; meta-analysis; multinutrients; vitamins; minerals; psychiatric symptoms; mood; depression; ADHD; autism 4 11 2020 2020-11-04 10.3390/nu12113394 COLLEGE NANME Psychology COLLEGE CODE HPS Swansea University Another institution paid the OA fee National Institutes of Health (NIH) NCCIH; the Foundation for Excellence in Mental Health Care; The Gratis Foundation; School of Psychology,Speech and Hearing, University of Canterbury (Rucklidge) 5R90AT00892403 and T32 AT002688 2021-10-18T13:21:11.9694433 2021-09-17T12:59:27.7294800 Faculty of Medicine, Health and Life Sciences School of Psychology Jeanette M. Johnstone 1 Andrew Hughes 2 Joshua Z. Goldenberg 3 Amy Romijn 0000-0001-5014-1539 4 Julia J. Rucklidge 5 57938__21194__3f501efebc2649ee93ff95df73f22ce2.pdf 57938.pdf 2021-10-18T09:25:05.7634571 Output 5431776 application/pdf Version of Record true © 2020 by the authors. This is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license true eng http://creativecommons.org/licenses/by/4.0/
title Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
spellingShingle Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Amy Romijn
title_short Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_fullStr Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_full_unstemmed Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
title_sort Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
author_id_str_mv e360b00b12b720c52e38c94a539e6555
author_id_fullname_str_mv e360b00b12b720c52e38c94a539e6555_***_Amy Romijn
author Amy Romijn
author2 Jeanette M. Johnstone
Andrew Hughes
Joshua Z. Goldenberg
Amy Romijn
Julia J. Rucklidge
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container_title Nutrients
container_volume 12
container_issue 11
container_start_page 3394
publishDate 2020
institution Swansea University
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doi_str_mv 10.3390/nu12113394
publisher MDPI AG
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Psychology{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Psychology
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description 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.
published_date 2020-11-04T04:14:03Z
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