Effect Of Vitamin D Supplementation On Anhedonia In Patients With Depressive Disorder

ObjectiveDepression is a major public health problem which could lead to disability,functional decline,and an elevated risk of suicide.Anhedonia is a core symptom of depression which severely impacts on prognosis.However,the current clinical treatment for loss of pleasure is not satisfactory.Epidemiological evidence suggests that vitamin D is strongly associated with anhedonia in patients with depression,but there have been few clinical trials.Our study aims to investigate the effect of vitamin D supplementation on anhedonia in patients with depressive disorder and to provide a theoretical basis for individualized treatment of depression.MethodsFrom February 2017 to November 2019,patients with depressive disorder were recruited at Heifei Fourth People’s Hospital based on inclusion and exclusion criteria.All patients were randomly divided into intervention group and control group.The control group receive conventional antidepressant medication.The treatment group received vitamin D drops 1600 IU/d on the basis.At the end of the study,the data on 148 subjects（75 in intervention group and 73 people in control group）were examined.Before and after intervention,vitamin D serum level,Revised Social Anhedonia Scale（RSAS）,Revised Physical Anhedonia Scale（RPAS）,Hamilton depression scale(HAMD₂₄)and Hamilton Anxiety Rating Scale（HAMA）were assessed and recorded for all participants.We used theX² test,t-test and Mann-Whitney U test to compare the differences between the intervention and control groups at baseline on different demographic characteristics,lifestyle habits,and antidepressant medication use.We used the t-test and the analysis of covariance（ANCOVA）compare the differences in 25（OH）D levels and the score of each scale between the two groups.Paired-samples t-test was used to compare data before and after the intervention within the group.Stratified analysis was performed on the intervention group according to the difference in baseline 25（OH）D levels.ResultsAmong all 148 depressed patients,the differences in demographic characteristics between the intervention and control groups were not statistically significant.At baseline,the difference in25（OH）D levels between depressed patients in the intervention and control groups was not statistically significant（38.24±13.63 nmol/L vs.41.05±14.28 nmol/L,P=0.223）.After 8 weeks of follow-up,25（OH）D levels were significantly higher in depressed patients in the intervention group compared with depressed patients in the control group（60.91±15.69 nmol/L vs.45.33±14.78nmol/L,P<0.001）and significantly higher in depressed patients in the intervention group compared with those at baseline（P<0.001）.There was no statistical difference in RSAS（23.49±4.82 vs.23.82±6.14,P=0.717）and RPAS（35.75±6.48 vs.34.56±9.15,P=0.364）scores between two groups when the study began.At the end of our study,the RSAS（20.28±5.42 vs.22.29±5.54,P=0.027）and RPAS（32.48±8.80 vs.35.92±10.71,P=0.034）scores were significantly lower in the intervention group than in the control group,and the difference was still significant after adjusting confounding factors（P=0.046 and 0.041,respectively）.Compared with the beginning of our study,the RSAS（23.48±3.44 vs.20.06±5.25,P<0.001）and RPAS（36.03±6.56 vs.32.03±8.68,P=0.001）scores were much lower in vitamin D deficiency patients of intervention group.However,this result wasn’t found in patients with Vitamin D insufficiency of intervention group.ConclusionThis study shows that the use of vitamin D supplement may obviously moderate anhedonia symptom in vitamin D deficiency patients with depressive disorder.