過剰体重または肥満の成人のサブシンドローム性うつ病症状の予防に対する多栄養素補給および食品関連行動活性化療法の効果: MooDFOODランダム化臨床試験
Mariska Bot1, Ingeborg A Brouwer2, Miquel Roca3
1Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, GGZ inGeest Specialized Mental Health Care, Amsterdam, the Netherlands.
JAMA
|March 6, 2019
まとめ
栄養補助食品と行動療法を含む栄養介入は,うつ病の症状のある肥満の成人の1年以上にわたって重度のうつ病 (MDD) を予防しませんでした. これらの戦略は,MDDの予防に推奨されません.
科学分野:
- 栄養精神科
- 精神 疾患 の 予防
- 臨床試験
背景:
- 重度のうつ病 (MDD) の予防策は,サブシンドローム性うつ病の症状を持つ肥満の成人では不明である.
- マルチ栄養サプリメントや行動活性化療法などの栄養介入は MDDの予防のための潜在的な方法です.
研究 の 目的:
- 多栄養素補給と食品関連行動活性化療法の有効性を,肥満の成人におけるMDDの新たなエピソードを予防するために,個別および組み合わせて調査する.
主な方法:
- 多中心の2x2因子ランダム化臨床試験で,過体重の成人1025人 (BMI25~40) が,うつ症状が増加した (PHQ-9 ≥5).
- 参加者は1年間毎日多栄養素サプリメント (オメガ-3,セレニウム,葉酸,ビタミンD3,カルシウム) またはプラセボ,および/または行動活性化療法を受け,または治療を受けなかった.
- MDDの発症は,3, 6, 12ヶ月のミニ国際神経精神科インタビューを用いて評価された.
主要な成果:
- 1025人の参加者のうち105人 (10%) が12ヶ月以内にMDDを発症した.
- MDDの発症の有意な違いは,サプリメント群とプラセボ群 (OR1. 06,95%CI 0. 87-1.29) で観察されなかった.
- 行動活性化療法は,MDD発症を有意に減少させなかった (OR 0. 93,95%CI 0. 76~1. 13),また,両方の介入の組み合わせも (相互作用のP . 48) なかった.
結論:
- 多栄養素サプリメントと行動活性化療法は,単独でも併用しても,サブシンドローム性抑うつ症状を有する肥満の成人の1年間の間に,メジャーうつ病を効果的に予防することができなかった.
- これらの発見は,この集団におけるMDDの主な予防のためにこれらの特定の栄養または行動介入の使用を支持しません.
- リスクのある人びとにうつ病を予防するための代替策や 組み合わせた戦略を探るには,さらなる研究が必要かもしれません.
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