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Article

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

1
Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA
2
Child and Adolescent Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA
3
Adult Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA
4
Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney 2007, Australia
5
Department of Psychology, Swansea University, Swansea SA2 8PP, UK
6
School of Psychology, Speech and Hearing, University of Canterbury, 8140 Christchurch, New Zealand
*
Authors to whom correspondence should be addressed.
Nutrients 2020, 12(11), 3394; https://doi.org/10.3390/nu12113394
Received: 20 October 2020 / Accepted: 28 October 2020 / Published: 4 November 2020
(This article belongs to the Section Micronutrients and Human Health)
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. View Full-Text
Keywords: systematic review; meta-analysis; multinutrients; vitamins; minerals; psychiatric symptoms; mood; depression; ADHD; autism systematic review; meta-analysis; multinutrients; vitamins; minerals; psychiatric symptoms; mood; depression; ADHD; autism
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MDPI and ACS Style

Johnstone, J.M.; Hughes, A.; Goldenberg, J.Z.; Romijn, A.R.; Rucklidge, J.J. Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2020, 12, 3394. https://doi.org/10.3390/nu12113394

AMA Style

Johnstone JM, Hughes A, Goldenberg JZ, Romijn AR, Rucklidge JJ. Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2020; 12(11):3394. https://doi.org/10.3390/nu12113394

Chicago/Turabian Style

Johnstone, Jeanette M., Andrew Hughes, Joshua Z. Goldenberg, Amy R. Romijn, and Julia J. Rucklidge 2020. "Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials" Nutrients 12, no. 11: 3394. https://doi.org/10.3390/nu12113394

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