Vitamin D status in patients with MS is negatively correlated with depression, but not with fatigue.
BACKGROUND
Depressive symptoms and fatigue are frequent and disabling symptoms of multiple sclerosis (MS). Depression and fatigue have been associated with a poor vitamin D status, and a poor vitamin D status is often found in MS.


OBJECTIVE
Assess whether vitamin D status contributes to depressive symptoms and fatigue in MS.


METHODS
Patients with MS that participated in previous studies in which depression and fatigue were assessed and of whom serum 25-hydroxyvitamin D (25(OH)D) levels were available within a timeframe of less than one half-life of 25(OH)D were included. Depression and fatigue were assessed with the Hospital Anxiety and Depression Scale and the Multidimensional Fatigue Inventory.


RESULTS
Fifty-nine patients were included. Mean scores of fatigue and depression were 14.6 (SD 4.2) and 6.2 (SD 4.4), respectively. The mean vitamin D status was 62.3 nm (SD 27.8). Vitamin D status correlated negatively with depression (r=-0.326, P=0.006). No significant correlation was found between vitamin D status and fatigue. In a multiple regression model, vitamin D status was not a significant contributor to depression, after controlling for age Expanded Disability Status Scale score and fatigue (P=0.078). Alternatively, depression and fatigue did not contribute to vitamin D status.


CONCLUSIONS
This study shows a negative correlation between vitamin D status and depressive symptoms in patients with MS. Although multiple confounders exist, we observed an indication that vitamin D status might contribute to the presence of depressive symptoms in MS. Therefore, further studies on vitamin D in MS should include depressive symptoms as outcome measures to confirm these findings.
Knippenberg
S
S
School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
Bol
Y
Y
Damoiseaux
J
J
Hupperts
R
R
Smolders
J
J
D000328:Adult; D000368:Aged; D015897:Comorbidity / Q000639:trends; D003863:Depression / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D015673:Fatigue Syndrome, Chronic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood / Q000453:epidemiology* / Q000523:psychology; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
D014807:Vitamin D