title: Nutrient- and non-nutrient-based natural health product (NHP) use in adults with mood disorders: prevalence, characteristics and potential for exposure to adverse events.
abstract: BACKGROUND
  To address knowledge gaps regarding natural health product (NHP) usage in mental health populations, we examined their use in adults with mood disorders, and explored the potential for adverse events.
  
  
  METHODS
  Food and NHP intake was obtained from 97 adults with mood disorders. NHP data was used to compare prevalence with population norms (British Columbia Nutrition Survey; BCNS). Bivariate and regression analyses examined factors associated with NHP use. Assessment of potential adverse effects of NHP use was based on comparing nutrient intakes from food plus supplements with the Dietary Reference Intakes and by reviewing databases for reported adverse health effects.
  
  
  RESULTS
  Two-thirds (66%; 95% CI 56 to 75) were taking at least one NHP; 58% (95% CI 47 to 68) were taking NHPs in combination with psychiatric medications. The proportion of each type of NHP used was generally higher than the BCNS (range of p's < 0.05 to 0.0001). When intakes from food and NHP sources were combined, a small proportion exceeded any Lowest-Observed-Adverse-Effect-Levels: only for niacin (n = 17) and magnesium (n = 6), two nutrients for which the potential for adverse effects is minimal. Conversely, about 38% (95% CI 28 to 49) of the sample were taking a non-nutrient based NHP for which previous adverse events had been documented.
  
  
  CONCLUSIONS
  The prevalent use of NHPs in this population suggests that health care providers need to be knowledgeable about their characteristics. The efficacy and safety of NHPs in relation to mental health warrants further investigation.
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada. karen.davison@ubc.ca
authors.forename: Karen M
authors.initials: KM
authors.lastname: Davison
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Kaplan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia; D003430:Cross-Sectional Studies; D019587:Dietary Supplements / Q000009:adverse effects / Q000032:analysis / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000178:diet therapy* / Q000378:metabolism; D009749:Nutrition Surveys