Zinc serum levels and common mental disorders: An integrative review
DOI:
https://doi.org/10.33448/rsd-v10i6.15441Keywords:
Zinc deficiency; Depression; Anxiety; Mental disorders.Abstract
The objective was to analyze the scientific production about the current evidence on the relationship between serum zinc concentrations and common mental disorders. This is an integrative literature review, carried out between March and July 2020, using the PICOS strategy for the selection of articles. The databases were accessed through the Capes Virtual Health Library and Capes Journals Portal, corresponding to: Science Direct, Springer Science, Medline / Pubmed, ProQuest LLC, AGRIS, Bentham Science Publishers, Cengage Learning, Web of Science, John Wiley & Sons, Scopus, Directory of Open Access Journals, Maney Publishing, and SAGE Publications. Seven publications were analyzed that evaluated individuals of both sexes, in different age groups, based on observational analytical studies. The studies listed for analysis, conducted in groups of different age groups and sample numbers, showed similar results, demonstrating the prevalence of reduced concentrations of zinc in the blood of patients with depression and / or anxiety. The correlation between serum zinc concentrations and common mental disorders, in most results, converges to evidence that serum zinc deficiency is significantly associated with depressive and anxiety symptoms. Based on the designs of the investigations listed, they cannot determine a causal relationship between zinc and depressive and anxiety symptoms. However, it is plausible to state, based on the results and physiological mechanisms of zinc, that the low peripheral concentration of this element may play a role in the pathophysiology of some domain of mental function.
References
Akhondzadeh, S., Mohammadi, M. R., & Khademi, M. (2004). Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: a double blind and randomized trial [ISRCTN64132371]. BMC Psychiatry, 4 (9), 1-6. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-4-9.
Amani, R., Saeidi, S., Nazari, Z., & Nematpour, S. (2010). Correlation Between Dietary Zinc Intakes and Its Serum Levels with Depression Scales in Young Female Students. Biol Trace Elem Res, 137 (2), 150-158. https://link.springer.com/article/10.1007/s12011-009-8572-x.
Campo, M. T., Ramon, E., Lupala, C. S., Pérez, J. J., Koch, K., & Garriga, P. (2016). Zinc Is Involved in Depression by Modulating G Protein-Coupled Receptor Heterodimerization. Mol Neurobiol, 53 (3), 2003-2015. https://pubmed.ncbi.nlm.nih.gov/25855059/.
Ciampo, L. A. D., & Ciampo, L. R. S. (2014). The importance of zinc for adolescent health. Adolesc. Saúde, 11 (2), 80-86. https://cdn.publisher.gn1.link/adolescenciaesaude.com/pdf/v11n2a11.pdf.
DiGirolamo, A. M., & Ramirez-Zea, M. (2010). Role of zinc in maternal and child mental health. Am J Clin Nutr, 89 (suppl), 940S-945S. https://academic.oup.com/ajcn/article/89/3/940S/4596790.
Doboszewska, U., Wlaź, P., Nowak, G., Radziwoń-Zaleska, M., Cui, R., & Młyniec, K. (2017). Zinc in the monoaminergic theory of depression: its relationship to neural plasticity. Neural Plast, 1-18. https://www.hindawi.com/journals/np/2017/3682752/.
Gonoodi, K., Moslem, A., Ahmadnezhad, M., Darroudi, S., Mazloum, Z., Tayefi, M., Tabatabaeizadeh, S. A., Eslami, S., Shafiee, M., Khashayarmanesh, Z., Haghighi, H. M., Ferns, G. A., & Ghayour-Mobarhan, M. (2018). Relationship of Dietary and Serum Zinc with Depression Score in Iranian Adolescent Girls. Biological Trace Element Research, 186 (2), 1-7. https://link.springer.com/article/10.1007%2Fs12011-018-1301-6.
Gronli, O., Kvamme, J. M., Friborg, O., & Wynn, R. (2013). Zinc deficiency is common in several psychiatric disorders. PLoS One, 8 (12). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868572/.
Henriques, R. T. M., Cabana, M. C. F. L., & Montarroyos, U. R. (2018). Prevalence of Common Mental Disorders associated with the burden placed on family caregivers of elderly. Mental, 12 (22), 35-52. http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S1679-44272018000100004&lng=pt&nrm=iso&tlng=en.
Islam, M. R., Ahmed, M. U., Mitu, S. A., Islam, M. S., Rahman, G. K. M. M., Qusar, M. M. A. S., & Hasnat, A. (2013). Comparative Analysis of Serum Zinc, Copper, Manganese, Iron, Calcium, and Magnesium Level and Complexity of Interelement Relations in Generalized Anxiety Disorder Patients. Biol Trace Elem Res, 154 (1), 21-27. https://link.springer.com/article/10.1007%2Fs12011-013-9723-7.
Joe, P., Getz, M., Redman, S., Petrilli, M., Kranz, T. M., Ahmad, S., & Malaspina, D. (2018). Serum zinc levels in acute psychiatric patients: A case series. Psychiatry Research, 261: 344-350. https://www.sciencedirect.com/science/article/abs/pii/S0165178117313070.
Jung, A., Spira, D., Steinhagen-Thiessen, E., Demuth, I., & Norman, K. (2017). Zinc Deficiency Is associated With Depressive Symptoms-Results from the Berlin Aging Study II. J Gerontol A Biol Sci Med Sci, 72 (8), 1149-1154. https://academic.oup.com/biomedgerontology/article/72/8/1149/2328605.
Kaner, G., Soylu, M., Yüksel, N., Inanç, N., Ongan, D., Başmısırlı, E. (2015). Evaluation of Nutritional Status of Patients with Depression. BioMed Res Int, 1-9. https://pubmed.ncbi.nlm.nih.gov/26413529/.
Li, Z., Li, B., Song, X., & Zhang, D. (2017). Dietary zinc and iron intake and risk of depression: A meta-analysis. Psychiatry Res, 251, 41-47. https://www.sciencedirect.com/science/article/abs/pii/S0165178116317747?via%3Dihub.
Li, Z., Wang, W., Xin, X., Song, X., & Zhang, D. (2018). Association of total zinc, iron, copper and selenium intakes with depression in the US adults. Journal of Affective Disorders. 228, 68-74. https://pubmed.ncbi.nlm.nih.gov/29232566/.
Manosso, L. M. (2016). Investigação de mecanismos de ação envolvidos no efeito tipo-antidepressivo do zinco em camundongos [tese] [internet]. [Florianópolis]: Universidade Federal de Santa Catarina, 254 p. https://repositorio.ufsc.br/handle/123456789/167962.
Manosso, L. M. (2019). O papel do zinco no transtorno depressivo maior. Rev Bras Nut Func, 43 (78), 1-19. https://www.researchgate.net/publication/334177606_O_papel_do_zinco_no_transtorno_depressivo_maior.
Markiewic-Żukowska, R., Gutowska, A., & Borawska, M. H. (2015). Serum Zinc Concentrations Correlate with Mental and Physical Status of Nursing Home Residents. PLoS One, 10 (1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311908/.
Mravunac, M., Szymlek-Gay, E. A., Daly, R. M., Roberts, B. R., Formica, M., Gianoudis, J., O’Connell, S. L., Nowson, C. A., & Cardoso, B. R. (2019). Greater Circulating Copper Concentrations and Copper/Zinc Ratios are Associated with Lower Psychological Distress, But Not Cognitive Performance, in a Sample of Australian Older Adults. Nutrients, 11(10). https://www.mdpi.com/2072-6643/11/10/2503.
Młyniec, K., Gaweł, M., & Nowak, G. (2015). Study of antidepressant drugs in GPR39 (zinc receptor−/−) knockout mice, showing no effect of conventional antidepressants, but effectiveness of NMDA antagonists. Behav. Brain Res, 287, 135-138. https://www.sciencedirect.com/science/article/abs/pii/S0166432815002181?via%3Dihub.
Mlyniec, K. (2015). Zinc in the Glutamatergic Theory of Depression. Current Neuropharmacology, 13 (4), 505-513. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4790399/#:~:text=Based%20on%20glutamatergic%20theory%20of,inhibition%20of%20the%20NMDA%20receptor.
Nakamura, M., Miura, A., Nagahata, T., Shibata, Y., Okada, E., & Ojima, T. (2019). Low Zinc, Copper, and Manganese Intake is Associated with Depression and Anxiety Symptoms in the Japanese Working Population: Findings from the Eating Habit and Well-Being Study. Nutrients, 11(4). https://www.mdpi.com/2072-6643/11/4/847#.
Nguyen, T. T. T., Miyagi, S., Tsujiguchi, H., Kambayashi, Y., Hara, A., Nakamura, H., Suzuki, K., Yamada, Y., Shimizu, Y., & Nakamura, H. (2019). Association between Lower Intake of Minerals and Depressive Symptoms among Elderly Japanese Women but Not Men: Findings from Shika Study. Nutrients, 11 (2). https://pubmed.ncbi.nlm.nih.gov/30781841/.
Nowak, G. (2015). Zinc, future mono/adjunctive therapy for depression: mechanisms of antidepressant action. Pharmacol Rep, 67 (3), 659–662. https://link.springer.com/article/10.1016/j.pharep.2015.01.015.
Petrilli, M. A., Kranz, T. M., Kleinhaus, K., Joe, P., Getz, M., Johnson, P., Chao, M. V., & Malaspina, D. (2017). The Emerging Role for Zinc in Depression and Psychosis. Front Pharmacol, 30 (8). https://www.frontiersin.org/articles/10.3389/fphar.2017.00414/full.
Ranjbar, E., Kaseaei, M. S., Mohammad-Shirazi, M., Nasrollahzadeh, J., Rashidkhani, B., Shams, J., Mostafari, S. A., & Mohammadi, M. R. (2013). Effects of zinc supplementation in patients with major depression, a randomized clinical trial. J Psychiatry, 8, 73–79. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3796297/.
Rivas-García, T. E., Marcelo-Pons, M., Martínez-Arnau, F., Serra-Catalá, N., Santamaría-Carrillo, Y., & Cauli, O. (2018). Blood zinc levels and cognitive and functional evaluation in non-demented older patients. Exp Gerontol, 108, 28-34. https://www.sciencedirect.com/science/article/abs/pii/S0531556518300639?via%3Dihub.
Russo, A. J. (2011). Decreased Zinc and Increased copper in Individuals with Anxiety. Nutr Metab Insights, 4, 1-5. https://journals.sagepub.com/doi/10.4137/NMI.S6349.
Salustri, C., Squitti, R., Zappasodi, F., Ventriglia, M., Bevacqua, M. G., Fontana, M., & Tecchio, F. (2011). Oxidative stress and brain glutamate-mediated excitability in depressed patients. J Affect Disord, 127, 321–325. https://www.sciencedirect.com/science/article/abs/pii/S0165032710003976.
Santos, G. B. V., Alves, M. C. G. P., Goldbaum, M., Cesar, C. L. G., & Gianini, R. J. (2019). Prevalência de transtornos mentais comuns
e fatores associados em moradores da área urbana de São Paulo, Brasil. Cad. Saúde Pública, 35 (11). https://www.scielo.br/scielo.php?pid=S0102-311X2019001305008&script=sci_abstract.
Saueressig, C., Silva, V. L., Antunes, L. C., Alba, V. D. (2016). Níveis de zinco sérico em pacientes internados com depressão. J. Bras. Psiquiatr, 65 (3), 239-244. https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0047-20852016000300239#:~:text=Os%20dados%20da%20literatura%20quanto,dentro%20da%20normalidade17%2C18.
Sawada, T., & Yokoi, K. (2010). Effect of zinc supplementation on mood states in young women: a pilot study. European Journal of Clinical Nutrition, 64 (3), 331-333. https://www.nature.com/articles/ejcn2009158.
Swardfager, W., Herrmann, N., Mazereeuw, G., Goldberger, K., Harimito, T., & Lanctôt, K. L. (2013). Zinc in depression: a meta-analysis. Biol. Psychiatry, 74, 872-878. https://www.biologicalpsychiatryjournal.com/article/S0006-3223(13)00451-4/fulltext.
Senicato, C., Azevedo, R. C. S., & Barros, M. B. A. (2018). Common mental disorders in adult women: identifying the most vulnerable segments. Ciênc. Saúde coletiva, 23 (8). https://doi.org/10.1590/1413-81232018238.13652016.
Silva, A. C., Vargas, L. S., Moraes, R. C. C., Lucchese, R., Guimarães, R. A., & Vera, I. (2019). Prevalência e fatores associados ao transtorno mental comum em assentados rurais*. SMAD, Rev. Eletrônica Saúde Mental Álcool Drog, 15(1), 23-31. http://dx.doi.org/10.11606/issn.1806-6976.smad.2019.00037.
Siwek, M., Szewczyk, B., Dudek, D., Styczeñ, K., Sowa-Kuæma, M., Mlyniec, K., Siwek, A., Witkowski, L., Pochwat, B., & Nowak, G. (2013). Zinc as a marker of affective disorders. Pharmacol Rep, 65, 1512–1518. https://www.sciencedirect.com/science/article/abs/pii/S1734114013715123.
Souza, M, T., Silva, M. D., & Carvalho, R. C (2010). Revisão integrativa: o que é e como fazer. Einstei, 8 (1), 102-106. https://www.scielo.br/scielo.php?pid=S1679-45082010000100102&script=sci_arttext&tlng=pt.
Styczeń, K., Sowa-Kućma, M., Siwek, M., Dudek, D., Reczyński, W., Szewczyk, B., Misztak, P., Topór-Madry, R., & Nowak, G. (2016). The serum zinc concentration as a potential biological marker in patients with major depressive disorder. Metab Brain Dis, 32, 97-103. https://link.springer.com/article/10.1007%2Fs11011-016-9888-9.
Tahmasebi, K., Amani, R., Nazari, Z., Ahmadi, K., Moazzen, S., & Mostafavi, S.-A. (2017). Association of Mood Disorders with Serum Zinc Concentrations in Adolescent Female Students. Biol Trace Elem Res, 178 (2), 180-188. https://doi.org/10.1007/s12011-016-0917-7.
Ursi, E. S (2005). Prevenção de lesões de pele no perioperatório: revisão integrativa da literatura. [dissertação] [internet]. Ribeirão Preto: Universidade de São Paulo; 2005. 129 p. https://www.teses.usp.br/teses/disponiveis/22/22132/tde-18072005-095456/pt-br.php.
Vashum, K. P., McEvoy, M., Milton, A. H., McElduff, P., Hure, A., Byles, J., & Attia, J. (2014). Dietary zinc is associated with a lower incidence of depression: findings from two Australian. Journal of Affective Disorders, 166, 249-257. https://www.sciencedirect.com/journal/journal-of-affective-disorders/vol/166/suppl/C.
Youssef, M. M., Underwood, M. D., Huang, Y. Y., Hsiung, S. C., Liu, Y., Simpson, N. R., Bakalian, M. J., Rosoklija, G. B., Dwork, A. J., Arango, V., & Mann, J. J. (2018). Association of BDNF Val66Met Polymorphism and Brain BDNF Levels with Major Depression and Suicide. Int J Neuropsychopharmacol, 21 (6), 528-538. https://academic.oup.com/ijnp/article/21/6/528/4843985.
World Health Organization [WHO] (2015). Compreensão do plano de ação de saúde mental para 2013-2020-2030. Geneva: World Health Organization; 2015. http://www.who.int/mental_health/action_plan_2013/en/
World Health Organization [WHO] (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization; 2017. https://apps.who.int/iris/handle/10665/254610.
World Health Organization [WHO] (2020a). Fact sheet nº 369: depression. Geneva: World Health Organization; 2020. http://www.who.int/mediacentre/factsheets/fs369/en/.
World Health Organization [WHO] (2020b). Improving the mental and brain health of children and adolescentes. Child and adolescent mental health. Retrieved Oct 13, 2020, from https://www.who.int/mental_health/maternal-child/child_adolescent/en/.
World Health Organization [WHO], Organização Pan-Americana da Saúde [OPAS] (2020). Folha Informativa. Transtornos Mentais. Retrieved Oct 13, 2020, from https://www.paho.org/pt/topicos/transtornos-mentais.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Sarah de Melo Rocha Cabral; Layonne de Sousa Carvalho; Alana Paulina de Moura Sousa; Marize Melo dos Santos
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.