Abstract：
BACKGROUND: High adherence to the Mediterranean diet (MD) has been associated with a reduced risk of depression in prospective cohort studies, but whether MD interventions are effective among adults with depression is uncertain.
OBJECTIVE: This study aimed to synthesize findings on the effects of MD interventions on the severity of depressive symptoms in adults with depression.
METHODS: PubMed, Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science were systematically searched from database inception to March 2023. The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and the Cochrane recommendations were followed. We included randomized controlled trials (RCTs) comparing outcomes after MD interventions with outcomes for control conditions in adults with depressive disorders or depressive symptoms.
METHODS: Two authors extracted the data independently. The Sidik-Jonkman estimator, the I2 metric, and the prediction interval were used to estimate between-study heterogeneity. To determine the risk of bias and the certainty of evidence from RCTs, we used the Cochrane Collaboration\'s Risk of Bias 2 and Grades of Recommendation, Assessment, Development, and Evaluation tools, respectively.
METHODS: In total, 1507 participants (mean age range: 22.0 years-53.3 years) with depression were initially included in the 5 RCTs of this review. Compared with control conditions, MD interventions significantly reduced depressive symptoms among young and middle-aged adults with major depression or mild to moderate depressive symptoms (standardized mean difference: -0.53; 95% confidence interval: -0.90 to -0.16; I2 = 87.1%). The prediction interval ranged from -1.86 to 0.81. The overall risk of bias was within the range of \"some concerns\" to \"high,\" while the certainty of evidence was low.
CONCLUSIONS: MD interventions appear to have substantial potential for alleviating depressive symptoms in people experiencing major or mild depression. However, to establish robust recommendations, there remains a need for high-quality, large-scale, and long-term RCTs.
BACKGROUND: PROSPERO registration no. CRD42022341895.
OBJECTIVE: This study aimed to synthesize findings on the effects of MD interventions on the severity of depressive symptoms in adults with depression.
METHODS: PubMed, Cochrane CENTRAL, PsycINFO, Scopus, and Web of Science were systematically searched from database inception to March 2023. The Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and the Cochrane recommendations were followed. We included randomized controlled trials (RCTs) comparing outcomes after MD interventions with outcomes for control conditions in adults with depressive disorders or depressive symptoms.
METHODS: Two authors extracted the data independently. The Sidik-Jonkman estimator, the I2 metric, and the prediction interval were used to estimate between-study heterogeneity. To determine the risk of bias and the certainty of evidence from RCTs, we used the Cochrane Collaboration\'s Risk of Bias 2 and Grades of Recommendation, Assessment, Development, and Evaluation tools, respectively.
METHODS: In total, 1507 participants (mean age range: 22.0 years-53.3 years) with depression were initially included in the 5 RCTs of this review. Compared with control conditions, MD interventions significantly reduced depressive symptoms among young and middle-aged adults with major depression or mild to moderate depressive symptoms (standardized mean difference: -0.53; 95% confidence interval: -0.90 to -0.16; I2 = 87.1%). The prediction interval ranged from -1.86 to 0.81. The overall risk of bias was within the range of \"some concerns\" to \"high,\" while the certainty of evidence was low.
CONCLUSIONS: MD interventions appear to have substantial potential for alleviating depressive symptoms in people experiencing major or mild depression. However, to establish robust recommendations, there remains a need for high-quality, large-scale, and long-term RCTs.
BACKGROUND: PROSPERO registration no. CRD42022341895.
摘要：
背景：在前瞻性队列研究中，高度坚持地中海饮食（MD）与抑郁风险降低相关，但MD干预对成人抑郁症患者是否有效尚不确定.
目的：本研究旨在综合研究MD干预对成人抑郁症患者抑郁症状严重程度的影响。
方法：PubMed，科克伦中部,PsycINFO,Scopus,和WebofScience从数据库开始到2023年3月进行了系统搜索。遵循系统评价和荟萃分析指南的首选报告项目和Cochrane建议。我们纳入了随机对照试验（RCT），比较MD干预后的结果与患有抑郁症或抑郁症状的成年人的对照结果。
方法：两位作者独立提取数据。Sidik-Jonkman估计器，I2度量，并使用预测间隔来估计研究之间的异质性。为了确定偏见的风险和RCT证据的确定性，我们使用了Cochrane协作的偏差风险2和推荐等级，评估,发展,和评估工具，分别。
方法：总共，1507名抑郁症患者（平均年龄：22.0岁-53.3岁）最初被纳入本综述的5个RCT。与控制条件相比，MD干预可显着降低患有重度抑郁症或轻度至中度抑郁症状的中青年成年人的抑郁症状（标准化平均差：-0.53；95％置信区间：-0.90至-0.16；I2=87.1％）。预测区间范围为-1.86至0.81。总体偏差风险在“一些担忧”到“高”的范围内，“而证据的确定性很低。
结论：MD干预对于缓解重度或轻度抑郁症患者的抑郁症状具有巨大潜力。然而,为了建立强有力的建议，仍然需要高质量，大规模,和长期RCT。
背景：PROSPERO注册号。CRD42022341895。
目的：本研究旨在综合研究MD干预对成人抑郁症患者抑郁症状严重程度的影响。
方法：PubMed，科克伦中部,PsycINFO,Scopus,和WebofScience从数据库开始到2023年3月进行了系统搜索。遵循系统评价和荟萃分析指南的首选报告项目和Cochrane建议。我们纳入了随机对照试验（RCT），比较MD干预后的结果与患有抑郁症或抑郁症状的成年人的对照结果。
方法：两位作者独立提取数据。Sidik-Jonkman估计器，I2度量，并使用预测间隔来估计研究之间的异质性。为了确定偏见的风险和RCT证据的确定性，我们使用了Cochrane协作的偏差风险2和推荐等级，评估,发展,和评估工具，分别。
方法：总共，1507名抑郁症患者（平均年龄：22.0岁-53.3岁）最初被纳入本综述的5个RCT。与控制条件相比，MD干预可显着降低患有重度抑郁症或轻度至中度抑郁症状的中青年成年人的抑郁症状（标准化平均差：-0.53；95％置信区间：-0.90至-0.16；I2=87.1％）。预测区间范围为-1.86至0.81。总体偏差风险在“一些担忧”到“高”的范围内，“而证据的确定性很低。
结论：MD干预对于缓解重度或轻度抑郁症患者的抑郁症状具有巨大潜力。然而,为了建立强有力的建议，仍然需要高质量，大规模,和长期RCT。
背景：PROSPERO注册号。CRD42022341895。
