The use of dietary supplements for mental health among the Saudi population: A cross-sectional survey.

Deemah Alateeq, Maha A Alsubaie, Faridah A Alsafi, Sultanah Hisham Alsulaiman, Ghazwa B Korayem

Other Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society 2022 4 trích dẫn

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Study Design

Loại nghiên cứu: Cross-sectional
Cỡ mẫu: 443

Can thiệp: The use of dietary supplements for mental health among the Saudi population: A cross-sectional survey. None
Đối chứng: Placebo
Xu hướng hiệu quả: Positive
Nguy cơ sai lệch: Moderate

Abstract

INTRODUCTION: Despite limited evidence about the efficacy and safety of dietary supplements (DSs) for improving mental health, people with or without mental disorders often tend to use them, especially during the ongoing COVID-19 pandemic. Previous studies focused on DS use for maintaining or improving overall health; Therefore, this study aimed to assess the prevalence of DSs for mental health among the SA population and to determine the factors that affect their use. METHODS: This cross-sectional study was based on an online survey of Saudi Arabian participants between July and August 2021 with an anonymous, self-completed questionnaire distributed using convenience sampling. The questionnaire included queries related to demographic information, DS use assessment, and mental health evaluation using the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder 7-item (GAD-7), questionnaire, and the Insomnia Severity Index (ISI). RESULTS: In total, 443 participants from various regions of Saudi Arabia completed the questionnaire. The prevalence of DS use in the Saudi population was 44%. Vitamin D (28%) and melatonin (20%) were the most commonly reported DSs used for mental health. The odds of DS use were three times higher in responders with previous mental health diagnoses (OR: 2.972; 95% CI: 1.602-5.515). Furthermore, the chances of using DSs almost doubled in patients with sub-threshold and moderate to severe insomnia (OR: 1.930; 95% CI: 1.191-3.126 and OR: 2.485; 95% CI: 1.247-4.954, respectively). CONCLUSION: Responders diagnosed by a specialist with psychiatric disorders or current insomnia had a higher chance of using DSs. Thus, healthcare providers must provide evidence-based information regarding DSs for mental health improvement and encourage the public to consult healthcare professionals before self-medicating for mental health problems.

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Tables

Table 1

Characteristics	Overall (N = 443)	DS users (N = 194)	Non DS users (N = 249)	P-value
Age, mean (SD)	37.56 (13)	36.18 (11.58)	38.63 (14.38)	0.053

Sex, n (%)				0.683
Male	119 (27)	54(27.8)	65(26.1)
Female	324 (73)	140(72.2)	184(73.9)

Marital status, n (%)				0.429
Single	178 (40)	85 (43.8)	93 (37.3)
Married	228 (51.5)	95 (49)	133 (53.4)
Divorced	29 (6.5)	12(6.2)	17 (6.8)
Widowed	8 (2)	2(1)	6 (2.4)

Education level, n (%)				0.108
High school or below	30 (7)	9 (4.6)	21 (8.4)
Diploma	26 (6)	9 (4.6)	17 (6.8)
Bachelors	249 (56)	104 (53.6)	145 (58.2)
Masters	70 (16)	36 (18.6)	34 (13.7)
PhD	68 (15)	36(18.6)	32(12.9)

Employment, n (%)				0.030
Student	64 (14)	25 (12.9)	39 (15.7)
Employee	172 (39)	84 (43.3)	88 (35.3)
Unemployed/ Retired	78 (18)	26 (13.4)	52 (20.9)
Housewife	54 (12)	18 (9.3)	36 (14.5)
Freelancer	16 (4)	10 (5.2)	6 (2.4)
Healthcare provider	59 (13)	31 (16)	28 (11.2)

Monthly income, n (%)				0.048
< 5000 SAR	26 (6)	7 (3.6)	19 (7.6)
5000 to 10,000 SAR	80 (18)	28 (14.4)	52 (20.9)
10,000 to 15,000 SAR	94 (21)	48(24.7)	46 (18.5)
> 15,000 SAR	243 (55)	111 (57.2)	132 (53)

Nationality, n (%)				0.465
Saudi	416 (94)	184 (94.8)	232 (93.2)
Non-Saudi	27 (6)	10 (5.2)	17 (6.8)

Region of living, n (%)				0.445
Northern region	12 (3)	2 (1)	10 (4)
Eastern region	40 (9)	18 (9.3)	22 (8.8)
Central region	275 (62)	123(63.4)	152 (61)
Western region	105 (24)	46 (23.7)	59 (23.7)
Southern region	11 (2)	5 (2.6)	6 (2.4)

Smoking status, n (%)				0.115
Non-smoker	355 (80)	147 (75.8)	208 (83.5)
Ex-smoker	19 (4)	11 (5.7)	8 (3.2)
Smoker	69 (16)	36 (18.6)	33 (13.3)

History of substance use, n (%)				0.082
	19 (4)	12 (6.2)	7 (2.8)

Admits to drinking alcohol, n (%)				0.975
	50 (11)	22 (11.3)	28 (11.2)
Positive history of diagnosis of a chronic medical condition(s), n (%)	118 (27)	58 (29.9)	60 (24.1)	0.171
Positive history of diagnosis of a mental disorder, n (%)	72 (16)	50(25.8)	22(8.8)	0.000

Positive history of psychiatric disorders diagnoses by a specialist, n (%)				0.482
Depression	27 (38)	19 (38)	8 (36.4)
Anxiety	17 (24)	12 (24)	5 (22.7)
Post-traumatic stress disorder	1 (1)	–	1 (4.5)
Panic disorder	7 (10)	4 (8)	3 (13.6)
Bipolar disorder	2 (3)	2(4)	–
Psychosis	1 (1)	–	1 (4.5)
Sleep disorders	14 (19)	11 (22)	3 (13.6)
Other	3 (4)	2 (4)	1 (4.5)
Prescribed psychotropic medication, n (%)	49 (68)	33 (66)	16 (72.7)	0.573

Table 2

DS name	N, (%)
Vitamin D	124 (64)
Melatonin	87 (45)
B12	80 (41)
Omega 3/fish oil	78 (40)
Vitamin C	63 (32)
Magnesium	51 (26)
Zinc	50 (25.8)
Vitamin B complex	41 (21)
Chamomile	39 (20)
Folic acid	38 (19.6)
Vitamin E	22 (11.3)
Probiotics	14 (7.2)
Vitamin K	11 (5.7)
Gingko	8 (4.1)
Ashwagandha	8 (4.1)
Acetyl-L-carnitine	6 (3.1)
St. John's wort	5 (2.6)
Lipidated curcumin	5 (2.6)
Rhodiola rosea	4 (2.1)
Kava Kava	1 (0.5)
Others*	17 (8.7)
Do not recall the name	18 (9.3)

Frequency of DS use
Always	42 (21.6)
Often	42 (21.6)
Sometimes	69 (35.6)
Rarely	40 (20.6)
Never	1 (0.5)

Experienced side effects when using DS
Yes	32 (16.5)
No	121 (62.4)

Table 3

Users (N = 194)	N (%)	Non-users (N = 249)	N (%)
DS improves mental health	96 (21.7)	I don't need it	178 (40.2)
Advice from a health professional	61 (13.8)	I didn't think of it as a treatment to improve mental health	90 (20.3)
Advice from a friend, relative, or colleague	49(11.1)	My information on its effectiveness is insufficient	68 (15.3)
DSs help prevent psychiatric disorders/sleep disorders	41 (9.3)	No reason	62 (14)
Fearing the side effects of medications	36 (8.1)	Fearing the side effects of dietary supplements	49 (11.6)
Psychotropic/sleep medications require a prescription	19 (4.3)	I don't believe in the effectiveness of DSs for mental health	26 (5.9)
DS stimulates the effectiveness of psychotropic/sleep medications	15 (3.4)	It is not safe	23 (5.2)
Psychotropic medications are addictive	11 (2.5)	High cost of DSs	19 (4.3)
Psychotropic medications make me feel stigmatized	6 (1.4)	A health professional advised me not to take it	6 (4.1)
Psychotropic medications are not effective	5 (1.1)	Other	9 (2)
Psychotropic/sleep medications are expensive	3 (0.7)
Other	12 (2.7)

Table 4

	DSs use
	Users	Non-users	Mean difference	t-value	P-value
	Mean (SD)	Mean (SD)	Mean difference	t-value	P-value
GAD-7 score	7.59 (5.29)	6.84 (5.26)	−0.749	−1.484	0.139
PHQ-9 score	8.23 (6.18)	6.57 (5.89)	−1.661	−2.881	0.004
ISI score	10.99 (5.05)	8.75 (4.58)	−2.243	−4.888	0.000

Table 5

Parameter	Crude		Multivariate adjusted
	OR (95% CI)	P-value	OR (95% CI)	P-value
Employment status
Student
Employee	1.489 (0.830–2.671)	0.182	1.542 (0.823–2.889)	0.176
Unemployed/ Retired	0.780 (0.392–1.552)	0.479	0.793 (0.378–1.663)	0.539
Housewife	0.780 (0.366–1.662)	0.520	0.727 (0.319–1.656)	0.448
Freelancer	2.600 (0.840–8.047)	0.097	2.816 (0.842–9.418)	0.093
Healthcare provider	1.727 (0.844–3.356)	0.135	1.886 (0.862–4.128)	0.112

Any previous diagnosis of a mental health disorder
No
Yes	3.583 (2.081–6.167)	0.000	2.972 (1.602–5.515)	0.001

General Anxiety Disorder-7
Lack of anxiety
Mild anxiety	1.599 (1.002–2.552)	0.049	1.067(0.617–1.844)	0.816
Moderate anxiety	1.339 (0.716–2.504)	0.360	0.667(0.311–1.432)	0.299
Severe anxiety	1.291 (0.674–2.471)	0.441	0.637(0.275–1.478)	0.294

Patient Health Questionnaire-9
No depression
Mild depression	1.677 (1.036–2.715)	0.035	1.394 (0.788–2.464)	0.254
Moderate depression	1.969 (1.104–3.514)	0.022	1.778 (0.882–3.585)	0.108
Moderately severe depression	2.129 (0.942–4.812)	0.069	1.923 (0.726–5.093)	0.188
Severe depression	1.234 (0.480–3.169)	0.662	1.003 (0.312–3.224)	0.996

Insomnia Severity Index
No clinical insomnia
Sub-threshold insomnia	2.067 (1.318–3.240)	0.002	1.930 (1.191–3.126)	0.008
Clinical insomnia (moderate severity)	2.571 (1.397–4.730)	0.002	2.485 (1.247–4.954)	0.010
Severe insomnia	6.957 (0.719–67.363)	0.094	9.616 (0.882–104.886	0.063

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The use of dietary supplements for mental health among the Saudi population: A cross-sectional survey.

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