The Relationship between Sustainable Dietary Patterns and Depression: A Review

Year 2024, Volume: 6 Issue: 2, 346 - 363

Merve Tokpunar

Abstract

Sustainable diets are diets that are protective as well as respectful of biodiversity and ecosystems. These diets are culturally acceptable, accessible, economically fair and cost-effective. The models of sustainable diets include the Mediterranean diet, Nordic diet, Vegan/vegetarian, Planet diet (semi-vegetarian diet), and Pescatarian diet. The Mediterranean diet appears to have numerous health benefits that are still under investigation, such as a reduction in mental disorders such as depression. As there is some controversy regarding this topic, this review aimed to clarify the relationship between sustainable nutrition diets and depression. Our review showed that plant-based sustainable dietary patterns appear to be associated with depressive symptoms. The continuation of the homocysteine cycle has positive effects on depressive symptoms because the Mediterranean diet is rich in B vitamins. The neuroendocrine modulation of omega-3 fatty acids, which are abundant in the Mediterranean diet, and the anti-inflammatory effects of omega-3 fatty acids are curative mechanisms of depression. The insufficient nutritional content of vegan-vegetarian diets such as vitamin B12, zinc, and omega-3 can cause depressive symptoms. However, more studies are needed on the effects of the Nordic (Scandinavian) and Planetary diets on depressive symptoms. In light of this review, it is necessary to focus on some interventions to disseminate sustainable nutrition models in different countries and encourage them to transform these nutritions guide into behaviors. For this, healthy nutrition guides and nutrition policies should be created and nutrition education should be planned.

Keywords

Sustinable nutrition, Sustainable diet, Depression, Mediterranean diet, Vegetarian.

Sürdürülebilir Diyet Modellerinin Depresyon ile İlişkisi: Derleme

Abstract

Sürdürülebilir diyetler biyolojik çeşitlilik ve ekosistemleri koruyucu, beslenme açısından yeterli, erişilebilir, ekonomik olarak adil ve uygun fiyatlı diyetlerdir. Aynı zamanda kültürel olarak kabul edilebilir, güvenli ve sağlıklı olmalı; doğal kaynakları ve insan kaynaklarını en iyi şekilde kullanmalıdırlar. Sürdürülebilir diyet modelleri; Akdeniz diyeti, Nordik diyetleri, Vegan, Vejeteryan ve Peskateryan Diyetleri, Gezegen diyeti (semi vejeteryan diyet)’dir. Depresyon bir duygudurum bozukluğudur ve sıradan ruh hali dalgalanmalarından ve günlük hayattaki zorluklara verilen kısa süreli duygusal reaksiyonlardan farklıdır. Özellikle tekrarlayan ve orta şiddette veya şiddetli depresyon önemli bir sağlık sorunu durumuna gelebilir. Bitkisel kaynaklı sürdürülebilir diyet modellerinin depresif semptomlar ile ilişkili olduğu görülmektedir. Akdeniz diyetinin B vitaminlerinden zengin olması sebebiyle homosistein döngüsünü devam ettirmesi, depresif semptomlar üzerinde pozitif etkiler göstermektedir. Akdeniz diyetinde fazla miktarda bulunan omega-3 yağ asitlerinin nörendokrin modülasyonu ve omega-3 yağ asitlerinin anti-inflamatuar etkileri depresyon üzerindeki iyileştirici mekanizmalarıdır. Vegan-vejeteryan diyetlerin B12 vitamin, çinko, omega-3 gibi besin öğeleri içeriğinin yetersiz olması depresif semptomlara neden olabilir. Nordik (İskandinav) ve Gezegen diyetinin depresif semptomlar üzerindeki etkileriyle ilgili daha fazla çalışma yapılması gerekmektedir.

Keywords

Sürdürülebilir beslenme, Sürdürülebilir diyet, Depresyon, Akdeniz diyeti, Vejeteryan.

References

• Abbaszadeh, A., Saharkhiz, M., Khorasanchi, Z., Karbasi, S., Askari, M., Hoseini, Z. S., ... & Bahrami, A. (2021). Impact of a Nordic diet on psychological function in young students. Nutrition and Health, 27(1), 97-104. https://doi.org/10.1177/026010602096498
• Aguliar-Valles, A., Kim, J., Jung, S., Woodside, B., & Luheshi, G. N. (2014). Role of brain transmigrating neutrophils in depression-like behavior during systemic infection. Molecular psychiatry, 19(5), 599-606. https://doi.org/10.1038/mp.2013.137
• Almeida, O. P., Ford, A. H., & Flicker, L. (2015). Systematic review and meta-analysis of randomized placebo-controlled trials of folate and vitamin B12 for depression. International Psychogeriatrics, 27(5), 727-737. https://doi.org/10.1017/S1041610215000046
• Askari, M., Daneshzad, E., Darooghegi Mofrad, M., Bellissimo, N., Suitor, K., & Azadbakht, L. (2020). Vegetarian diet and the risk of depression, anxiety, and stress symptoms: a systematic review and meta-analysis of observational studies. Critical Reviews in Food Science and Nutrition, 62(1), 261-271. https://doi.org/10.1080/10408398.2020.1814991
• Bains N, Abdijadid, S. Major Depressive Disorder. [Updated 2022 Jun 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559078/
• Bazan, N. G., Molina, M. F., & Gordon, W. C. (2011). Docosahexaenoic acid signalolipidomics in nutrition: significance in aging, neuroinflammation, macular degeneration, Alzheimer’s, and other neurodegenerative diseases. Annual review of nutrition, 31, 321. https://doi.org/ 10.1146/annurev.nutr.012809.104635
• Bazan, N. G., Eady, T. N., Khoutorova, L., Atkins, K. D., Hong, S., Lu, Y., ... & Belayev, L. (2012). Novel aspirin-triggered neuroprotectin D1 attenuates cerebral ischemic injury after experimental stroke. Experimental neurology, 236(1), 122-130. https://doi.org/10.1016/j.expneurol.2012.04.007
• Beaglehole, R. (2003). The world health report 2003: shaping the future. World Health Organization. https://books.google.com.tr/books?id=Vv-rOQZs_e0C&lpg=PR7&ots=2BpZdT52h8&lr&pg=PR7#v=onepage&q&f=false
• Bjelland, I., Tell, G. S., Vollset, S. E., Refsum, H., & Ueland, P. M. (2003). Folate, vitamin B12, homocysteine, and the MTHFR 677C→ T polymorphism in anxiety and depression: the Hordaland Homocysteine Study. Archives of general psychiatry, 60(6), 618-626. https://doi.org/ 10.1001/archpsyc.60.6.618
• Burlingame, B., & Dernini, S. (2012). Biodıversity and Sustainable Diets Unıted Against Hunger 3–5 November 2010 FAO Headquarters, Rome. https://ensser.org/wp-content/uploads/fileadmin/files/2012_FAO.pdf
• Chai, B. C., van der Voort, J. R., Grofelnik, K., Eliasdottir, H. G., Klöss, I., & Perez-Cueto, F. J. (2019). Which diet has the least environmental impact on our planet? A systematic review of vegan, vegetarian and omnivorous diets. Sustainability, 11(15), 4110. https://doi.org/10.3390/su11154110
• Clarys, P., Deliens, T., Huybrechts, I., Deriemaeker, P., Vanaelst, B., De Keyzer, W., ... & Mullie, P. (2014). Comparison of nutritional quality of the vegan, vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diet. Nutrients, 6(3), 1318-1332. https://doi.org/10.3390/nu6031318
• Corminboeuf, O., & Leroy, X. (2015). FPR2/ALXR agonists and the resolution of inflammation. Journal of medicinal chemistry, 58(2), 537-559.
• Çelik, F. H., & Hocaoğlu, Ç. (2016). Major depresif bozukluk’tanımı, etyolojisi ve epidemiyolojisi: bir gözden geçirme. Çağdaş Tıp Dergisi, 6(1), 51-66. https://doi.org/10.16899/ctd.03180
• Dantzer, R., O'connor, J. C., Freund, G. G., Johnson, R. W., & Kelley, K. W. (2008). From inflammation to sickness and depression: when the immune system subjugates the brain. Nature reviews neuroscience, 9(1), 46-56. https://doi.org/10.1038/nrn2297
• Derbyshire, E. J. (2017). Flexitarian diets and health: a review of the evidence-based literature. Frontiers in nutrition, 3, 55. https://doi.org/10.3389/fnut.2016.00055
• Dernini, S., & Berry, E. M. (2015). Mediterranean diet: from a healthy diet to a sustainable dietary pattern. Frontiers in nutrition, 2, 15. https://doi.org/10.3389/fnut.2015.00015
• Dernini, S., Berry, E. M., Serra-Majem, L., La Vecchia, C., Capone, R., Medina, F. X., ... & Trichopoulou, A. (2016). Med Diet 4.0: the Mediterranean diet with four sustainable benefits. Public health nutrition, 20(7), 1322-1330.https://doi.org/10.1017/S1368980016003177
• Diaz R. J., & Rosenberg, R. (2008). Spreading dead zones and consequences for marine ecosystems. Science, 321(5891), 926-929. https://doi.org/10.1126/science.1156401
• Dowlati, Y., Herrmann, N., Swardfager, W., Liu, H., Sham, L., Reim, E. K., & Lanctôt, K. L. (2010). A meta-analysis of cytokines in major depression. Biological psychiatry, 67(5), 446-457. https://doi.org/10.1016/j.biopsych.2009.09.033
• EAT-Lancet Commision (2019). https://eatforum.org/content/uploads/2019/07/EAT-Lancet_Commission_Summary_Report.pdf
• Fazelian S., Sadeghi E., Firouzi S., & Haghighatdoost, F (2022). Adherence to the vegetarian diet may increase the risk of depression: a systematic review and meta-analysis of observational studies. Nutrition Reviews, 80(2), 242-254. https://doi.org/10.1093/nutrit/nuab013
• Foley, J. A., DeFries, R., Asner, G. P., Barford, C., Bonan, G., Carpenter, S. R., ... & Snyder, P. K. (2005). Global consequences of land use. science, 309(5734), 570-574. https://doi.org/10.1126/science.1111772
• Food and Agriculture Organizations of the United Nations (2014). Tackling Climate Change Through Livestock. http://www.fao.org/ag/againfo/resources/en/publications/tackling_climate_change/index.htm
• Food and Agriculture Organization of the United Nations World Health Organisation (2019). Sustainable healthy diets: guiding principles. https://www.fao.org/3/ca6640en/ca6640en.pdf
• Food and Agriculture Organisation. 2018. The State of World Fisheries and Aquaculture 2018 – Meeting the sustainable development goals. Rome. License: CC BY-NC-SA 3.0 IGO. https://www.fao.org/3/i9540en/i9540en.pdf
• Gerber, P. J., Steinfeld, H., Henderson, B., Mottet, A., Opio, C., Dijkman, J., ... & Tempio, G. (2013). Tackling climate change through livestock: a global assessment of emissions and mitigation opportunities. Food and Agriculture Organization of the United Nations (FAO). https://www.cabdirect.org/cabdirect/abstract/20133417883
• Grosso, G., Galvano, F., Marventano, S., Malaguarnera, M., Bucolo, C., Drago, F., & Caraci, F. (2014a). Omega-3 fatty acids and depression: scientific evidence and biological mechanisms. Oxidative medicine and cellular longevity, 2014. https://doi.org/10.1155/2014/313570
• Grosso, G., Pajak, A., Marventano, S., Castellano, S., Galvano, F., Bucolo, C., ... & Caraci, F. (2014b). Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. PloS one, 9(5), e96905. https://doi.org/10.1371/journal.pone.0096905
• Hallahan, B., Ryan, T., Hibbeln, J. R., Murray, I. T., Glynn, S., Ramsden, C. E., ... & Davis, J. M. (2016). Efficacy of omega-3 highly unsaturated fatty acids in the treatment of depression. The British Journal of Psychiatry, 209(3), 192-201. https://doi.org/ 10.1192/bjp.bp.114.160242
• Harvard T.H. Chan School of Public Health (2019). The Nutrition Source, Plate and the Planet, https://www.hsph.harvard.edu/nutritionsource/sustainability/plate-and-planet/#planetary-health-diet
• Hopwood C. J. (2022). The link between vegetarian diet and depression might be explained by depression among meat-reducers. Food Quality and Preference, 102, 104679. https://doi.org/10.1016/j.foodqual.2022.104679
• Jain, R., Larsuphrom, P., Degremont, A., Latunde‐Dada, G. O., & Philippou, E. (2022). Association between vegetarian and vegan diets and depression: a systematic review. Nutrition Bulletin, 47(1), 27-49. https://doi.org/10.1111/nbu.12540
• Karamustafalıoğlu, O., & Yumrukçal, H. (2011). Depresyon ve anksiyete bozuklukları. Şişli Etfal Hastanesi Tıp Bülteni, 45(2), 65-74. https://jag.journalagent.com/sislietfaltip/pdfs/SETB-14622-REVIEW_ARTICLE-KARAMUSTAFALIOGLU.pdf
• Kaur C., & Kapoor H. C. (2001). Antioxidants in fruits and vegetables–the millennium’s health. International journal of food science & technology, 36(7), 703-725. https://doi.org/10.1111/j.1365-2621.2001.00513.x
• Kovacs, B., Miller, L., Heller, M. C., & Rose, D. (2021). The carbon footprint of dietary guidelines around the world: a seven country modeling study. Nutrition journal, 20(1), 1-10. https://doi.org/10.1186/s12937-021-00669-6
• Lee, M. F., Eather, R., & Best, T. (2021). Plant-based dietary quality and depressive symptoms in Australian vegans and vegetarians: a cross-sectional study. BMJ nutrition, prevention & health, 4(2), 479. https://doi.org/10.1136/bmjnph-2021-000332
• Liu, T., Zhang, L., Joo, D., & Sun, S. C. (2017). NF-κB signaling in inflammation. Signal transduction and targeted therapy, 2(1), 1-9. https://doi.org/10.1038/sigtrans.2017.23
• Logan A. C., & Jacka, F. N. (2014). Nutritional psychiatry research: an emerging discipline and its intersection with global urbanization, environmental challenges and the evolutionary mismatch. Journal of Physiological Anthropology, 33(1), 1-16. https://doi.org/10.1186/1880-6805-33-22
• Lomagno, K. A., Hu, F., Riddell, L. J., Booth, A. O., Szymlek-Gay, E. A., Nowson, C. A., & Byrne, L. K. (2014). Increasing iron and zinc in pre-menopausal women and its effects on mood and cognition: a systematic review. Nutrients, 6(11), 5117-5141. https://doi.org/10.3390/nu6115117
• Marx, W., Lane, M., Hockey, M., Aslam, H., Berk, M., Walder, K., ... & Jacka, F. N. (2021). Diet and depression: exploring the biological mechanisms of action. Molecular psychiatry, 26(1), 134-150. https://doi.org/10.1038/s41380-020-00925-x
• Masana, M. F., Haro, J. M., Mariolis, A., Piscopo, S., Valacchi, G., Bountziouka, V., ... & Panagiotakos, D. B. (2018). Mediterranean diet and depression among older individuals: the multinational MEDIS study. Experimental gerontology, 110, 67-72. https://doi.org/10.1016/j.exger.2018.05.012
• Mannikkö, R., Komulainen, P., Schwab, U., Heikkilä, H. M., Savonen, K., Hassinen, M., ... & Rauramaa, R. (2015). The Nordic diet and cognition–The DR's EXTRA Study. British Journal of Nutrition, 114(2), 231-239. https://doi.org/ 10.1017/S0007114515001890
• Medawar, E., Huhn, S., Villringer, A., & Veronica Witte, A. (2019). The effects of plant-based diets on the body and the brain: a systematic review. Translational psychiatry, 9(1), 1-17. https://doi.org/10.1038/s41398-019-0552-0
• Mithril, C., Dragsted, L. O., Meyer, C., Blauert, E., Holt, M. K., & Astrup, A. (2012). Guidelines for the new Nordic diet. Public health nutrition, 15(10), 1941-1947. https://doi.org/ 10.1017/S136898001100351X
• Myint, A. M., Leonard, B. E., Steinbusch, H. W., & Kim, Y. K. (2005). Th1, Th2, and Th3 cytokine alterations in major depression. Journal of affective disorders, 88(2), 167-173. https://doi.org/10.1016/j.jad.2005.07.008
• Ocklenburg, S., & Borawski, J. (2021). Vegetarian diet and depression scores: a meta-analysis. Journal of Affective Disorders, 294, 813-815. https://doi.org/10.1016/j.jad.2021.07.098
• Orlich, M. J., Jaceldo-Siegl, K., Sabaté, J., Fan, J., Singh, P. N., & Fraser, G. E. (2014). Patterns of food consumption among vegetarians and non-vegetarians. British journal of nutrition, 112(10), 1644-1653. https://doi.org/ 10.1017/S000711451400261X
• Pandey, K. B., & Rizvi, S. I. (2009). Plant polyphenols as dietary antioxidants in human health and disease. Oxidative medicine and cellular longevity, 2(5), 270-278. https://doi.org/10.4161/oxim.2.5.9498
• Pekcan, A. G. (2019). Sürdürülebilir beslenme ve beslenme örüntüsü: bitkisel kaynaklı beslenme. Beslenme ve Diyet Dergisi, 47(2), 1-10. https://doi.org/10.33076/2019.BDD.1268
• Perry, V. H., Cunningham, C., & Holmes, C. (2007). Systemic infections and inflammation affect chronic neurodegeneration. Nature Reviews Immunology, 7(2), 161-167. https://doi.org/10.1038/nri2015
• Psaltopoulou, T., Sergentanis, T. N., Panagiotakos, D. B., Sergentanis, I. N., Kosti, R., & Scarmeas, N. (2013). Mediterranean diet, stroke, cognitive impairment, and depression: a meta‐analysis. Annals of neurology, 74(4), 580-591. https://doi.org/10.1002/ana.23944
• Raison, C. L., Capuron, L., & Miller, A. H. (2006). Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends in immunology, 27(1), 24-31. https://doi.org/10.1016/j.it.2005.11.006
• Rihmer, Z., & Angst J. (2007). Duygudurum Bozuklukları: Epidemiyoloji. Aydın H, Bozkurt A,(çev. eds). Türkçe: Kaplan & Sadock’s Comprehensive Text book of Psychiatry, 8, 1575-1582.
• Sabet, J. A., Ekman, M. S., Lundvall, A. S., Risérus, U., Johansson, U., Öström, Å., ... & Brummer, R. J. (2021). Feasibility and acceptability of a healthy Nordic diet intervention for the treatment of depression: a randomized controlled pilot trial. Nutrients, 13(3), 902. https://doi.org/10.3390/nu13030902
• Salem, N., & Niebylski, C. D. (1995). The nervous system has an absolute molecular species requirement for proper function. Molecular membrane biology, 12(1), 131-134. https://doi.org/10.3109/09687689509038508
• Sanchez-Villegas, A., Henriquez, P., Bes-Rastrollo, M., & Doreste, J. (2006). Mediterranean diet and depression. Public health nutrition, 9(8A), 1104-1109. https://doi.org/10.1017/S1368980007668578
• Sanchez-Villegas, A., Martínez-González, M. A., Estruch, R., Salas-Salvadó, J., Corella, D., Covas, M. I., & Serra-Majem, L. (2013). Mediterranean dietary pattern and depression: the PREDIMED randomized trial. BMC medicine, 11(1), 1-12. https://doi.org/10.1186/1741-7015-11-208
• Saveanu, R. V., & Nemeroff, C. B. (2012). Etiology of depression: genetic and environmental factors. Psychiatric clinics, 35(1), 51-71. https://doi.org/10.1016/j.psc.2011.12.00
• Sikalidis, A. K., Kelleher, A. H., & Kristo, A. S. (2021). Mediterranean Diet. Encyclopedia, 1(2), 371-387. https://doi.org/10.3390/encyclopedia1020031
• Springmann, M., Wiebe, K., Mason-D'Croz, D., Sulser, T. B., Rayner, M., & Scarborough, P. (2018). Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: a global modelling analysis with country-level detail. The Lancet Planetary Health, 2(10), e451-e461. https://doi.org/10.1016/S2542-5196(18)30206-7
• Springmann, M., Clark, M. A., Rayner, M., Scarborough, P., & Webb, P. (2021). The global and regional costs of healthy and sustainable dietary patterns: a modelling study. The Lancet Planetary Health, 5(11), e797-e807. https://doi.org/10.1016/S2542-5196(21)00251-5
• Stanger, O., Fowler, B., Piertzik, K., Huemer, M., Haschke-Becher, E., Semmler, A., ... & Linnebank, M. (2009). Homocysteine, folate and vitamin B12 in neuropsychiatric diseases: review and treatment recommendations. Expert review of neurotherapeutics, 9(9), 1393-1412.7 https://doi.org/10.1586/ern.09.75
• Sugimoto, M. A., Sousa, L. P., Pinho, V., Perretti, M., & Teixeira, M. M. (2016). Resolution of inflammation: what controls its onset?. Frontiers in immunology, 7, 160. https://doi.org/10.3389/fimmu.2016.00160
• Thomas E., & Seedat S. (2018). The diagnosis and management of depression in the era of the DSM-5. South African family practice, 60(1), 22-28. https://journals.co.za/doi/epdf/10.10520/EJC-e1675d2df
• Tilman, D., Clark, M., Williams, D. R., Kimmel, K., Polasky, S., & Packer, C. (2017). Future threats to biodiversity and pathways to their prevention. Nature, 546(7656), 73-81. https://doi.org/10.1038/nature22900
• Tordjman, K., Grinshpan, L., Novack, L., Göen, T., Segev, D., Beacher, L., ... & Berman, T. (2016). Exposure to endocrine disrupting chemicals among residents of a rural vegetarian/vegan community. Environment international, 97, 68-75. https://doi.org/10.1016/j.envint.2016.10.018
• Uusitupa, M., & Schwab U. (2013). Diet, inflammation and prediabetes—Impact of quality of diet. Canadian journal of diabetes, 37(5), 327-331. https://doi.org/10.1016/j.jcjd.2013.07.029
• Wager-Smith, K., & Markou, A. (2011). Depression: a repair response to stress-induced neuronal microdamage that can grade into a chronic neuroinflammatory condition?. Neuroscience & Biobehavioral Reviews, 35(3), 742-764. https://doi.org/10.1016/j.neubiorev.2010.09.010
• Willett P.W.., Rockström, J., Loken, B., Springmann, M., Lang, T., Vermeulen, S., ... & Murray, C. J. (2019). Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems. The Lancet, 393(10170), 447-492. https://doi.org/10.1016/S0140-6736(18)31788-4
• Wohleb, E. S., Franklin, T., Iwata, M., & Duman, R. S. (2016). Integrating neuroimmune systems in the neurobiology of depression. Nature Reviews Neuroscience, 17(8), 497-511. https://doi.org/10.1038/nrn.2016.69 World Health Organisation (WHO) (2021). Depression. https://www.who.int/news-room/fact-sheets/detail/depression
• Wozniak, H., Larpin, C., de Mestral, C., Guessous, I., Reny, J. L., & Stringhini, S. (2020). Vegetarian, pescatarian and flexitarian diets: sociodemographic determinants and association with cardiovascular risk factors in a Swiss urban population. British Journal of Nutrition, 124(8), 844-852. https://doi.org/10.1017/S0007114520001762
• Vermeulen, S. J., Campbell, B. M., & Ingram, J. S. (2012). Climate change and food systems. Annual review of environment and resources, 37(1), 195-222. https://doi.org/10.1146/annurev-environ-020411-130608
• Viala, E. (2008). Water for food, water for life a comprehensive assessment of water management in agriculture. Irrigation and Drainage Systems, 22 (1), 127-129 https://doi.org/10.1007/s10795-008-9044-8
• Yalçın, B. M., & Öztürk, O. (2016). The management of major depressive disorder in primary care. Turkish Journal of Family Medicine and Primary Care, 10(4), 250-258. https://doi.org/ 10.21763/tjfmpc.271331
• Yin, W., Löf, M., Chen, R., Hultman, C. M., Fang, F., & Sandin, S. (2021). Mediterranean diet and depression: a population-based cohort study. International Journal of Behavioral Nutrition and Physical Activity, 18(1), 1-10. https://doi.org/10.1186/s12966-021-01227-3
• Zorrilla, E. P., Luborsky, L., McKay, J. R., Rosenthal, R., Houldin, A., Tax, A., ... & Schmidt, K. (2001). The relationship of depression and stressors to immunological assays: a meta-analytic review. Brain, behavior, and immunity, 15(3), 199-226. https://doi.org/10.1006/brbi.2000.0597