Vitamin D deficiency and psychotic features in mentally ill adolescents: a cross-sectional study

BMC Psychiatry. 2012 May 9;12:38. doi: 10.1186/1471-244X-12-38.

Abstract

Background: Vitamin D deficiency is a re-emerging epidemic, especially in minority populations. Vitamin D is crucial not only for bone health but for proper brain development and functioning. Low levels of vitamin D are associated with depression, seasonal affective disorder, and schizophrenia in adults, but little is known about vitamin D and mental health in the pediatric population.

Methods: One hundred four adolescents presenting for acute mental health treatment over a 16-month period were assessed for vitamin D status and the relationship of 25-OH vitamin D levels to severity of illness, defined by presence of psychotic features.

Results: Vitamin D deficiency (25-OH D levels <20 ng/ml) was present in 34%; vitamin D insufficiency (25-OH D levels 20-30 ng/ml) was present in 38%, with a remaining 28% in the normal range. Adolescents with psychotic features had lower vitamin D levels (20.4 ng/ml vs. 24.7 ng/ml; p=0.04, 1 df). The association for vitamin D deficiency and psychotic features was substantial (OR 3.5; 95% CI 1.4-8.9; p <0.009). Race was independently associated with vitamin D deficiency and independently associated with psychosis for those who were Asian or biracial vs. white (OR=3.8; 95% CI 1.1‒13.4; p<0.04). Race was no longer associated with psychosis when the results were adjusted for vitamin D level.

Conclusions: Vitamin D deficiency and insufficiency are both highly prevalent in adolescents with severe mental illness. The preliminary associations between vitamin D deficiency and presence of psychotic features warrant further investigation as to whether vitamin D deficiency is a mediator of illness severity, result of illness severity, or both. Higher prevalence of vitamin D deficiency but no greater risk of psychosis in African Americans, if confirmed, may have special implications for health disparity and treatment outcome research.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • African Americans
  • Asian Americans
  • Child
  • Cross-Sectional Studies
  • European Continental Ancestry Group
  • Female
  • Hispanic Americans
  • Humans
  • Male
  • Mentally Ill Persons
  • Psychotic Disorders / complications*
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / psychology
  • Severity of Illness Index
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / psychology