Prevalence of vitamin D deficiency in patients with schizophrenia at King Chulalongkorn Memorial Hospital
Keywords:
Vitamin D deficiency, schizophrenia, Positive and Negative Syndrome Scale in Thai version (PANSS-T)Abstract
Background: Vitamin D is considered a neurosteroid hormone which can impact brain development and normal brain function, as well as inflammatory and immunological process. Several risk factors of schizophrenia such as season of birth, latitude and migration are linked to vitamin D deficiency. This study aimed to investigate the prevalence of vitamin D deficiency in patients with schizophrenia and investigate relationship between vitamin D levels and schizophrenia.
Objective: To study the prevalence of vitamin D deficiency among patients with schizophrenia at King Chulalongkorn Memorial Hospital.
Methods: Cross-sectional descriptive study, data were collected from schizophrenic patients at King Chulalongkorn Memorial Hospital. Questionnaire on personal data and sun exposure, assessment of psychological illness based on Positive and Negative Syndrome Scale in Thai version (PANSS-T) were obtained and blood 25-hydroxy vitamin D (25 (OH) D) levels were analyzed. The prevalence of vitamin D deficiency was assessed and presented in frequency and percentage, Chi-square test was used to identify factors contributing to vitamin D levels. Pearson’s correlation was used to identify factors relating to vitamin D levels. Spearman’s rank correlation was used to assess the relationship between vitamin D levels and PANSS-T score. Multiple linear regression analysis was used to identify factors predicting vitamin D levels.
Results: There were 88 subjects who participated in this research project: mean age of 40.8 10.8 years old; 62.5% male; mean vitamin D level of 21.53
8.568 ng/ml. The prevalence of vitamin D deficiency is 45.5% - mean PANSS-T score of 45.56
9.56. Based on the correlation analysis, vitamin D levels are negatively correlated with body mass index (BMI) (r = - 0248, P = 0.017). Vitamin D levels are not related to PANSS-T scores. In addition, Factors predicting vitamin D levels are BMI, sex and duration of illness (P < 0.05).
Conclusions: The study reveals that 45.5% of schizophrenic patients treated at King Chulalongkorn Memorial Hospital had vitamin D deficiency. There is a negative correlation between vitamin D levels and BMI, sex and duration of illness. Factors predicting vitamin D levels are BMI, sex and duration of illness. The study demonstrates no relationship between vitamin D levels and PANSS-T score,
Downloads
References
Saha S, Chant D, Welham J, McGrath J. A systematic review of the prevalence of schizophrenia. PLoS Med 2005;2:e141. https://doi.org/10.1371/journal.pmed.0020141
Charlson FJ, Ferrari AJ, Santomauro DF, Diminic S, Stockings E, Scott JG, et al. Global epidemiology and burden of schizophrenia: findings from the global burden of disease study 2016. Schizophr Bull 2018;44:1195-203. https://doi.org/10.1093/schbul/sby058
Chiang M, Natarajan R, Fan X. Vitamin D in schizophrenia: a clinical review. Evid Based Ment Health 2016;19:6-9. https://doi.org/10.1136/eb-2015-102117
Boerman R, Cohen D, Schulte PF, Nugter A. Prevalence of vitamin D deficiency in adult outpatients with bipolar disorder or schizophrenia. J Clin Psychopharmacol 2016;36:588-92.
https://doi.org/10.1097/JCP.0000000000000580
Chaiyodsilp S, Pureekul T, Srisuk Y, Euathanikkanon C. A cross section study of vitamin D levels in Thai office worker. Bangkok Med J 2015;9:8-11. https://doi.org/10.31524/bkkmedj.2015.02.002
Valipour G, Saneei P, Esmaillzadeh A. Serum vitamin D levels in relation to schizophrenia: a systematic review and meta-analysis of observational studies. J Clin Endocrinol Metab 2014;99:3863-72.
https://doi.org/10.1210/jc.2014-1887
Nilchaikovit T, Uneanong S, Kessawai D, Thomyangkoon P. The Thai version of the Positive and Negative Syndrome Scale (PANSS) for schizophrenia: criterion validity and interrater reliability. J Med Assoc Thai 2000;83:646-51.
Chailurkit L, Aekplakorn W, Ongphiphadnakul B. Regional variation and determinants of vitamin D status in sunshine-abundant Thailand. BMC Public Health 2011;11:853.
https://doi.org/10.1186/1471-2458-11-853
Akinlade KS, Olaniyan OA, Lasebikan VO, Rahamon SK. Vitamin D levels in different severity groups of schizophrenia. Front Psychiatry 2017;8:105. https://doi.org/10.3389/fpsyt.2017.00105
Lagunova Z, Porojnicu AC, Lindberg F, Hexeberg S, Moan J. The dependency of vitamin D status on body mass index, gender, age and season. Anticancer Res 2009;29:3713-20.
https://doi.org/10.14341/2071-8713-4886
Nerhus M. Migration and vitamin D in psychotic disorders-Across sectional study of clinical and cognitive correlation [Thesis]. Oslo, Norway: University of Oslo; 2017.
Prasanty N, Amin MM, Effendy E, Simbolon J. Low vitamin D serum level increases severity symptoms in schizophrenic patients measured by Positive and Negative Symptoms Scale (PANSS) in Batak Tribe Sumatera Utara, Medan-Indonesia. Bali Med J 2018;7:249-54. https://doi.org/10.15562/bmj.v7i1.921
Wrzosek M, £ukaszkiewicz J, Wrzosek M, Jakubczyk A, Matsumoto H, Piątkiewicz P, et al. Vitamin D and the central nervous system. Pharmacol Rep 2013;65:271-8. https://doi.org/10.1016/S1734-1140(13)71003-X
Albayrak Y, Ünsal C, Beyazyüz M, Ünal A, Kuloğlu M. Reduced total antioxidant level and increased oxidative stress in patients with deficit schizophrenia: a preliminary study. Prog Neuropsychopharmacol Biol Psychiatry 2013;45:144-9. https://doi.org/10.1016/j.pnpbp.2013.04.020
Sullivan EM, O'Donnell P. Inhibitory interneurons, oxidative stress, and schizophrenia. Schizophr Bull 2012;38:373-6. https://doi.org/10.1093/schbul/sbs052
Kannan S, Visintainer P, Ganguri HB, Conroy R, Gudala M, Wittcopp C. Body mass index is a strong predictor of vitamin D deficiency in multiethnic obese children. Obes Res Open J 2016;4:11-8.
https://doi.org/10.17140/OROJ-4-128
Delle MS, Di Fulvio P, Iannetti E, Valerii L, Capone L, Nespoli MG, et al. Body mass index represents a good predictor of vitamin D status in women independently from age. Clin Nutr 2018 pii: S0261-5614(18)30089-X.
Verdoia M, Schaffer A, Barbieri L, Di Giovine G, Marino P, Suryapranata H, et al. Impact of gender difference on vitamin D status and its relationship with the extent of coronary artery disease. Nutr Metab Cardiovasc Dis 2015;25:464-70. https://doi.org/10.1016/j.numecd.2015.01.009
AlQuaiz AM, Kazi A, Fouda M, Alyousefi N. Age and gender differences in the prevalence and correlates of vitamin D deficiency. Arch Osteoporos 2018;13:49.
https://doi.org/10.1007/s11657-018-0461-5
Lally J, Gardner-Sood P, Firdosi M, Iyegbe C, Stubbs B, Greenwood K, et al. Clinical correlates of vitamin D deficiency in established psychosis. BMC Psychiatry 2016;16:76.
https://doi.org/10.1186/s12888-016-0780-2
Yüksel RN,Altunsoy N, Tikir B, Cingi Külük M, Unal K, Goka S, et al. Correlation between total vitamin D levels and psychotic psychopathology in patients with schizophrenia: therapeutic implications for add-on vitamin D augmentation. Ther Adv Psychopharmacol 2014;4:268-75.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Chulalongkorn Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
