NEW YORK (EGMN) – Vitamin D deficiency was linked with an increased prevalence of psychotic symptoms in adolescents hospitalized for psychiatric reasons in a single-center study of 77 patients.

“The association of vitamin D deficiency with psychotic features warrants further investigation as a risk factor for both physical and mental health outcomes” in adolescents with serious mental illness, Dr. Barbara L. Gracious and her associates said in a poster presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry.

“The importance of vitamin D for brain development and function in both healthy and psychiatric populations is less well appreciated and understood, compared with its known role in bone health and emerging role in metabolic health,” said Dr. Gracious, a psychiatrist at Nationwide Children’s Hospital in Columbus, Ohio, and her colleagues.

Prior study findings documented links between vitamin D levels and seasonal affective disorder, depression, and schizophrenia, observations that highlighted the potential for vitamin D levels to modulate vulnerability to mental disorders.

To explore a possible link between vitamin D and psychosis, Dr. Gracious and her associates studied 77 adolescents who presented at the University of Rochester (New York) for inpatient or partial hospital mental health treatment during October 2008-June 2009. The patients averaged 15 years old, and underwent a psychiatric assessment at the time of their hospitalization by an emergency-room psychiatrist and by the attending child psychiatrist. Psychosis was defined as hallucinations, paranoia, or delusions. The researchers measured blood levels of 25-hydroxy vitamin D with an immunoassay.

The assays showed that 31 of the referred adolescents (40%) had vitamin D deficiency, defined as a blood level less than 20 ng/mL; 26 (34%) had vitamin D insufficiency, defined as a blood level of 20-30 ng/mL; and 20 (26%) had a normal vitamin D level, defined as greater than 30 ng/mL.

Overall, the researchers identified psychotic symptoms in 19 of the 77 patients (25%). The psychotic prevalence rate among vitamin D–deficient adolescents was 13 out of 31 (42%). Among 26 adolescents with vitamin D insufficiency, 3 (12%) had psychotic symptoms. In 20 adolescents with a normal vitamin D level, 3 patients (15%) showed psychotic symptoms.

In an unadjusted, odds ratio analysis, vitamin D–deficient adolescents had a significant, fourfold increased risk of psychosis, compared with patients with normal vitamin D levels.

On the basis of these findings, physicians should now consider clinical screening of vitamin D levels in severely mentally ill adolescents at high risk for chronic mental and metabolic illness, and supplementing those who are deficient or insufficient, Dr. Gracious and her associates concluded. Further research should explore the levels of vitamin D intake and sun exposure needed by these patients, and also explore the role that vitamin D plays in the severity of mental illness in patients of other ages, they said.

Dr. Gracious did not have any disclosures.

Copyright (c) 2010 Elsevier Global Medical News. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

纽约(EGMN)——俄亥俄州哥伦布全国儿童医院精神病医生Barbara L. Gracious博士及其同事在美国儿童和青少年精神病学会年会壁报论文中称，维生素D缺乏与青少年精神病患者精神病症状患病率增加相关。

既往研究显示，维生素D与季节性情感障碍、抑郁症和精神分裂症相关，表明维生素D水平可能对精神性疾病易感性具有调节作用。但是维生素D对精神病患者身心健康的重要性尚缺乏认识和了解。

为探讨维生素D与精神病之间潜在的相关性，研究者对2008年10月~2009年6月期间在罗切斯特大学住院或部分住院治疗的77例青少年患者进行研究。平均年龄为15岁，住院时接受了急诊科精神病医生和儿童精神病主治医生的精神病评估，精神病定义为幻觉、偏执或妄想。研究者采用免疫分析法测量患者血液25-羟维生素D水平。

分析显示，31例青少年(40%)为维生素D缺乏(<20 ng/ml)，26例为维生素D不足(20～30 ng/ml)，20例为维生素D正常(>30 ng/ml)。总体上，研究者确定精神病性症状的患者有19例(19/77，25%)，其中维生素D缺乏、不足和正常的患者精神病患病率分别为42%(13/31)、12% (3/26)和15%(3/20)。未调整的比值比分析显示，维生素D缺乏的青少年精神病风险比正常者显著增加4倍。

基于上述发现，维生素D水平应作为严重精神疾病青少年患者身心健康预后风险因素加以深入研究，并应考虑对高危青少年患者进行维生素D水平筛查和补充，对其维生素D摄入水平和日光暴露需求量进行探讨，还应开展维生素D对其他年龄段严重精神病患者作用的研究。

研究者无利益冲突披露。

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