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Adults with intellectual disabilities under psychiatric care have low levels of vitamin D – Sept 2014

Vitamin D deficiency in patients with intellectual disabilities: prevalence, risk factors and management strategies

British Journal of Psych
Valeria Frighi valeria.frighi at psych.ox.ac.uk, Alireza Morovat, Matthew T. Stephenson, Sarah J. White, Christina V. Hammond and Guy M. Goodwin
Valeria Frighi, MD, Department of Psychiatry, University of Oxford and Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Alireza Morovat, PhD, FRCPath, Department of Clinical Biochemistry, Oxford University Hospitals NHS Trust, Oxford; Matthew T. Stephenson, FRCPsych, MSysPsych, Oxfordshire Learning Disability NHS Trust (now Southern Health NHS Foundation Trust), Oxford; Sarah J. White, RGN, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford; Christina V. Hammond, BSc, Guy M. Goodwin, Dphil, FRCPsych, FMedSci, Department of Psychiatry, University of Oxford, Oxford, UK
Declaration of interest: V.F. and G.M.G. have received grants from the Baily Thomas Charitable Fund. G.M.G. has also received grants from Servier, and speaker honoraria or fees for advice from AstraZeneca, Cephalon/Teva, Eli Lilly, GSK, Lundbeck, Merck, Otsuka, Servier, Takeda and Sunovion.

VitaminDWiki Summary and coment

In this study people in psych wards were almost 2X more likely to have < 20 ng of vitamin D
It is well known that people in psych wards have low level of vitamin D
Many of the categories of people at high risk of being vitamin D deficient are listed in the abstract


Background
People with intellectual disabilities have a high risk of osteoporosis and fractures, which could partly be as a result of vitamin D deficiency.

Aims
To compare the serum vitamin D (25(OH)D) levels of 155 patients with intellectual disabilities under psychiatric care and 192 controls, investigate potential risk factors for vitamin D deficiency in people with intellectual disabilities and assess available treatments.

Method
Cross-sectional observational study followed by treatment evaluation.

Results
Almost twice as many patients with intellectual disabilities had vitamin D deficiency (25(OH)D <50 nmol/l) compared with controls (77.3% v. 39.6%, P<0.0001).
In the intellectual disabilities group,

  • winter season (P<0.0001),
  • dark skin pigmentation (P<0.0001),
  • impaired mobility (P = 0.002) and
  • obesity (P = 0.001)

were independently associated with lower serum 25(OH)D.
In most patients, 800 IU colecalciferol daily normalised 25(OH)D levels.

Conclusions
Vitamin D deficiency is highly prevalent in people with intellectual disabilities, partly because of insufficient exposure to sunlight. Screening and treatment strategies, aiming to reduce these patients’ high fracture risk, should be introduced. Similar strategies may be required in other psychiatric populations at risk for fractures and with a tendency to spend excessive time indoors.


2nd article similar topic - Dec 2014

Vitamin D deficiency in patients with intellectual disabilities: prevalence, risk factors and management strategies
Br J Psychiatry. 2014 Dec;205(6):458-64. doi: 10.1192/bjp.bp.113.143511. Epub 2014 Sep 25.
Frighi V1, Morovat A1, Stephenson MT1, White SJ1, Hammond CV1, Goodwin GM1.

Background People with intellectual disabilities have a high risk of osteoporosis and fractures, which could partly be as a result of vitamin D deficiency. Aims To compare the serum vitamin D (25(OH)D) levels of 155 patients with intellectual disabilities under psychiatric care and 192 controls, investigate potential risk factors for vitamin D deficiency in people with intellectual disabilities and assess available treatments.

Method Cross-sectional observational study followed by treatment evaluation.

Results Almost twice as many patients with intellectual disabilities had vitamin D deficiency (25(OH)D <50 nmol/l) compared with controls (77.3% v. 39.6%, P<0.0001). In the intellectual disabilities group, winter season (P<0.0001), dark skin pigmentation (P<0.0001), impaired mobility (P = 0.002) and obesity (P = 0.001) were independently associated with lower serum 25(OH)D.

In most patients, 800 IU colecalciferol daily normalised 25(OH)D levels.

Conclusions Vitamin D deficiency is highly prevalent in people with intellectual disabilities, partly because of insufficient exposure to sunlight. Screening and treatment strategies, aiming to reduce these patients' high fracture risk, should be introduced. Similar strategies may be required in other psychiatric populations at risk for fractures and with a tendency to spend excessive time indoors.

PMID: 25257061 Publisher wants $30 for the PDF


See also VitaminDWiki

See also web

  • Vitamin D deficiency in psychosis: our current (limited) understanding according to the latest meta-analysis.
    Patients with psychosis did have significantly lower vitamin D levels than healthy controls (6 studies analysed)
    2 studies examined the relationship between severity of vitamin D deficiency and severity of psychotic symptoms:
      1 found no correlations;
      1 found correlations between low vitamin D and high disorientation, psychomotor activity, low physical energy and somatic complaints.
    This paper was a comment on Belvederi Murri M, Respino M, Masotti M, Innamorati M, Mondelli V, Pariante C, Amore M. Vitamin D and psychosis: Mini meta-analysis. Schizophr Res. 2013 Jul 29.

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