Hypovitaminosis D is associated with negative symptoms, suicide risk, agoraphobia, impaired functional remission, and antidepressant consumption in schizophrenia.
Eur Arch Psychiatry Clin Neurosci. 2018 Aug 4. doi: 10.1007/s00406-018-0932-0. [Epub ahead of print]
Schizophrenics with low Vitamin D also found to be 2.7 X higher risk of suicide
Overview Schizophrenia and Vitamin D contains the following summary
Many reasons to think that schizophrenia is associated with low vitamin D
1) 97% of patients with schizophrenia are vitamin D deficient
2) Schizophrenia varies with latitude (UVB) by 10X (controversy)
3) Schizophrenia is more common in those with dark skin (when away from the equator)
4) Schizophrenia is associated with low natal vitamin D
5) Schizophrenia has been increasing around the world when vitamin D has been decreasing (controversy)
6) Schizophrenia is associated with low birth rate, which is associated with low vitamin D
7) Schizophrenia is associated with Autism which is associated with low vitamin D
8) Schizophrenia Bulletin Editorial (Jan 2014) speculated that Vitamin D could be a major player
9) Schizophrenia 2X more likely if low vitamin D - meta-analysis
10) Schizophrenia increased 40 % for Spring births after Danes stopped vitamin D fortification
11) Schizophrenia is associated with season of birth
12) Schizophrenia is associated with poor Vitamin D Receptor genes
13) Schizophrenia risk is decreased if give Vitamin D after birth
14) Schizophrenia symptoms reduced when Vitamin D levels are restored
Suicide associated with low vitamin D starts with
Hints that suicide is associated with low vitamin D:
- Suicide peaks in the Spring, when vitamin D values are lowest
- Suicide has increased while vitamin D has been decreasing
- Suicide higher in dark-skinned individuals (low vitamin D due to built-in sun protection)
- Suicide higher in prison (shut-ins have low levels of vitamin D)
- Suicide rate is higher at high latitudes (where vitamin D is less available)
See Criteria to associate a health problem with low vitamin D
Fond G1,2,3, Faugere M4,5,6, Faget-Agius C4,5,6, Cermolacce M4,5,6, Richieri R4,5,6, Boyer L4,5,6, Lançon C4,5,6.
- 1 Department of Psychiatry, La Conception University Hospital, 13005, Marseille, France. guillaume.fond at ap-hm.fr.
- 2 Faculté de Médecine, Secteur Timone, EA 3279, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ, 27 Boulevard Jean Moulin, 13005, Marseille, France. guillaume.fond at ap-hm.fr.
- 3 SHU Adult Psychiatry, Sainte Marguerite University Hospital, 13274, Marseille, France. guillaume.fond at ap-hm.fr.
- 4 Department of Psychiatry, La Conception University Hospital, 13005, Marseille, France.
- 5 Faculté de Médecine, Secteur Timone, EA 3279, EA 3279: CEReSS-Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, Aix-Marseille Univ, 27 Boulevard Jean Moulin, 13005, Marseille, France.
- 6 SHU Adult Psychiatry, Sainte Marguerite University Hospital, 13274, Marseille, France.
Hypovitaminosis D has been associated with, respectively, major depressive disorder, schizophrenia (SZ), and cognitive disorders in the general population, and with positive and negative symptoms and metabolic syndrome in schizophrenia. The objective was to determine the prevalence of hypovitaminosis D and associated factors in a non-selected multicentric sample of SZ subjects in day hospital. Hypovitaminosis D was defined by blood vitamin D level < 25 nM. Depressive symptoms were assessed by the Calgary Depression Rating Scale Score and Positive and Negative Syndrome Scale Score. Anxiety disorders and suicide risk were evaluated by the Structured Clinical Interview for Mental Disorders. Functioning was evaluated with the Functional Remission of General Schizophrenia Scale. Hypovitaminosis D has been found in 27.5% of the subjects.
In multivariate analysis, hypovitaminosis D has been significantly associated with, respectively,
- higher suicide risk (aOR = 2.67 [1.31-5.46], p = 0.01),
- agoraphobia (aOR = 3.37 [1.66-6.85], p < 0.0001),
- antidepressant consumption (aOR = 2.52 [1.37-4.64], p < 0.001),
- negative symptoms (aOR = 1.04 [1.01-1.07], p = 0.04),
- decreased functioning (aOR = 0.97[0.95-0.99], p = 0.01), and
- increased leucocytosis (aOR = 1.17 [1.04-1.32], p = 0.01)
independently of age and gender. No association with alcohol use disorder, metabolic syndrome, peripheral inflammation, insulin resistance, or thyroid disturbances has been found (all p > 0.05). Despite some slight abnormalities, no major cognitive impairment has been associated with hypovitaminosis D in the present sample (all p > 0.05 except for WAIS similarities score). Hypovitaminosis D is frequent and associated with suicide risk, agoraphobia and antidepressant consumption in schizophrenia, and more slightly with negative symptoms. Patients with agoraphobia, suicide risk and antidepressant consumption may, therefore, benefit in priority from vitamin D supplementation, given the benefit/risk profile of vitamin D. Further studies should evaluate the impact of vitamin D supplementation on clinical outcomes of SZ subjects.
PMID: 30078128 DOI: 10.1007/s00406-018-0932-0