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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2012; 12: 38.
Published online 2012 May 9. doi:  10.1186/1471-244X-12-38
PMCID: PMC3441857
Copyright ©2012 Gracious et al.; licensee BioMed Central Ltd.
Vitamin D deficiency and psychotic features in mentally ill adolescents: A cross-sectional study
Barbara L Gracious,corresponding author1,4 Teresa L Finucane,2 Meriel Friedman-Campbell,3 Susan Messing,2,5 and Melissa N Parkhurst2
1Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children’s Hospital and The Ohio State University, Columbus, OH, USA
2Clinical Research Coordinator, University of Rochester Medical Center, Department of Psychiatry, 300 Crittenden Boulevard, Rochester, New York, 14642, USA
3Psychiatric Nurse Practitioner, Irwin Army Community Hospital Behavioral Health, 600 Caisson Hill Road, Fort Riley, KS, 66442, USA
4Nationwide Children’s Hospital 700 Children’s Drive, Columbus, OH, 43205, USA
5Senior Research Associate, Department of Biostatistics and Computational Biology, University of Rochester Medical Center
corresponding authorCorresponding author.
Barbara L Gracious: Barbara.gracious/at/nationwidechildrens.org; Teresa L Finucane: tlfinucane/at/hotmail.com; Meriel Friedman-Campbell: meriel.f.campbell/at/us.army.mil; Susan Messing: Susan_Messing/at/urmc.rochester.edu; Melissa N Parkhurst: Melissa_Parkhurst/at/urmc.rochester.edu
Received December 17, 2011; Accepted May 9, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords: Vitamin D, Adolescents, Deficiency, Psychosis
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