Relationship between serum vitamin B12 level, sociodemographic variables, and medical comorbidity in psychiatric in-patients
DOI:
https://doi.org/10.18203/2320-6012.ijrms20220285Keywords:
Vitamin B12, Comorbidities, Psychiatric, In-patients, Folate, Depression, AnxietyAbstract
Background: To compare serum vitamin B12 levels in psychiatric in-patients and their caregivers and, to study the relationship between psychiatric diagnosis and vitamin B12 levels in psychiatric in-patients.
Methods: Adult psychiatric in-patients (n=103) and their adult caregiver (n=103) were enrolled in the present cross-sectional study. All participants underwent estimation of serum vitamin B12, complete blood counts, mean corpuscular volume (MCV), serum folate, and serum ferritin.
Results: Vitamin B12 deficiency was found more frequently (60.2%) in psychiatric patients compared to their caregiver (3.9%) (p=0.000). Psychiatric in-patients were significantly younger in age, with a lower level of serum vitamin B12 and folate, fewer numbers of polymorphs, and more numbers of lymphocytes in their peripheral compared to their caregivers. There was no statistically significant difference in socio-demographic variables such as food habit, gender, residence (rural/urban), and occupation between those patients who were deficient and those who were non-deficient in vitamin B12. There was no statistically significant difference between the psychiatric diagnoses and comorbidities in patients with and without vitamin B12 deficiency. Patients with vitamin B12 deficiency were also not different in terms of their psychiatric diagnosis and associated comorbidities when compared with the patient without vitamin B12 deficiency.
Conclusions: Around 60% of psychiatric inpatients have low serum vitamin B12 levels. Lifestyle-related factors and chronic medical illness likely contribute to vitamin B12 deficiency in psychiatric in-patients. Adult psychiatric patients with other medical comorbidities should be screened for vitamin B12 deficiency.
References
Herrmann W, Lorenzl S, Obeid R. Review of the role of hyperhomocysteinemia and B-vitamin deficiency in neurological and psychiatric disorders: current evidence and preliminary recommendations. Fortschr Neurol Psychiatr. 2007;75:515–27.
Catalano G, Catalano MC, O’Dell KJ, Humphrey DA, Fritz EB. The utility of laboratory screening in medically ill patients with psychiatric symptoms. Ann Clin Psychiatry. 2001;13:135–40.
Regland B. Schizophrenia and single-carbon metabolism. Prog Neuropsychopharmacol Biol Psychiatry. 2005;29:1124–32.
Catalano G, Catalano MC, Rosenberg EI, Embi PJ, Embi CS. Catatonia: another neuropsychiatric presentation of vitamin B12 deficiency? Psychosomatics.1998;39:456–60.
Holmes JM. Cerebral manifestations of vitamin B12 deficiency. BMJ. 1956;2:1394–8.
Hintikka J, Tolmunen T, Tanskanen A, Viinamaki H. High vitamin B12 level and good treatment outcomes may be associated in major depressive disorder. BMC Psychiatry. 2003;3:17.
Brett AS, Roberts MS. Screening for vitamin B12 deficiency in psychiatric patients. J Gen Intern Med. 1994;9:522–4.
Misra UK, Kalita J, Das A. Vitamin B12 deficiency neurological syndromes. A clinical, MRI, and electrodiagnostic study. Electromyogr Clin Neurophysiol. 2003;43:57-64.
Pandey S, Kalita J, Misra UK. A sequential study of visual evoked potential in patients with vitamin B12 deficiency neurological syndrome. Clin Neurophysiol. 2004;115:914-8.
Shulman R. Vitamin B12 deficiency and psychiatric illness. Br J Psychiatry. 1967;113:252-6.
Burton RH. Folate and cobalamin in psychiatric illness. 1997;38(6):305-14.
Lahtinen E, Lehtinen V, Riikonen E, Ahonen J. (eds). Framework for promoting mental health in Europe. STAKES National Research and Development Centre for Welfare and Health; 1999.
De Girolamo G, Dagani J, Purcell R, Cocchi A, McGorry PD. Epidemiology and psychiatric science. 2012;219(1):47-57.
Hermesh H, Weizman A, Shahar A, Munitz H. Vitamin B-12 and folic acid levels in obsessive-compulsive disorder. Act a Psychiatrica Scandinavica.1988;78:8-10.
Levitt AJ, Joffe RT. Vitamin B-12 in psychotic depression. Br J Psychiatry. 1988;153:266-7.
Renvoize EB, Gaskell RK, KIar HM. Results of investigations in 150 demented patients Consecutively admitted to a psychiatric hospital. Br J Psychiatry. 1985;147:204-5.
Rawlinson F, Eagles JM. Dietary vitamin B12 deficiency (letter). Br J Psychiatry. 1984;145:671.
Hector M, Burton JR. What are the psychiatric manifestations of vitamin B12 deficiency? JAGS. 1988;36:1105-12.
Watanabe F. Vitamin B12 sources and bioavailability. Exp Biol Med. 2007;232:1266–74.
Lin WC, Zhang J, Leung GY, Clark RE. Chronic physical conditions in older adults with mental illness and/or substance use disorders. J Am Geriatr Soc. 2011;59(10):1913-21.
Scott K, McGee MA, Schaaf D, Baxter J. Mental-physical comorbidity in an ethnically diverse population. Soc Sci Med. 2008;66(5):1165-73.
Scott D, Happell B. The high prevalence of poor physical health and unhealthy lifestyle behaviours in individuals with severe mental illness. Issues Ment Health Nurs. 2011;32(9):589-97.
Herbert V, Zalusky R. Pteroylglutamic acid (PGA) clearance after intravenous injection. Studies using two microbiologic assay organisms. Clin Res. 1961;9:161.
Herbert V, Zalusky, R. Vitamin B, in folic acid metabolism in Proc. Fifth Int Congr. Biochemistry, Sissakian A (ed). London, Pergamon Press: 1961.
