Folic acid, vitamin B12, and psychotic symptoms among young psychiatric inpatients
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v30.i2.18765Keywords:
folic acid, psychiatric hospitalization, psychopathology, psychosis, vitamin B12Abstract
Introduction: Folic acid and/or vitamin B12 deficiency are known to be associated with neuropsychiatric disorders. However, the association between serum levels of these molecules and psychotic symptoms is not established. The aim of this study was to investigate the association between folic acid and vitamin B12 serum levels and the presence of psychotic symptoms among child and young adult psychiatric inpatients.
Material and Methods: This was a retrospective cohort study of 165 patients under 25 years of age admitted due to psychiatric disorders between 2005 and 2018 and with folic acid and vitamin B12 serum levels assessed during hospitalization. Two groups of patients were defined according to presence or absence of psychotic symptoms. Rehospitalization was also assessed.
Results: Folic acid serum levels were significantly lower (p=0.01) in children and young adults hospitalized for psychiatric disorders with psychotic symptoms compared to patients of the same age with acute psychiatric illness without psychotic symptoms. A similar non-significant trend was found for vitamin B12. Rehospitalization rates were also higher in the first group.
Conclusion: Results from this study suggest that low folic acid serum levels are associated with psychotic symptoms regardless of the baseline diagnosis.
Downloads
References
Bailey RL, West KP, Black RE. The epidemiology of global micronutrient deficiencies. Ann Nutr Metab. 2015; 66:22–33.
Frankenburg FR. The role of one-carbon metabolism in schizophrenia and depression. Harvard Review of Psychiatry. 2007; 15:146-60.
Bottiglieri T. Folate, Vitamin B12, and Neuropsychiatric Disorders. Nutr Rev. 2010; 54:382-90.
Kim TH, Moon SW. Serum homocysteine and folate levels in korean schizophrenic patients. Psychiatry Investig. 2011; 8:134-40.
Kapoor A, Baig M, Tunio SA, Memon AS, Karmani H. Neuropsychiatric and neurological problems among vitamin B12 Deficient young vegetarians. Neurosciences. 2017; 22:228-32.
Reynolds E. Vitamin B12, folic acid, and the nervous system. Lancet Neurology. 2006; 5: 949–60.
Bourre JM. Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: Micronutrients. The Journal of Nutrition, Health & Aging. 2006; 10:377-85.
Muntjewerff JW, Van Der Put N, Eskes T, Ellenbroek B, Steegers E, Blom H, et al. Homocysteine metabolism and B-vitamins in schizophrenic patients: Low plasma folate as a possible independent risk factor for schizophrenia. Psychiatry Res. 2003; 121:1-9.
Mahadik S, Kamaraju M, Kale A, Pillai A, Sapkale S, Joshi S, et al. Reduced folic acid, vitamin B12 and docosahexaenoic acid and increased homocysteine and cortisol in never-medicated schizophrenia patients: Implications for altered one-carbon metabolism. Psychiatry Res. 2009; 175:47-53.
Misiak B, Frydecka D, Slezak R, Piotrowski P, Kiejna A. Elevated homocysteine level in first-episode schizophrenia patients--the relevance of family history of schizophrenia and lifetime diagnosis of cannabis abuse. Metab Brain Dis. 2014; 29:661-70.
Ayesa-Arriola R, Pérez-Iglesias R, Rodríguez-Sánchez JM, Mata I, Gómez-Ruiz E, García-Unzueta M, et al. Homocysteine and cognition in first-episode psychosis patients. Eur Arch Psychiatry Clin Neurosci. 2012; 262:557-64.
Stubbs B, Ward PB, Teasdale SB, Carney R, Firth J, Berk M, et al. Nutritional Deficiencies and Clinical Correlates in First-Episode Psychosis: A Systematic Review and Meta-analysis. Schizophr Bull. 2017.
Cao B, Wang DF, Xu MY, Liu YQ, Yan LL, Wang JY, et al. Lower folate levels in schizophrenia: A meta-analysis. Psychiatry Research. 2016; 245:1-7.
Chen X, Zhang J, Li X, Zhang W, Lv L, Fan X, et al. Serum levels of BDNF, folate and homocysteine: In relation to hippocampal volume and psychopathology in drug naïve, first episode schizophrenia. Schizophr Res. 2014; 159:51-5.
Lerner V, Kanevsky M, Dwolatzky T, Rouach T, Kamin R, Miodownik C. Vitamin B12 and folate serum levels in newly admitted psychiatric patients. Clin Nutr. 2006; 26:60-7.
Arankowsky-Sandoval G, Solís-Rodríguez F, Pérez-Mutul J, Gurubel-Maldonado J, García-Miss M del R, López-Canul B, et al. Folate, homocysteine, interleukin-6, and tumor necrosis factor alfa levels, but not the methylenetetrahydrofolate reductase C677T polymorphism, are risk factors for schizophrenia. J Psychiatr Res. 2009; 44:441-6.
Wang D, Zhai JX, Liu DW. Serum folate levels in schizophrenia: A meta-analysis. Psychiatry Research. 2016; 235:83-98.
Herrán A, García-Unzueta MT, Amado JA, López-Cordovilla JJ, Díez-Manrique JF, Vázquez-Barquero JL. Folate levels in psychiatric outpatients. Psychiatry and Clinical Neurosciences. 1999; 53:531-3.
Goff DC, Bottiglieri T, Arning E, Shih V, Freudenreich O, Evins AE, et al. Folate, homocysteine, and negative symptoms in schizophrenia. Am J Psychiatry. 2004; 161:1705-8.
Jayaram N, Varambally S, Venkatasubramanian G, Rao MG, Raveendranathan D, Gangadhar BN, et al. Vitamin B 12 Levels and Psychiatric Symptomatology: A Case Series . J Neuropsychiatry Clin Neurosci. 2013; 25:150-2.
Firth J, Stubbs B, Sarris J, Rosenbaum S, Teasdale S, Berk M, et al. The effects of vitamin and mineral supplementation on symptoms of schizophrenia: A systematic review and meta-analysis. Psychological Medicine. 2017; 47:1515-27.
Ssonko M, Ddungu H, Musisi S. Low serum vitamin B12 levels among psychiatric patients admitted in Butabika mental hospital in Uganda. BMC Res Notes. 2014; 7:90.
Ipcioglu OM, Ozcan O, Gultepe M, Ates A, Basoglu C, Cakir E. Reduced urinary excretion of homocysteine could be the reason of elevated plasma homocysteine in patients with psychiatric illnesses. Clin Biochem. 2008; 41: 831-5.
Lucia B, Kontis D, Allin M, Gazi A, Kallai E, Haidemenos A. Plasma homocysteine, folate and B12 in chronic schizophrenia. Prog Neuro-Psychopharmacology Biol Psychiatry. 2007; 31:1289-96.
Reif A, Pfuhlmann B, Lesch KP. Homocysteinemia as well as methylenetetrahydrofolate reductase polymorphism are associated with affective psychoses. Prog Neuro-Psychopharmacology Biol Psychiatry. 2005.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 2013; 5th ed.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Filipa Pedro dos Reis, Luísa Duarte, Teresa Cartaxo, Vítor Santos
![Creative Commons License](http://i.creativecommons.org/l/by-nc/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.