Vitamin d status and cardiometabolic risk factors in long-term psychiatric inpatients

Vitamin D Deficiency and Risk Factors Related to Acute Psychiatric Relapses in Patients with Severe Mental Disorders: A Preliminary Study

Previous studies have indicated that vitamin (Vit) D deficiency is frequent in psychiatric patients, regardless of diagnostic category. We aimed to assess whether acute psychiatric relapses in inpatients was associated with Vit D deficiency compared to stabilized outpatients. The cohort (152 total patients, 75 males and 77 females) had a mean age of 47.3 ± 14.4 years at admission and was grouped according to psychiatric diagnosis. Psychopathological symptom severity was assessed by the Brief Psychiatric Rating Scale (BPRS), a multidimensional symptom inventory. Total calcium serum levels were measured using standard laboratory methods, while plasma levels of 25-OH-Vit D and parathyroid hormone (PTH) were measured by automated chemiluminescence immunoassays. The psychiatric inpatient subgroup showed a significant difference in serum levels of 25-OH-Vit D and PTH (p < 0.001). Correlation analysis between serum levels of 25-OH-Vit D and BPRS total and subitem scores indicated a significantly negative relationship. In addition, linear regression analysis evidenced that the inpatient condition might predict low PTH and 25-OH-Vit D serum levels. Hospitalized psychiatric patients are at increased risk for Vit D deficiency regardless of their diagnostic categories. The mechanism underlying the association between acute psychiatric relapses and Vit D deficiency remains unclear. Therefore, screening for Vit D deficiency should pertain to the health assessment of patients with major psychiatric disorders.

[All-rounder vitamin D?]

BACKGROUND

Many indications are discussed for vitamin D substitution, such as osteoporosis, autoimmune diseases, cancer and psychiatric diseases. Also discussed is the fact that the majority of the German population suffer from a vitamin D deficiency.

OBJECTIVE

Review of the study results for these individual diseases and a critical analysis of the currently established therapeutic reference range, which defines a vitamin D deficiency.

MATERIAL AND METHODS

A literature search was carried out in the statements of the German Society for Nutrition, in scientific publications and journals.

RESULTS

The study results on prevention and therapy of various diseases with vitamin D show inconsistent results. Well-established indications are the prevention of rickets in babies and the supportive therapy for osteoporosis. The currently established reference range for the definition of a vitamin D deficiency came from studies where vitamin D deficiency was correlated to an increase in parathyroid hormone. Different laboratories use different methods for measurement of vitamin D levels.

CONCLUSION

More studies are needed to clarify the role of vitamin D in the prevention and treatment of various diseases. Another problem is that different laboratories do not use the same measurement methods to determine vitamin D and the use of different methods leads to widely varying results which cannot be compared. Therefore, a standardization of the methods would be desirable.

Physician Prescribing Practices of Vitamin D in a Psychiatric Hospital

Vitamin D supplementation has become an increasingly popular prescribing practice, despite our limited knowledge of both the definition and degree of deficiency as well as the expected benefits or risks of exogenous administration. Many of the hypothesized benefits of vitamin D supplementation include a variety of improvements in mental health; however, these claims are not consistently or robustly supported by current research. In this paper, we provide a brief overview of what is currently known about vitamin D deficiency and about outcomes of supplementation as well as a summary of the data relative to prescribing practices for inpatients in an urban psychiatric hospital.

Factors associated with vitamin D status of low-income, hospitalized psychiatric patients: results of a retrospective study

BACKGROUND

Recent evidence has indicated a potential role of vitamin D3 in a range of neuropsychiatric outcomes, as well as on cognitive function, but conflicting data have left that role uncertain. Understanding potential associations of vitamin D status with psychiatric illness will allow clinicians to better assess therapeutic options. Few studies have examined vitamin D status among a racially diverse group of psychiatric patients who have been hospitalized, and none has done so in the southern US where socioeconomic inequality is high.

METHODS

In this retrospective study, medical records from 113 patients hospitalized for psychiatric illness were retrieved and analyzed. Vitamin D status in this population was estimated, along with any patterns of association between deficiency and risk factors.

RESULTS

The vast majority of patients hospitalized for psychiatric illness in this biracial, low-income sample had either insufficient or deficient vitamin D levels. African-American patients had lower levels of vitamin D than Caucasian patients.

DISCUSSION

Our findings demonstrate that hospitalized psychiatric patients are at increased risk for vitamin D deficiency and in particular low-income, African-American populations. These results suggest that vitamin D should be assessed and therapy considered at the initiation of psychiatric hospitalizations.