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Open Access Highly Accessed Research article

Vitamin D deficiency and psychotic features in mentally ill adolescents: A cross-sectional study

Barbara L Gracious14*, Teresa L Finucane2, Meriel Friedman-Campbell3, Susan Messing25 and Melissa N Parkhurst2

Author Affiliations

1 Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children’s Hospital and The Ohio State University, Columbus, OH, USA

2 Clinical Research Coordinator, University of Rochester Medical Center, Department of Psychiatry, 300 Crittenden Boulevard, Rochester, New York, 14642, USA

3 Psychiatric Nurse Practitioner, Irwin Army Community Hospital Behavioral Health, 600 Caisson Hill Road, Fort Riley, KS, 66442, USA

4 Nationwide Children’s Hospital 700 Children’s Drive, Columbus, OH, 43205, USA

5 Senior Research Associate, Department of Biostatistics and Computational Biology, University of Rochester Medical Center

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BMC Psychiatry 2012, 12:38  doi:10.1186/1471-244X-12-38

Published: 9 May 2012

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