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Open Access Research article

Association between vitamin b12 levels and melancholic depressive symptoms: a Finnish population-based study

Jussi Seppälä1, Hannu Koponen23, Hannu Kautiainen45, Johan G Eriksson106789, Olli Kampman1112, Jaana Leiviskä8, Satu Männistö13, Pekka Mäntyselkä1415, Heikki Oksa16, Yrjö Ovaskainen17, Merja Viikki1819, Mauno Vanhala45 and Jussi Seppälä20*

Author Affiliations

1 Department of Psychiatry, South-Savo Hospital District, Mikkeli, Finland

2 Department of Psychiatry, Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, Kuopio, 70211, Finland

3 Department of Psychiatry, Kuopio University Hospital, P.O. Box 1777, Kuopio, 70211, Finland

4 Unit of Family Practice, Central Finland Central Hospital, Jyväskylä, 40620, Finland

5 Unit of Primary Health Care, Kuopio University Hospital, P.O. Box 1777, Kuopio, 70211, Finland

6 Department of General Practice and Primary Health Care, University of Helsinki, P.O. Box 33, Helsinki, 00014, Finland

7 Unit of General Practice, Helsinki University General Hospital, P.O. Box 590, Helsinki, 00029, Finland

8 National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland

9 Folkhälsan Research Center, P.O. Box 63, Helsinki, 00014, Finland

10 Vasa Central Hospital, Vasa, 65130, Finland

11 Medical School, University of Tampere, Tampere, 33014, Finland

12 Department of Psychiatry, Seinäjoki Hospital District, Seinäjoki, 60220, Finland

13 Department of Chronic Disease Prevention, National Institute for Health and Welfare, P.O. Box 30, Helsinki, 00271, Finland

14 Institute of Clinical Medicine, General Practice, University of Turku, Turku, 20014, Finland

15 Unit of Primary Health Care, Turku University Hospital, Turku, 20520, Finland

16 Tampere University Hospital, P.O. Box 2000, Tampere, 33521, Finland

17 Private practices, Diacor, Helsinki, 00380, Finland

18 Medical School, University of Tampere, Tampere, 33014, Finland

19 Tampere Mental Health Center, P.O. Box 487, Tampere, 33101, Finland

20 Department of Psychiatry, South-Savo Hospital District, Moisiontie 10, Mikkeli, FIN, 50520, Finland

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BMC Psychiatry 2013, 13:145  doi:10.1186/1471-244X-13-145

Published: 24 May 2013

Abstract

Background

An association between vitamin B12 levels and depressive symptoms (DS) has been reported in several epidemiological studies. The purpose of this study was to evaluate vitamin B12 levels in population-based samples with melancholic or non-melancholic DS as the relationship between vitamin B12 levels and different subtypes of DS has not been evaluated in previous studies.

Methods

Subjects without previously known type 2 diabetes, aged 45–74 years were randomly selected from the National Population Register as a part of the Finnish diabetes prevention programme (FIN-D2D). The study population (N = 2806, participation rate 62%) consisted of 1328 men and 1478 women. The health examinations were carried out between October and December 2007 according to the WHO MONICA protocol. The assessment of DS was based on the Beck Depression Inventory (BDI, cut-off ≥10 points). A DSM-IV- criteria based summary score of melancholic items in the BDI was used in dividing the participants with DS (N = 429) into melancholic (N = 138) and non-melancholic DS (N = 291) subgroups. In the statistical analysis we used chi-squared test, t-test, permutation test, analysis of covariance, multivariate logistic regression analysis and multinomial regression model.

Results

The mean vitamin B12 level was 331±176 pmol/L in those without DS while the subjects with non-melancholic DS had a mean vitamin B12 level of 324 ± 135 pmol/L, and those with melancholic DS had the lowest mean vitamin B12 level of 292±112 pmol/L (p < 0.001 after adjusted for age, sex, use of antidepressive medication and chronic diseases sum index). The adjusted difference of vitamin B12 levels between the non-melancholic and the melancholic group was 33 pmol/L (95%CI 8 to 57, p = 0.008). Melancholic DS and vitamin B12 levels showed an independent linearly inverse association. The relative risk ratio (RRR) for melancholic DS was 2.75 (95%CI 1.66 to 4.56) in the lowest vitamin B12 level tertile versus the highest (p for linearity <0.001) when those without DS formed the reference group. The RRR in the non-melancholic subgroup was nonsignificant.

Conclusions

The vitamin B12 level was associated with melancholic DS but not with non-melancholic DS.

Keywords:
Beck depression inventory; Melancholic depressive symptoms; Non-melancholic depressive symptoms; Population-based; Vitamin B12