Low vitamin D is associated with negative and depressive symptoms in psychotic disorders.

Mari Nerhus, Akiah O Berg, Levi R Kvitland, Ingrid Dieset, Sigrun Hope, Sandra R Dahl, Melissa A Weibell, Kristin L Romm, Ann Faerden, Ole A Andreassen, Ingrid Melle

Journal: Schizophrenia research 2018;178(1-3):44-49

PMID: 27595553

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Abstract

BACKGROUND

There are indications that low S-25(OH)D is associated with increased disease severity in psychotic disorder. Our first aim was to investigate the relations between low S-25(OH)D and positive, negative and depressive symptoms. Our second aim was to explore if associations between S-25(OH)D and symptoms were influenced by levels of inflammatory markers.

METHODS

Participants (N=358) with a medical history of one or more psychotic episodes were recruited. Current symptomatology was assessed by The Structured Interview for the Positive and Negative Syndrome Scaleanalyzed by a five-factor model. The Calgary Depression Scale for Schizophrenia was used to assess depression and suicidal ideation. Blood samples were analyzed for S-25(OH)D, CRP, sTNF-R1, IL-Ra and OPG. We performed bivariate correlations and multiple regression models to evaluate the effect of S-25(OH)D on the outcomes.

RESULTS

Low S-25(OH)D was significantly associated with negative symptoms (adjusted R=0.113, F(6,357)=8.58, p<0.001) and with depression (adjusted R=0.045, F(4,357)=5.233, p<0.001) when adjusting for possible confounding factors (i.e. gender, education, diagnose, hospitalization status, ethnicity, season and thyroid status). CRP was correlated with both S-25(OH)D (rho=-0.13, p=0.02) and negative symptoms (rho=0.14, p=0.01), but did not act as a mediator. The correlations between S-25(OH)D and the inflammatory markers sTNF-R1, IL-Ra and OPG were not significant.

CONCLUSION

There is a strong association between low S-25(OH)D and higher negative and depressive symptoms in psychotic disorders. Randomized controlled trials should be performed to investigate the effect of vitamin D supplementation as adjuvant treatment strategy in patients with prominent negative or depressive symptoms.

Address: NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. Electronic address: [email protected].; NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. Electronic address: [email protected].; NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. Electronic address: [email protected].; NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. Electronic address: [email protected].; NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. Electronic address: [email protected].; Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway. Electronic address: [email protected].; Regional Center for Clinical Research in Psychosis, Psychiatric Division, Stavanger, Norway. Electronic address: [email protected].; Regional Centre for Early Intervention in Psychosis, Division of Mental Health and Addiction, Oslo University hospital, Norway. Electronic address: [email protected].; Section of acute psychiatry, Division of Mental Health and Addiction, Oslo University hospital, Norway. Electronic address: [email protected].; NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. Electronic address: [email protected].; NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. Electronic address: [email protected].

DOI: 10.1016/j.schres.2016.08.024

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MeSH Terms: Adult, Biomarkers, Cross-Sectional Studies, Depression, Female, Humans, Interview, Psychological, Male, Psychiatric Status Rating Scales, Psychotic Disorders, Regression Analysis, Schizophrenia, Schizophrenic Psychology, Suicidal Ideation, Vitamin D Deficiency