First-Episode Psychosis associated with low Vitamin D, Vitamin C and Folate – meta-analysis

Created December 2017

Nutritional Deficiencies and Clinical Correlates in First-Episode Psychosis: A Systematic Review and Meta-analysis

Schizophrenia Bulletin , sbx162, https://doi.org/10.1093/schbul/sbx162, 30 November 2017

Joseph Firth Rebekah Carney Brendon Stubbs Scott B Teasdale Davy Vancampfort Philip B Ward Michael Berk Jerome Sarris

Schizophrenia might be treated by folic acid, vitamin B12 and vitamin D – May 2014 Overview Schizophrenia and Vitamin D contains the following summary {include} --- 1. Note: This stiuy did not look at the interaction of cognition and Omega-3 Items in BOTH the categories Cognition and Omega-3 in VitaminDWiki {category}

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Objective

Diet is increasingly recognized as a potentially modifiable factor influencing the onset and outcomes of psychiatric disorders. Whereas, previous research has shown long-term schizophrenia is associated with various nutritional deficiencies, this meta-analysis aimed to determine the prevalence and extent of nutritional deficits in first-episode psychosis (FEP).

Method

A search of electronic databases conducted in July 2017 identified 28 eligible studies, examining blood levels of 6 vitamins and 10 minerals across 2612 individuals: 1221 individuals with FEP and 1391 control subjects. Meta-analyses compared nutrient levels in FEP to nonpsychiatric controls. Clinical correlates of nutritional status in patient samples were systematically reviewed.

Results

Significantly lower blood levels of folate (N = 6, n = 827, g = −0.624, 95% confidence interval [CI] = −1.176 to −0.072, P = .027) and vitamin D (N = 7, n = 906, g = −1.055, 95% CI = −1.99 to −0.119, P = .027) were found in FEP compared to healthy controls. Synthesis of clinical correlates found both folate and vitamin D held significant inverse relationships with psychiatric symptoms in FEP. There was also limited evidence for serum level reductions of vitamin C (N = 2, n = 96, g = −2.207, 95% CI = −3.71 to −0.71, P = .004). No differences were found for other vitamins or minerals.

Conclusions

Deficits in vitamin D and folate previously observed in long-term schizophrenia appear to exist from illness onset, and are associated with worse symptomology. Further research must examine the direction and nature of these relationships (ie, mediator, moderator, or marker) with clinical status in FEP. Future trials assessing efficacy of nutrient supplementation in FEP samples should consider targeting and stratifying for baseline deficiency.

Review of study in Medscape

Low Folate, Vitamin D, Implicated in First-Episode Psychosis

  • "Seeing it (nutrional deficiencies) in young people, even prior to antipsychotic treatment, is surprising," quote from study author

  • "One study found that in newly diagnosed patients with schizophrenia who were receiving vitamin C supplementation, higher levels of vitamin C were associated with greater symptomatic improvement over 8 weeks."

  • "Dr Firth emphasized that levels of vitamin C, D, and folate "should be assessed in young people being treated for psychosis, and if deficient, clinicians should recommend dietary improvement or perhaps even supplementation if diet alone cannot resolve the deficits." "

Tags: Cognitive