Psychotic problems associated with low vitamin D – review

Created September 2021

The association between vitamin D and symptom domains in psychotic disorders: A systematic review

Schizophr Res . 2021 Sep 8;237:79-92. doi: 10.1016/j.schres.2021.08.001 - PDF is behind a paywall

Jonathan Tsiglopoulos 1, Nicholas Pearson 1, Nathan Mifsud 1, Kelly Allott 1, Brian O'Donoghue 2

NOTE: This review probably ignores dose size, dose duration. dose type, any use of Omega-3, initial vitamin D level in RCTs low vitamin D as child or in utero, etc. 1. Intervention of Vitamin D for Depression {category} --- 1. Meta-analyses of Depression {category} --- 1. Meta-analyses of Omega-3 and Depression {category} --- 1. Depression category listing has items along with related searches 1. Depression summary {include} 1. Anxiety studies include {include} 1. Cognitive category starts with the following {include} 1. Overview Schizophrenia and Vitamin D contains the following summary {include}

Background: Vitamin D deficiency is prevalent among people with psychosis and may play a role in the aetiology of psychotic disorders. However, its impact on clinical symptom severity has not been independently reviewed.

Methods: We conducted a systematic search of randomized trials and observational studies that assessed the relationship between vitamin D and symptom domains (positive and negative psychotic symptoms, total and general psychopathology, cognitive and depressive) in people with a psychotic disorder.

Results: 1040 articles were identified, of which 29 were eligible for inclusion: 26 observational studies and 3 randomized trials. Five studies included people with First-Episode Psychosis (FEP) and 24 included people with enduring psychosis. Most observational studies found that vitamin D was

  • inversely associated with negative symptoms (57%; 13/23),

  • positively associated with cognitive performance (63%; 5/8), and

  • bore no association with positive symptoms (68%; 15/22),

    • total psychopathology (64%; 7/11),

    • general psychopathology (57%; 4/7) or

    • depressive symptoms (64%; 9/14).

Randomized controlled trials indicated that vitamin D supplementation

  • improved cognitive performance (100%; 1/1) and, in some cases,

reduced

  • total psychopathology (50%; 1/2),

  • general psychopathology (50%; 1/2) and

  • negative symptoms (30%; 1/3), but had

  • no effect on positive (100%; 3/3) or depressive (100%; 3/3) symptoms.

Some positive associations were attenuated when controlled for potential confounders.

Conclusion: Low vitamin D was found to be inversely associated with more severe clinical symptoms in some, but not all symptom domains in people with psychosis. These preliminary findings warrant further exploration, particularly in regard to cognitive performance and negative symptoms.

Tags: Cognitive Depression