Two reports have shown that a substantial proportion of patients suffering from various psychiatric syndromes have low serum folate concentrations (Hunter, Jones Jones and Matthews, 1967; Carney, 1967). The present investigation was concerned to examine further the prevalence of low serum folate in a series of depressive patients on admission to hospital. As folate deficiency contributes to the development of mental symptoms in epileptic patients (Reynolds, 1968), we also examined the relationship of low serum folate concentrations to the severity of the depressive illness, certain personality traits, and the response to anti-depressant treatment. The relationship of low serum folate to variables which could influence it such as diet and drugs was also examined. In a proportion of these patients serum folate measurements were repeated just before the patient's discharge. Serum B12 concentrations were also estimated.

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SUMMARY Serum and red cell folate levels and serum vitamin B12 levels have been estimated in 33 normal controls; 34 epileptic outpatients, 19 of whom also suffered from psychiatric illness; 33 epileptic inpatients with psychiatric illness; and 30 non-epileptic inpatients with psychiatric illness. Significant lowering of serum folate and red cell folate levels was observed in epileptic patients with psychiatric illness, and a less significant fall in red cell folate levels was found in nonepileptic psychiatric patients. Serum folate levels less than 2-5 ng/ml. were found in two controls, seven outpatient epileptics, 29 inpatients, and 10 non-epileptic patients. Red cell folate levels less than 100 ng/ml. were found in two controls, nine outpatient epileptics, 23 inpatient epileptics, and seven non-epileptic patients. A significant correlation was found between serum and red cell folate values in control, epileptic, and non-epileptic patients. In the epileptic patients there was a significant association between low serum and red cell folate levels and the presence of psychiatric illness. The origin and possible significance of these findings are discussed.