The Relationship between Symptom Severity and Low Vitamin D Levels in Patients with Schizophrenia

Abstract

BackgroundIn recent years, the relationship between schizophrenia and environmental factors has come into prominence. This study investigated the relationship between vitamin D levels and the positive and negative symptoms of schizophrenia by comparing vitamin D levels between patients with schizophrenia and a healthy control group.MethodsThe study included 80 patients diagnosed with schizophrenia and 74 age- and sex-matched controls. The Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS) were used to evaluate symptom severity. The 25-hydroxyvitamin D (25OHD) levels of all subjects both patients and healthy controls were analyzed in relation to measurements of symptom severity.ResultsThere were no significant differences between the groups in terms of age, sex, or physical activity. Their mean 25OHD levels were also similar (23.46±13.98ng/mL for the patient group and 23.69±9.61ng/mL for the control group). But when patients with schizophrenia were grouped based on their vitamin D levels, the results indicated a statistically significant differences between their vitamin D levels and their total SANS, affective flattening, and total SAPS, bizarre behavior and positive formal thought disorder scores (p = 0.019, p = 0.004, p = 0.015, p = 0.009 and p = 0.019, respectively). There is a negative correlation between 25OHD levels and SANS total points (r = -0.232, p = 0.038); a negative correlation for attention points (r = -0.227, p = 0.044) and negative correlation with positive formal thoughts (r = -0.257, p = 0.021).ConclusionThe results of this study show a relationship between lower levels of vitamin D and the occurrence of positive and negative symptoms, along with increased severity of symptoms at lower levels of vitamin D, suggesting that treatment for schizophrenia should include assessment of patients’ vitamin D levels. We recommend that patients with schizophrenia should be assessed with regard to their vitamin D levels.

Hypovitaminosis D is associated with depression and anxiety in schizophrenia: Results from the national FACE-SZ cohort.

“…been found in the present study, contrary to previous findings (Doğan Bulut et al, 2016;Graham et al, 2015). The discrepancy with Doğan Bulut et al study may be due to the use of different scales (PANSS vs.…”

“…Scale for the Assessment of Negative Symptoms SANS and Scale for the Assessment of Positive Symptoms SAPS) and discrepancies in antipsychotic treatments. The present sample was larger than other studies (N=140 vs. respectively N=80 and N=20) (Doğan Bulut et al, 2016;Graham et al, 2015). Another explanation may be that depressive symptoms may be strongly associated with negative symptoms (Fond G., et al, 2018) and depressive symptoms have not been explored in the previous studies except one (Nerhus et al, 2016).…”

Vitamin D Supplementation Guidelines for General Population and Groups at Risk of Vitamin D Deficiency in Poland—Recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the Expert Panel With Participation of National Specialist Consultants and Representatives of Scientific Societies—2018 Update

“…The pleiotropic aspect of vitamin D action was tested in numerous observational studies, suggesting association between low serum concentration of 25(OH)D and increased risk of neoplasms (among others cancers of the colon, breast, ovary, prostate, pancreas, skin, kidneys, brain tumors, multiple myeloma and leukemia) ( 74 – 78 ), immunological diseases [multiple sclerosis ( 79 – 82 ), asthma ( 83 , 84 ), non-specific inflammatory bowel diseases ( 85 , 86 ) and systemic lupus erythematosus ( 87 , 88 )], autoimmune endocrine disorders [diabetes type 1 ( 89 , 90 ), Addison disease ( 91 , 92 ), Hashimoto disease ( 93 , 94 ), Graves-Basedow disease ( 95 , 96 ) and autoimmune polyendocrine syndromes ( 97 )], immunodeficiencies and recurrent infections ( 98 ) (i.e., tuberculosis and influenza), components of metabolic syndrome (including arterial hypertension and cardiovascular diseases, atherosclerosis, ischemic heart disease, diabetes type 2 and obesity) ( 99 – 105 ), as well psychiatric disorders [depression ( 106 ), schizophrenia ( 107 , 108 )] and neurodegerative diseases [dementia ( 109 – 111 ), Alzheimer disease ( 112 , 113 ), deterioration of cognitive functions ( 109 , 110 , 114 )]. Vitamin D deficiency is also associated with increased mortality in the general population ( 115 – 117 ), in patients in intensive care units ( 118 – 120 ), and in patients with neoplasms ( 121 ).…”

Association Between Vitamin D Insufficiency and Metabolic Syndrome in Patients With Psychotic Disorders

“…In one study, the prevalence of vitamin deficiency/insufficiency was 92.5% in patients in the acute phase of schizophrenia [ 5 ]. The level of vitamin D also affects symptom severity in patients with schizophrenia [ 6 , 7 ]. Levels of vitamin D in utero predict later risk for schizophrenia [ 8 ].…”