Vitamin D deficiency in long‐term hospitalization psychiatric wards in an equatorial nation

Abstract

Introduction: Vitamin D deficiency and insufficiency have been shown to be prevalent in several populations, including in people who have a mental illness. Deficiency has been linked to specific mental health sequelae. Furthermore, deficiency may be perpetuated by medications routinely prescribed to people with severe mental illness. Therefore, symptoms of mental illness may be exacerbated by deficient levels of vitamin D, and treatments for mental illness may exacerbate deficiency. This study sought to determine the vitamin D levels of people hospitalized for a period longer than a year in an equatorial nation, Singapore. The inpatient population was then categorized according to levels to determine the need for supplementation. Methods: Total 25-hydroxy vitamin D in serum and plasma levels were tested in 403 individuals in long-term psychiatric wards. Blood serum and plasma levels were classified into three groups. Regression models were constructed to test the associations between levels and clinical covariates. Results: Forty (9.9%) people had vitamin D levels that were sufficient. A link was found between vitamin D levels and medications given for gastrointestinal illnesses (β −2.48, p = .014, 95%CI-4.46 to-0.51) and between vitamin D levels and length of stay (β −0.13, p = .027, 95%CI-0.24 to-0.01). No other relationships were statistically significant. Discussion: Despite its geographic location and opportunities for regular outdoor activity, vitamin D deficiency, and insufficiency are prevalent among people hospitalized for long periods of time in an equatorial nation. The level of deficiency is comparable to those observed in other settings.

Revisiting vitamin D status and supplementation for in-patients with intellectual and developmental disability in the North of England, UK

“… 36 Studies have also shown that hospital in-patients from warmer latitudes with higher UV indices also have a propensity for vitamin D deficiency. 18 …”

“…9,10 People with intellectual and developmental disability (IDD) are likely to be at greater risk of developing these chronic illnesses 11 as well as being at increased risk of falls. 12 A number of primary studies have highlighted vitamin D insufficiency and deficiency among groups of people with IDD, [13][14][15] among institutionalised populations at a range of global latitudes [16][17][18] and among those with comorbid epilepsy, in part due to enzyme-inducing medication. 19 Studies among IDD populations have also investigated the risks of fractures and low bone mineral density, 20,21 potentially as the result of vitamin D insufficiency.…”

Severe Vitamin D Deficiency—A Possible Cause of Resistance to Treatment in Psychiatric Pathology

“…Some data suggest that the psychiatric population has a higher rate of vitamin D deficiency than the general population [17,[23][24][25][26][27][28][29][30][31]. Patients from a psychiatric ward in Serbia have been included in a cross-sectional design study, and a significant number of patients had a lower vitamin D level than expected [30].…”

“…Patients from a psychiatric ward in Serbia have been included in a cross-sectional design study, and a significant number of patients had a lower vitamin D level than expected [30]. Even in an equatorial nation, despite the geographic location and outdoor activities, levels of vitamin D were still low among psychiatric hospitalized subjects [29].…”

Rehospitalisation rates after long-term follow-up of patients with severe mental illness admitted for more than one year: a systematic review

“…However, in regions such as the Americas and Eastern Mediterranean countries, more than 25% of all inpatients with psychiatric disorders have stays exceeding one year [ 26 ]. Long-term hospitalisation and its challenges in transitioning to community-based care have surfaced as national concerns in countries such as India, Singapore, China, and South Korea since the 2010s [ 2 , 3 , 15 , 20 , 28 ].…”