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      Vitamin D Deficiency in Adult Patients with Schizophreniform and Autism Spectrum Syndromes: A One-Year Cohort Study at a German Tertiary Care Hospital

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          Abstract

          Introduction

          Vitamin D has many immunomodulatory, anti-inflammatory, and neuroprotective functions, and previous studies have demonstrated an association between vitamin D deficiency and neuropsychiatric disease. The aim of our study was to analyze the prevalence of vitamin D deficiency in a 1-year cohort of adult inpatients with schizophreniform and autism spectrum syndromes in a naturalistic inpatient setting in Germany.

          Participants and methods

          Our study was comprised of 60 adult schizophreniform and 23 adult high-functioning autism spectrum patients who were hospitalized between January and December of 2015. We compared our findings with a historical German reference cohort of 3,917 adults using Pearson’s two-sided chi-squared test. The laboratory measurements of 25-hydroxyvitamin D2/3 [25(OH)vitamin D] were obtained using a chemiluminescence immunoassay.

          Results

          In the schizophreniform group, we found decreased (<20 ng/ml) 25(OH)vitamin D levels in 48/60 (80.0%) of the patients. In the autism spectrum group, decreased levels were detected in 18/23 (78.3%) of the patients. 25(OH)vitamin D deficiencies were found in 57.3% of the historical control group. Particularly, severe deficiencies (<10 ng/ml) occurred much more frequently in the schizophreniform (38.3%) and autism spectrum groups (52.2%), when compared to the control group (16.3%). The recommended 25(OH)vitamin D values of >30 ng/ml were observed in only 5% of the schizophreniform patients, 8.7% of the autism spectrum patients, and 21.9% of the healthy controls.

          Discussion

          We found very high rates of 25(OH)vitamin D deficiencies in both patient groups and have discussed whether our findings might be related to alterations in the immunological mechanisms. Irrespective of the possible pathophysiological links between vitamin D deficiency and schizophrenia or autism spectrum disorders, a more frequent measurement of vitamin D levels seems to be justified in these patient groups. Further prospective, controlled, blinded, and randomized research should be conducted to analyze the effectiveness of vitamin D supplementation on the improvement of psychiatric symptoms.

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          Clinical practice. Vitamin D insufficiency.

          Clifford Rosen (2011)
          Article 0 comments Cited 225 times – based on 0 reviews     Review now
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            IOF position statement: vitamin D recommendations for older adults.

            B Dawson-Hughes, A Mithal, J-P Bonjour … (2010)
            This position paper of the International Osteoporosis Foundation makes recommendations for vitamin D nutrition in elderly men and women from an evidence-based perspective.
            Article 0 comments Cited 184 times – based on 0 reviews     Review now
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              New clues about vitamin D functions in the nervous system.

              Emmanuel Garcion, Nelly Wion-Barbot, Claudia Montero-Menei … (2002)
              Accumulating data have provided evidence that 1 alpha,25 dihydroxyvitamin D(3) [1,25-(OH)(2)D(3)] is involved in brain function. Thus, the nuclear receptor for 1,25-(OH)(2)D(3) has been localized in neurons and glial cells. Genes encoding the enzymes involved in the metabolism of this hormone are also expressed in brain cells. The reported biological effects of 1,25-(OH)(2)D(3) in the nervous system include the biosynthesis of neurotrophic factors and at least one enzyme involved in neurotransmitter synthesis. 1,25-(OH)(2)D(3) can also inhibit the synthesis of inducible nitric oxide synthase and increase glutathione levels, suggesting a role for the hormone in brain detoxification pathways. Neuroprotective and immunomodulatory effects of this hormone have been described in several experimental models, indicating the potential value of 1,25-(OH)(2)D(3) pharmacological analogs in neurodegenerative and neuroimmune diseases. In addition, 1,25-(OH)(2)D(3) induces glioma cell death, making the hormone of potential interest in the management of brain tumors. These results reveal previously unsuspected roles for 1,25-(OH)(2)D(3) in brain function and suggest possible areas of future research.
              Article 0 comments Cited 163 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Psychiatry
                Journal ID (iso-abbrev): Front Psychiatry
                Journal ID (publisher-id): Front. Psychiatry
                Title: Frontiers in Psychiatry
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-0640
                Publication date (Electronic): 06 October 2016
                Publication date Collection: 2016
                Volume: 7
                Electronic Location Identifier: 168
                Affiliations
                [1] 1Section of Experimental Neuropsychiatry, Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg , Freiburg, Germany
                [2] 2Department of Neurology, Medical Center – University of Freiburg , Freiburg, Germany
                [3] 3Institute for Clinical Chemistry and Laboratory Medicine, Medical Center – University of Freiburg , Freiburg, Germany
                Author notes

                Edited by: Karl Bechter, University of Ulm, Germany

                Reviewed by: Dietmar Fuchs, Innsbruck Medical University, Austria; Armando D’Agostino, University of Milan, Italy; Bernhard J. Mitterauer, Volitronics-Institute for Basic Research Psychopathology and Brain Philosophy, Austria; Ute Christiane Meier, Barts and The London School of Medicine and Dentistry, UK

                *Correspondence: Ludger Tebartz van Elst, tebartzvanelst@ 123456uniklinik-freiburg.de

                Specialty section: This article was submitted to Schizophrenia, a section of the journal Frontiers in Psychiatry

                Article
                DOI: 10.3389/fpsyt.2016.00168
                PMC ID: 5052261
                PubMed ID: 27766084
                SO-VID: d0ac2898-f57d-4362-ab08-66292918e3e0
                Copyright © Copyright © 2016 Endres, Dersch, Stich, Buchwald, Perlov, Feige, Maier, Riedel and van Elst.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 29 July 2016
                Date accepted : 23 September 2016
                Page count
                Figures: 1, Tables: 1, Equations: 0, References: 41, Pages: 8, Words: 6334
                Categories
                Subject: Psychiatry
                Subject: Original Research

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: schizophrenia,autism spectrum disorder,vitamin d,inflammation,mild encephalitis
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: schizophrenia, autism spectrum disorder, vitamin d, inflammation, mild encephalitis

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