Vitamin D Levels in Lebanese Patients with Schizophrenia: A Case-Control Study

Abstract

Objectives: To compare the vitamin D status in schizophrenics to that of healthy controls; secondary objectives were to assess the correlation between severe vitamin D deficiency and the severity of schizophrenia symptoms and to evaluate the potential factors influencing this status. Methods: A case-control study, conducted between March and July 2016, recruited 100 patients with schizophrenia and 100 controls with no known psychiatric disorders and matched for age and sex. Results: Schizophrenic patients had a more severe vitamin D deficiency compared to healthy controls (9% vs. 3%). Vitamin D insufficiency was found in 28% of schizophrenic patients compared to 37% in healthy controls (p=0.053). BCRS and MRSS scales were significantly associated with a more severe vitamin D deficiency (p=0.006). We couldn't detect any association between the total PANSS score and its three subscales with vitamin D deficiency (p>0.05). Sun exposure, intermediate and high socioeconomic levels would significantly increase the odds of having an increased level of vitamin D as compared to low socioeconomic level (OR=1.046, OR=141.919 and OR=132.110) respectively. Higher MRSS scores would significantly increase the odds of having a more severe vitamin D deficiency by 15.2% (OR=0.848, CI 0.731-0.984, p=0.029). Conclusion: Vitamin D insufficiency is prevalent in patients with schizophrenia. Further work is needed to answer the question of causality. Is vitamin D deficiency the result or the cause of schizophrenia? Future cohort studies may investigate the association with longer follow-up. Spreading awareness among health care professionals for routine serum vitamin D testing, along with patient education, are necessary to avoid this problem. risk factors [8], such as ethnicity, dietary factors, sedentary lifestyle, physical activity, body mass index, urban living and socioeconomic status [7,8,14,15]. Vitamin D has also been linked to mental illnesses including Alzheimer's [16], premenstrual mood disorder [17], major depression [18] and psychosis [19]. However, the relationship between vitamin D status and brain functions is still not elucidated [19], despite some evidence of negative, cognitive [20,21] and mood [22] effects in people with insufficient vitamin D levels. A recent study showed that in schizophrenic patients, a significantly greater severity of negative symptoms was correlated with lower vitamin D status, while overall symptom severity and positive symptom severity approached a significant relationship with vitamin D status. These findings lead researchers to hypothesize that inadequate vitamin D status may account for some portion of the symptom burden experienced by schizophrenic persons [1]. Lebanon has a high prevalence of 25(OH)-D deficiency in adults and older adults [23,24] however, data regarding vitamin D levels in psychiatric patients is still lacking. Therefore, the primary objective of this study was to compare the vitamin D status in schizophrenics to that of healthy controls; secondary objectives were to assess the