Food and Behaviour Research

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Vitamin D and clinical symptoms in First Episode Psychosis (FEP): A prospective cohort study

Lally J, Ajnakina O, Singh N, Gardner-Sood P, Stubbs B, Stringer D, Di Forti M, David AS, Smith S, Murray RM, Howes OD, Gaughran F (2018) Schizophr Res.  2018 Aug 25.  pii: S0920-9964(18)30503-6. doi: 10.1016/j.schres.2018.08.011. [Epub ahead of print] 

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Abstract:

BACKGROUND:

There is a paucity of longitudinal research investigating vitamin D in people with early psychosis.

METHOD:

Vitamin D levels were measured in 168 patients (64% (n = 108) male, mean age 29.3 (9.8) years) with first episode psychosis (FEP), along with measures of clinical state at baseline and at 12 months follow up. We assessed the a) cross sectional, and; b) longitudinal relationships between continuous and categorical 25-hydroxyvitamin D (25(OH)D) levels and clinical symptoms at first contact for psychosis and at 12 months.

RESULTS:

In FEP, 80% (n = 134) at baseline, and 76% at 12 months follow up, had suboptimal vitamin D levels (

CONCLUSION:

We identified a prospective association between higher baseline serum Vitamin D levels and lower total psychotic symptoms and negative symptoms of psychosis at 12 months after first contact for psychosis. The results of this study require replication in larger prospective studies, and highlight the need for large randomised trials to assess the effect of vitamin D supplementation on symptoms of psychosis in FEP.

FAB RESEARCH COMMENT:

Research over many years has shown that low Vitamin D status - especially in very early life - is linked with increased risks for psychosis and other neurodevelopmental disorders (see Vitamin D and schizophrenia).

Far fewer studies have investigated Vitamin D in relation to actual symptons of psychosis in adults, as was done in this study. 

Only 1 in 5 adults with first-episode psychosis had 'normal' Vitamin D levels when first assessed - and the proportion with normal levels declined from 20% to 16% over 12 months of follow-up. 

Importantly, lower initial Vitamin D levels predicted higher total symptoms of psychosis 12 months later, particularly 'negative' symptoms (such as social withdrawal, blunted emotional expression and impaired cognition).

While observational studies like this one can never provide evidence of causality, these findings support the case for investigating whether Vitamin D supplementation might be of benefit in patients with first-episode psychosis.

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