John Lally1, Olesya Ajnakina2, Nidhita Singh3, Poonam Gardner-Sood4, Brendon Stubbs5, Dominic Stringer6, Marta Di Forti7, Anthony S David8, Shubulade Smith9, Robin M Murray10, Oliver D Howes11, Fiona Gaughran12. 1. Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland; Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland; Department of Psychiatry, St Vincent's Hospital Fairview, Dublin, Ireland. Electronic address: john.lally@kcl.ac.uk. 2. Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. Electronic address: Olesya.ajnakina@kcl.ac.uk. 3. Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. Electronic address: Nidhita.singh@kcl.ac.uk. 4. Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. Electronic address: Poonam.sood@kcl.ac.uk. 5. Psychological Medicine Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, SE5 8AF, UK; Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK. Electronic address: brendon.stubbs@kcl.ac.uk. 6. Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK. Electronic address: dominic.stringer@kcl.ac.uk. 7. Department of Social Genetic and Developmental Psychiatry (SGDP), Institute of Psychiatry Psychology and Neuroscience, Kings College London, UK. Electronic address: marta.diforti@kcl.ac.uk. 8. Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King's College London, UK. Electronic address: anthony.david@kcl.ac.uk. 9. Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK; Forensic Intensive Care Service, South London and Maudsley NHS Foundation Trust, London, UK. Electronic address: Shubulade.Smith@slam.nhs.uk. 10. Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Psychiatry, Experimental Biomedicine and Clinical Neuroscience (BIONEC),University of Palermo, Italy. Electronic address: robin.murray@kcl.ac.uk. 11. Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; MRC Clinical Sciences Centre (Imperial Hammersmith Campus), UK. Electronic address: oliver.howes@kcl.ac.uk. 12. Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK. Electronic address: Fiona.p.gaughran@kcl.ac.uk.
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 (<20 ng/ml). Suboptimal levels of 25 (OH) D at baseline were not cross-sectionally associated with clinical symptoms. Higher vitamin D levels at baseline (n = 77) were significantly associated with better visual reproduction-immediate recall (β = 0.249, 95%CI = -0.012-0.871, p = 0.044). Higher baseline vitamin D levels were prospectively associated with lower total PANSS (β = -0.24, 95%CI = -0.47-0.01, p = 0.04) and PANSS negative symptom scores (β = -0.12, 95%CI = -0.23-0.01, p = 0.04) at 12 months. 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.
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 (<20 ng/ml). Suboptimal levels of 25 (OH) D at baseline were not cross-sectionally associated with clinical symptoms. Higher vitamin D levels at baseline (n = 77) were significantly associated with better visual reproduction-immediate recall (β = 0.249, 95%CI = -0.012-0.871, p = 0.044). Higher baseline vitamin D levels were prospectively associated with lower total PANSS (β = -0.24, 95%CI = -0.47-0.01, p = 0.04) and PANSS negative symptom scores (β = -0.12, 95%CI = -0.23-0.01, p = 0.04) at 12 months. 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.
Authors: Joseph Firth; Scott B Teasdale; Kelly Allott; Dan Siskind; Wolfgang Marx; Jack Cotter; Nicola Veronese; Felipe Schuch; Lee Smith; Marco Solmi; André F Carvalho; Davy Vancampfort; Michael Berk; Brendon Stubbs; Jerome Sarris Journal: World Psychiatry Date: 2019-10 Impact factor: 49.548