Vitamin B 12 Deficiency  Among Depressive Patients Presenting  in Tertiary Care  Hospital of Karachi

Saman Ijaz; Shahzad  Rauf; Usama Bin  Zubair; Fariha  Iqbal; Waleed  Iqbal; Zeeshan  Nasir

doi:10.51253/pafmj.v75i1.11041

Authors

Saman Ijaz Department of Psychiatry, Pakistan Navy Station Shifa Hospital, Karachi Pakistan
Shahzad Rauf Department of Psychiatry, Pakistan Navy Station Shifa Hospital, Karachi Pakistan
Usama Bin Zubair epartment of Psychiatry, Fauji Foundation Hospital, Rawalpindi Pakistan
Fariha Iqbal Department of Psychiatry, Pakistan Navy Station Shifa Hospital, Karachi Pakistan
Waleed Iqbal Department of Psychiatry, Pakistan Navy Station Shifa Hospital, Karachi Pakistan
Zeeshan Nasir Department of Anesthesia, Pakistan Navy Station Shifa Hospital, Karachi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i1.11041

Keywords:

Depression, Hamilton Rating Score, Vitamin B 12 deficiency.

Abstract

Objective: To determine the frequency of deficiency of levels of vitamin B12 among depressed patients presenting in tertiary care hospital.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Pakistan Naval Ship Shifa Hospital, Karachi Pakistan, from Jun to Dec 2022.

Methodology: The clinically diagnosed depressed patients aged 18 to 90 years after ERC approval were included. The inclusion criteria was clinical depressive symptoms, single and multiple episodes, and scoring of more than 10 on the Hamilton depression rating scale (HAM-D). After consent, a blood sample was sent for serum vitamin B12 levels. Levels less than 200 pg/ml were considered as deficient.

Result: The mean age for the study population was 46.82±15.64 years. 39(19.5%) of the patients were aged more than 55 years. The majority, 112(56%), were females; 121(60.5%) had no known psychiatric co-morbid; 115(57.5%) had no known medical co-morbid; 128(64%) had vitamin B12 deficiency; 128(64%) were diagnosed one year or more and 111(55.5%) were on oral vitamin B12 supplements. 67(33.5%) had serum vitamin B12 deficiency. 128(64%) were currently depressed; 130(65%) had HAM scores greater than 10.

Conclusion: Our study has shown high vitamin B12 deficiency in depressive patients. It was shown to be significantly associated with female gender, age >30 years, co-existing psychiatric illness, disease duration greater than 1 year, Hamilton Rating Score >10, and multiple episodes.

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References

Kapoor A, Baig M, Tunio SA, Memon AS, Karmani H. Neuropsychiatric and neurological problems among Vitamin B12 deficient young vegetarians. Neurosciences 2017; 22(3): 228-232. https://doi.org/10.17712/nsj.2017.3.20160445

Esnafoglu E, Yaman E. Vitamin B12, folic acid, homocysteine and vitamin D levels in children and adolescents with obsessive compulsive disorder. Psychiatry Res 2017; 254: 232-237. https://doi.org/10.1016/j.psychres.2017.04.032

Ghosh S, Sinha JK, Khandelwal N, Chakravarty S, Kumar A, Raghunath M. Increased stress and altered expression of histone modifying enzymes in brain are associated with aberrant behaviour in vitamin B12 deficient female mice. Nutr Neurosci 2020; 23(9): 714-723.

https://doi.org/10.1080/1028415X.2018.1548676

Zou R, Dai Y, Wang D, Zhang X. Association between MTHFR polymorphism and seizure control in epileptic patients with hyperhomocysteinaemia. Epileptic Disord 2022; 24(5): 889-97.

https://doi.org/10.1684/epd.2022.1470

Pu J, Liu Y, Gui S, Tian L, Yu Y, Wang D, et al. Effects of pharmacological treatment on metabolomic alterations in animal models of depression. Transl Psychiatry 2022; 12(1): 175.

https://doi.org/10.1038/s41398-022-01947-5

Esnafoglu E, Ozturan DD. The relationship of severity of depression with homocysteine, folate, vitamin B12, and vitamin D levels in children and adolescents. Child Adolesc Ment Health 2020; 25(4): 249-255.

https://doi.org/10.1111/camh.12387

Kwok T, Wu Y, Lee J, Lee R, Yung CY, Choi G, et al. A randomized placebo-controlled trial of using B vitamins to prevent cognitive decline in older mild cognitive impairment patients. Clin Nutr 2020; 39(8): 2399-2405.

https://doi.org/10.1016/j.clnu.2019.11.005

Ekinci GN, Sanlier N. The relationship between nutrition and depression in the life process: A mini-review. Exp Gerontol 2023; 172: 112072.

https://doi.org/10.1016/j.exger.2022.112072

Huang X, Fan Y, Han X, Huang Z, Yu M, Zhang Y, et al. Association between Serum Vitamin Levels and Depression in U.S. Adults 20 Years or Older Based on National Health and Nutrition Examination Survey 2005(-)2006. Int J Environ Res Public Health 2018; 15(6): 1215.

https://doi.org/10.3390/ijerph15061215

Geng C, Yang Z, Xu P, Zhang H. Possible association between vitamin B12 deficiency and restless legs syndrome. Clin Neurol Neurosurg 2022; 223: 107477.

https://doi.org/10.1016/j.clineuro.2022.107477

Gougeon L, Payette H, Morais JA, Gaudreau P, Shatenstein B, Gray-Donald K. A prospective evaluation of the depression-nutrient intake reverse causality hypothesis in a cohort of community-dwelling older Canadians. Br J Nutr 2017; 117(7): 1032-1041. https://doi.org/10.1017/S0007114517000782

Elstgeest LE, Brouwer IA, Penninx BW, van Schoor NM, Visser M. Vitamin B(12), homocysteine and depressive symptoms: a longitudinal study among older adults. Eur J Clin Nutr 2017; 71(4): 468-475. https://doi.org/10.1038/ejcn.2016.224

Pan LA, Segreti AM, Wrobleski J, Shaw A, Hyland K, Hughes M, et al. Metabolomic disorders: confirmed presence of potentially treatable abnormalities in patients with treatment refractory depression and suicidal behavior. Psychol Med 2023; 53(13): 6046-6054. https://doi.org/10.1017/S0033291722003233

Khosravi M, Sotoudeh G, Amini M, Raisi F, Mansoori A, Hosseinzadeh M, et al. The relationship between dietary patterns and depression mediated by serum levels of Folate and vitamin B12. BMC Psychiatry 2020; 20(1): 63.

https://doi.org/10.1186/s12888-020-2455-2

Nguyen HD, Oh H, Kim MS. Mixtures modeling identifies vitamin B1 and B3 intakes associated with depression. J Affect Disord 2022; 301: 68-80.

https://doi.org/10.1016/j.jad.2021.12.133

Liu X, Zhao W, Hu F, Hao Q, Hou L, Sun X, et al. Comorbid anxiety and depression, depression, and anxiety in comparison in multi-ethnic community of west China: prevalence, metabolic profile, and related factors. J Affect Disord 2022; 298(Pt A): 381-387. https://doi.org/10.1016/j.jad.2021.10.083

Dhiman P, Pillai RR, Wilson AB, Premkumar N, Bharadwaj B, Ranjan VP, et al. Cross-sectional association between vitamin B12 status and probable postpartum depression in Indian women. BMC Pregnancy Childbirth 2021; 21(1): 146.

https://doi.org/10.1186/s12884-021-03622-x

Barclay ME, Rinne GR, Somers JA, Lee SS, Coussons-Read M, Dunkel Schetter C. Maternal Early Life Adversity and Infant Stress Regulation: Intergenerational Associations and Mediation by Maternal Prenatal Mental Health. Res Child Adolesc Psychopathol 2023; 51(12): 1839-1855.

https://doi.org/10.1007/s10802-022-01006-z

Oldra CM, Benvegnu DM, Silva DRP, Wendt GW, Vieira AP. Relationships between depression and food intake in climacteric women. Climacteric 2020; 23(5): 474-481.

https://doi.org/10.1080/13697137.2020.1736025

Gastaldon C, Solmi M, Correll CU, Barbui C, Schoretsanitis G. Risk factors of postpartum depression and depressive symptoms: umbrella review of current evidence from systematic reviews and meta-analyses of observational studies. Br J Psychiatry 2022; 221(4): 591-602.

https://doi.org/10.1192/bjp.2021.222

Khattri JB, Godar ST, Subedi A. A Study of Vitamin D among Patients Presenting in the Psychiatric OPD of Manipal Teaching Hospital, Pokhara. Kathmandu Univ Med J 2019; 17(68): 293-297.

Ribeiro RHT, Ribeiro FA, Silva RPM, Bortolini MJS, Garrote-Filho MDS, Penha-Silva N, et al. Depression, Hematologic Parameters, and Blood Levels of Vitamin B(12) in Patients With Laryngopharyngeal Reflux Under Use of Proton Pump Inhibitors. Clin Med Insights Ear Nose Throat 2019; 12: 1179550619828683. https://doi.org/10.1177/1179550619828683