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Vitamin D deficiency is to be expected due to immune changes related to mental health problems

Published online by Cambridge University Press:  02 January 2018

Annie Swanepoel*
Affiliation:
Child and Adolescent Mental Health Service, Hertfordshire Partnership University Foundation NHS Trust, Hoddesdon, UK, email: annie.swanepoel@hpft.nhs.uk
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Abstract

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Creative Commons
Creative Common License - CCCreative Common License - BY
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 2017 The Author

Stewart & Lewis Reference Stewart and Lewis1 have shown that adolescent psychiatric in-patients typically have vitamin D deficiency and hypothesise that this may be due to reduced exposure to sunlight. This may well be true, but it is much more likely that the reduced vitamin D levels are due to changes in the immune system linked with psychiatric disorders. For example, it is now well known that depression is associated with inflammation Reference Berk, Williams, Jacka, O'Neill, Pasco and Moylan2 and that immune markers are typically raised. What is less well known is that vitamin D is a negative acute-phase reactant, Reference Waldron, Ashby, Cornes, Bechervaise, Razavi and Thomas3 which means that its levels drop in response to inflammation. Therefore, a low level may not indicate a deficiency, but rather the presence of inflammation. It would be interesting to reanalyse the data and see whether there are any links with particular diagnoses.

References

1 Stewart, NF, Lewis, SN. Vitamin D deficiency in adolescents in a tier 4 psychiatric unit. BJPsych Bull 2017; 41: 404–6.CrossRefGoogle Scholar
2 Berk, M, Williams, LJ, Jacka, FN, O'Neill, A, Pasco, JA, Moylan, S, et al. So depression is an inflammatory disease, but where does the depression come from? BMC Med 2013; 11: 200.CrossRefGoogle ScholarPubMed
3 Waldron, JL, Ashby, HL, Cornes, MP, Bechervaise, J, Razavi, C, Thomas, OL, et al. Vitamin D: a negative acute-phase reactant. J Clin Pathol 2013; 66: 620–2.Google Scholar
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