The role of vitamins in psychiatry: A review

Abstract

Genetic factors, stress, nutrition, medications and environ-mental variables are factors that affect the occurrence of psychiatric disorders. The effect of dietary nutrients on mental health is an area that attracted the attention of re-searchers and has been studied for over a century. The role of vitamins in psychiatric disorders is an issue that can be addressed within the nutritional factor. It has been known that some vitamin deficiencies can cause psychiatric symp-toms and disorders. The role of vitamins in the formation and treatment of schizophrenia, mood disorders, anxiety disorders, eating disorders and neurocognitive disorders has been investigated. When the literature is reviewed, it is seen that the data obtained from the studies in this field are not consistent. Especially, studies on the use of vitamin supplements in the treatment of these disorders have re-vealed conflicting results.

Keywords

• Psychiatry
• vitamins
• schizophrenia
• depression
• anxiety
• neurocognitive disorders

Vitaminlerin psikiyatrideki rolü: Bir gözden geçirme

Abstract

Genetik faktörler, stres, beslenme, ilaçlar ve çevresel de-ğişkenler psikiyatrik bozuklukların oluşumunu etkileyen faktörlerdir. Diyetteki besin maddelerinin ruh sağlığına etkisi bir asır öncesinden beri araştırmacıların ilgisini çeken ve üzerinde çalışmalar yapılan bir alandır. Vitaminlerin psikiyatrik bozukluklardaki yeri, beslenme faktörü içerisin-de ele alınabilecek bir konudur. Bazı vitamin eksikliklerinin psikiyatrik belirti ve bozukluklara neden olabileceği bilin-mektedir. Şizofreni, duygudurum bozuklukları, anksiyete bozuklukları, yeme bozuklukları ve nörobilişsel bozukluk-ların oluşumunda ve tedavisinde vitaminlerin rolü araştırıl-mıştır. Literatüre bakıldığı zaman bu alanda yapılmış ça-lışmalardan elde edilen verilerin tutarlı olmadığı görülmek-tedir. Özellikle vitamin takviyelerinin bu bozuklukların tedavisinde kullanımı ile ilgili çalışmalar çelişkili sonuçlar ortaya çıkarmıştır.

Keywords

• Psikiyatri
• vitaminler
• şizofreni
• depresyon
• anksiyete
• nörobilişsel bozukluklar

References

1. 1. Hyman S, Chisholm D, Kessler R, Patel V, Whiteford H. Mental disorders. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB et al. (Eds). Disease control priorities in developing countries. New York: Oxford University Press, 2006: 605-25.
2. 2. Steel Z, Marnane C, Iranpour C, et al. The global preva-lence of common mental disorders: A systematic review and meta-analysis 1980–2013. Int J Epidemiol 2014;43(2):476-93.
3. 3. Charlson FJ, Baxter AJ, Dua T, Degenhardt L, White-ford HA, Vos T. Excess mortality from mental, neurologi-cal and substance use disorders in the Global Burden of Disease Study 2010. Epidemiol Psychiatr Sci 2015;24(2):121-40.
4. 4. Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. The Lancet Psychiatry 2016; 3(2):171-8.
5. 5. Hoobler BR. Symptomatology of Vitamin B deficiency in infants. JAMA 1928;91(5):307-10.
6. 6. Reed GE. The use of manganese chloride as treatment in dementia præcox. Can Med Assoc J 1929;21(1):46.
7. 7. Sydenstricker V, Cleckley H. The effect of nicotinic acid in stupor, lethargy and various other psychiatric disorders. American Journal of Psychiatry 1941;98(1):83-92.
8. 8. Young LM, Pipingas A, White DJ, Gauci S, Scholey A. A systematic review and meta-analysis of B vitamin supp-lementation on depressive symptoms, anxiety, and stress: Effects on healthy and ‘at-risk’individuals. Nutrients 2019;1(9):2232.

9. 9. Lim SY, Kim EJ, Kim A, Lee HJ, Choi HJ, Yang SJ. Nutritional factors affecting mental health. Clin Nutr Res 2016;5(3):143-52.
10. 10. Belvederi Murri M, Respino M, Masotti M, et al. Vita-min D and psychosis: Mini meta-analysis. Schizophr Res 2013;150(1):235-9.
11. 11. Casseb GAS, Kaster MP, Rodrigues ALS. Potential role of vitamin D for the management of depression and anxiety. CNS Drugs 2019;33(7):619-37.
12. 12. Landel V, Annweiler C, Millet P, Morello M, Féron F. Vitamin D, cognition and Alzheimer's disease: The therape-utic benefit is in the D-tails. J Alzheimers Dis 2016;53(2):419-44.
13. 13. Jamilian H, Amirani E, Milajerdi A, et al. The effects of vitamin D supplementation on mental health, and biomar-kers of inflammation and oxidative stress in patients with psychiatric disorders: A systematic review and meta-analysis of randomized controlled trials. Prog Neuropsyc-hopharmacol Biol Psychiatry 2019;94:109651.
14. 14. Allott K, McGorry PD, Yuen HP, et al. The Vitamins in psychosis study: A randomized, double-blind, placebo-controlled trial of the effects of vitamins B(12), B(6), and folic acid on symptoms and neurocognition in first-episode psychosis. Biol Psychiatry 2019;86(1):35-44.
15. 15. Kozyra M, Klas J, Szabat M, Samoń-Drzewicka AM, Milanowska J. The relationship between the diet, microele-ments, macronutrients and vitamins on the schizophrenia–literature analysis. J Educ Health Sport 2020;10(9):369-77.
16. 16. Whiteford HA, Degenhardt L, Rehm J, et al. Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. The lancet 2013;382(9904):1575-86.
17. 17. Bobo WV, Rapoport JL, Abi‐Dargham A, Fatemi SH, Meltzer HY. The neurobiology of schizophrenia. In: Tas-man A, Kay J, Lieberman JA, First MB, Riba MB (Eds). Psychiatry. New Jersey: John Wiley & Sons Ltd, 2015.
18. 18. Goff DC, Bottiglieri T, Arning E, et al. Folate, ho-mocysteine, and negative symptoms in schizophrenia. Am J Psychiatry 2004;161(9):1705-8.
19. 19. Herrán A, García-Unzueta MT, Amado JA, López-Cordovilla JJ, Díez-Manrique JF, Vázquez-Barquero JL. Folate levels in psychiatric outpatients. Psychiatry Clin Neurosci 1999;53(4):531-3.
20. 20. Muntjewerff JW, Kahn RS, Blom HJ, den Heijer M. Homocysteine, methylenetetrahydrofolate reductase and risk of schizophrenia: A meta-analysis. Mol Psychiatry 2006;11(2):143-9.
21. 21. Brown AS, Bottiglieri T, Schaefer CA, et al. Elevated prenatal homocysteine levels as a risk factor for schizoph-renia. Arch Gen Psychiatry 2007;64(1):31-9.
22. 22. Roffman JL, Petruzzi LJ, Tanner AS, et al. Biochemi-cal, physiological and clinical effects of l-methylfolate in schizophrenia: A randomized controlled trial. Mol Psychi-atry 2018;23(2):316-22.
23. 23. Firth J, Stubbs B, Sarris J, et al. The effects of vitamin and mineral supplementation on symptoms of schizophre-nia: A systematic review and meta-analysis. Psychol Med 2017;47(9):1515-27.
24. 24. Eyles D, Brown J, Mackay-Sim A, McGrath J, Feron F. Vitamin D3 and brain development. Neuroscience 2003;118(3):641-53.
25. 25. McGrath JJ, Eyles DW, Pedersen CB, et al. Neonatal vitamin D status and risk of schizophrenia: A population-based case-control study. Arch Gen Psychiatry 2010;67(9):889-94.
26. 26. Firth J, Carney R, Stubbs B, et al. Nutritional deficien-cies and clinical correlates in first-episode psychosis: A systematic review and meta-analysis. Schizophr Bull 2018;44(6):1275-92.
27. 27. Itzhaky D, Amital D, Gorden K, Bogomolni A, Arnson Y, Amital H. Low serum vitamin D concentrations in pati-ents with schizophrenia. Isr Med Assoc J 2012;14(2):88-92.
28. 28. Valipour G, Saneei P, Esmaillzadeh A. Serum vitamin D levels in relation to schizophrenia: A systematic review and meta-analysis of observational studies. J Clin Endocri-nol Metab 2014;99(10):3863-72.
29. 29. Goldsmith CA, Rogers DP. The case for autoimmunity in the etiology of schizophrenia. Pharmacotherapy 2008;28(6):730-41.
30. 30. Sirota P, Bogdanov I, Katzav A, Hershko R, Chapman J. Reduced anticardiolipin antibodies in first episode and chronic schizophrenia. Psychiatry Res 2006;144(2-3):211-6.
31. 31. Strous RD, Shoenfeld Y. Schizophrenia, autoimmunity and immune system dysregulation: A comprehensive model updated and revisited. J Autoimmun 2006;27(2):71-80.
32. 32. McCann JC, Ames BN. Is there convincing biological or behavioral evidence linking vitamin D deficiency to brain dysfunction? FASEB J 2008;22(4):982-1001.
33. 33. Halicka HD, Zhao H, Li J, Traganos F, Studzinski GP, Darzynkiewicz Z. Attenuation of constitutive DNA damage signaling by 1,25-dihydroxyvitamin D3. Aging (Albany NY) 2012;4(4):270-8.
34. 34. McGrath J. Hypothesis: Is low prenatal vitamin D a risk-modifying factor for schizophrenia? Schizophr Res 1999;40(3):173-7.
35. 35. van der Leeuw C, de Witte LD, Stellinga A, et al. Vita-min D concentration and psychotic disorder: Associations with disease status, clinical variables and urbanicity. Psyc-hol Med 2020;50(10):1680-6.
36. 36. Krivoy A, Onn R, Vilner Y, et al. Vitamin D supple-mentation in chronic schizophrenia patients treated with clozapine: A randomized, double-blind, placebo-controlled clinical trial. EBioMedicine 2017;26:138-45.
37. 37. Hedelin M, Löf M, Olsson M, et al. Dietary intake of fish, omega-3, omega-6 polyunsaturated fatty acids and vitamin D and the prevalence of psychotic-like symptoms in a cohort of 33,000 women from the general population. BMC Psychiatry 2010;10:38.
38. 38. Sanacora G, Zarate CA, Krystal JH, Manji HK. Targe-ting the glutamatergic system to develop novel, improved therapeutics for mood disorders. Nat Rev Drug Discov 2008;7(5):426-37.
39. 39. Deligiannidis KM, Byatt N, Freeman MP. Pharmacot-herapy for mood disorders in pregnancy: A review of pharmacokinetic changes and clinical recommendations for therapeutic drug monitoring. J Clin Psychopharmacol 2014;34(2):244-55.
40. 40. Maj M, Akiskal HS, Lopez-Ibor JJ, Sartorius N. Bipo-lar Disorders. West Sussex: Wiley; 2002.
41. 41. Cederlöf M, Larsson H, Lichtenstein P, Almqvist C, Serlachius E, Ludvigsson JF. Nationwide population-based cohort study of psychiatric disorders in individuals with Ehlers-Danlos syndrome or hypermobility syndrome and their siblings. BMC Psychiatry 2016;16:207.
42. 42. Çelik FH, Hocaoğlu Ç. Major depresif bozukluk tanımı, etyolojisi ve epidemiyolojisi: Bir gözden geçirme. Çağdaş Tıp Dergisi 2016;6(1):51-66.
43. 43. Olchanski N, McInnis Myers M, Halseth M, et al. The economic burden of treatment-resistant depression. Clin Ther 2013;35(4):512-22.
44. 44. Yeloğlu ÇH. Önemli bir ruh sağlığı sorunu: Bipolar bozukluk. Mustafa Kemal Üniversitesi Tıp Dergisi 2017;8(30):41-54.
45. 45. Hsieh YC, Chou LS, Lin CH, Wu HC, Li DJ, Tseng PT. Serum folate levels in bipolar disorder: A systematic review and meta-analysis. BMC Psychiatry 2019;19(1):305.
46. 46. Kempisty B, Mostowska A, Górska I, et al. Association of 677C>T polymorphism of methylenetetrahydrofolate reductase (MTHFR) gene with bipolar disorder and schi-zophrenia. Neurosci Lett 2006;400(3):267-71.
47. 47. Ozbek Z, Kucukali CI, Ozkok E, et al. Effect of the methylenetetrahydrofolate reductase gene polymorphisms on homocysteine, folate and vitamin B12 in patients with bipolar disorder and relatives. Prog Neuropsychopharmacol Biol Psychiatry 2008;32(5):1331-7.
48. 48. Abdulle AM, Pathan JY, Moussa N, Gariballa S. As-sociation between homocysteine and endothelial dysfunc-tion markers in stroke disease. Nutr Neurosci 2010;13(1):2-6.
49. 49. Łojko D, Stelmach-Mardas M, Suwalska A. Is diet important in bipolar disorder? Psychiatr Pol 2018;52(5):783-95.
50. 50. Boerman R, Cohen D, Schulte PF, Nugter A. Prevalen-ce of vitamin D deficiency in adult outpatients with bipolar disorder or schizophrenia. J Clin Psychopharmacol 2016;36(6):588-92.
51. 51. Bottiglieri T, Laundy M, Crellin R, Toone BK, Carney MW, Reynolds EH. Homocysteine, folate, methylation, and monoamine metabolism in depression. J J Neurol Neuro-surg Psychiatry 2000;69(2):228-32.
52. 52. Khosravi M, Sotoudeh G, Amini M, Raisi F, Mansoori A, Hosseinzadeh M. The relationship between dietary patterns and depression mediated by serum levels of Folate and vitamin B12. BMC Psychiatry 2020;20(1):63.
53. 53. Sarris J, Murphy J, Mischoulon D, et al. Adjunctive nutraceuticals for depression: A systematic review and meta-analyses. Focus (American Psychiatr Publ) 2018;16(3):328-40.
54. 54. Parker GB, Brotchie H, Graham RK. Vitamin D and depression. J Affect Disord 2017;208:56-61.
55. 55. Hoffmann K, Emons B, Brunnhuber S, Karaca S, Juc-kel G. The role of dietary supplements in depression and anxiety - a narrative review. Pharmacopsychiatry 2019;52(6):261-79.
56. 56. Abraham A, Krishnan S, Subhakumari KN, Chakka-lakkudy GG. Vitamin D levels in depressive disorder. J Evid Based Med Healthc 2019;6(11):862-5.
57. 57. Geng C, Shaikh AS, Han W, Chen D, Guo Y, Jiang P. Vitamin D and depression: Mechanisms, determination and application. Asia Pac J Clin Nutr 2019;28(4):689-94.
58. 58. Okereke OI, Reynolds CF 3rd, Mischoulon D, et al. The VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention (VITAL-DEP): Rationale and design of a large-scale ancillary study evaluating vitamin D and marine ome-ga-3 fatty acid supplements for prevention of late-life dep-ression. Contemp Clin Trials. Contemp Clin Trials 2018;68:133-45.
59. 59. Milaneschi Y, Shardell M, Corsi AM, et al. Serum 25-hydroxyvitamin D and depressive symptoms in older wo-men and men. J Clin Endocrinol Metab 2010;95(7):3225-33.
60. 60. May HT, Bair TL, Lappé DL, et al. Association of vitamin D levels with incident depression among a general cardiovascular population. Am Heart J 2010;159(6):1037-43.
61. 61. Li G, Mbuagbaw L, Samaan Z, et al. Efficacy of vita-min D supplementation in depression in adults: A systema-tic review. J Clin Endocrinol Metab 2014;99(3):757-67.
62. 62. Spedding S. Vitamin D and depression: A systematic review and meta-analysis comparing studies with and wit-hout biological flaws. Nutrients 2014;6(4):1501-18.
63. 63. Abay E. Anksiyete Bozuklukları. In: Sadock B, Sadock VA, Ruiz P editors. Kaplan & Sadock Psikiyatri (Çev. ed. Bozkurt A). Ankara: Güneş Tıp Kitabevi, 2016, pp: 387-417.
64. 64. Kupfer DJ. Anxiety and DSM-5. Dialogues Clin Neu-rosci 2015;17(3):245-6.
65. 65. Zhu C, Zhang Y, Wang T, et al. Vitamin D supplemen-tation improves anxiety but not depression symptoms in patients with vitamin D deficiency. Brain and Behav 2020;10(11):e01760.
66. 66. Bičíková M, Dušková M, Vítků J, et al. Vitamin D in anxiety and affective disorders. Physiol Res 2015;64(2):101-3.
67. 67. American Psychiatric Association: Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing, Arlington, VA, 2013.
68. 68. Michalska A, Szejko N, Jakubczyk A, Wojnar M. Nonspecific eating disorders - a subjective review. Psychi-atr Polska 2016;50(3):497-507.
69. 69. Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: A systematic literature review. Am J Clin Nutr 2019;109(5):1402-13.
70. 70. Díaz-Marsá M, Alberdi-Páramo I, Niell-Galmés L. Nutritional supplements in eating disorders. Actas Esp Psiquiatr 2017;45(Supplement):26-36.
71. 71. Foerde K, Steinglass JE, Shohamy D, Walsh BT. Neu-ral mechanisms supporting maladaptive food choices in anorexia nervosa. Nat Neurosci 2015;18(11):1571-3.
72. 72. King JA, Geisler D, Ritschel F, et al. Global cortical thinning in acute anorexia nervosa normalizes following long-term weight restoration. Biol Psychiatry 2015;77(7):624-32.
73. 73. Setnick J. Micronutrient deficiencies and supplementa-tion in anorexia and bulimia nervosa: A review of literature. Nutr Clin Pract 2010;25(2):137-42.
74. 74. Marcantonio ER. Delirium in hospitalized older adults. N Engl J Med 2017;377(15):1456-66.
75. 75. Goodwill AM, Szoeke C. A systematic review and meta-analysis of the effect of low vitamin D on cognition. J Am Geriatr Soc 2017;65(10):2161-8.
76. 76. Quraishi SA, Litonjua AA, Elias KM, et al. Association between pre-hospital vitamin D status and hospital-acquired new-onset delirium. Br J Nutr 2015;113(11):1753-60.
77. 77. Bowman K, Jones L, Pilling LC, et al. Vitamin D levels and risk of delirium: A mendelian randomization study in the UK Biobank. Neurology 2019;92(12):e1387-e94.
78. 78. Chouët J, Sacco G, Karras SN, Llewellyn DJ, Sánchez-Rodríguez D, Annweiler C. Vitamin D and delirium in older adults: A case-control study in geriatric acute care unit. Front Neurol 2020;11:1034.
79. 79. Patrick RP, Ames BN. Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: Relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. FASEB J 2015;29(6):2207-22.
80. 80. van der Mast RC, Fekkes D. Serotonin and amino acids: Partners in delirium pathophysiology? Semin Clin Neuropsychiatry 2000;5(2):125-31.
81. 81. Vahdat Shariatpanahi M, Velayati A, Jamalian SA, Babevaynejad M, Vahdat Shariatpanahi Z. The relationship between serum cobalamin, folic acid, and homocysteine and the risk of post-cardiac surgery delirium. Neuropsychiatr Dis Treat 2019;15:1413-9.
82. 82. Hshieh TT, Fong TG, Marcantonio ER, Inouye SK. Cholinergic deficiency hypothesis in delirium: A synthesis of current evidence. J Gerontol A Biol Sci Med Sci 2008;63(7):764-72.
83. 83. Sevuk U, Baysal E, Ay N, et al. Relationship between cobalamin deficiency and delirium in elderly patients under-going cardiac surgery. Neuropsychiatr Dis Treat 2015;11:2033-9.
84. 84. Kwok T, Lee J, Lam L, Woo J. Vitamin B(12) supple-mentation did not improve cognition but reduced delirium in demented patients with vitamin B(12) deficiency. Arch Gerontol Geriatr 2008;46(3):273-82.
85. 85. Behrens A, Graessel E, Pendergrass A, Donath C. Vitamin B - Can it prevent cognitive decline? A systematic review and meta-analysis. Syst Rev 2020;9(1):111.
86. 86. Anjum I, Jaffery SS, Fayyaz M, Samoo Z, Anjum S. The Role of vitamin D in brain health: A mini literature review. Cureus 2018;10(7):e2960.
87. 87. Jayedi A, Rashidy-Pour A, Shab-Bidar S. Vitamin D status and risk of dementia and Alzheimer's disease: A meta-analysis of dose-response. Nutr Neurosci 2019;22(11):750-9.
88. 88. Sommer I, Griebler U, Kien C, et al. Vitamin D defici-ency as a risk factor for dementia: A systematic review and meta-analysis. BMC Geriatr 2017;17(1):16.
89. 89. Schneider ALC, Zhao D, Lutsey PL, et al. Serum vita-min D concentrations and cognitive change over 20 years: The atherosclerosis risk in communities neurocognitive study. Neuroepidemiology 2018;51(3-4):131-7.
90. 90. Aggarwal BB, Sundaram C, Prasad S, Kannappan R. Tocotrienols, the vitamin E of the 21st century: Its potential against cancer and other chronic diseases. Biochem Phar-macol 2010;80(11):1613-31.
91. 91. Lopes da Silva S, Vellas B, Elemans S, et al. Plasma nutrient status of patients with Alzheimer's disease: Syste-matic review and meta-analysis. Alzheimers Dement 2014;10(4):485-502.
92. 92. Dong Y, Chen X, Liu Y, et al. Do low-serum vitamin E levels increase the risk of Alzheimer disease in older peop-le? Evidence from a meta-analysis of case-control studies. Int J Geriatr Psychiatry 2018;33(2):e257-e63.
93. 93. de Wilde MC, Vellas B, Girault E, Yavuz AC, Sijben JW. Lower brain and blood nutrient status in Alzheimer's disease: Results from meta-analyses. Alzheimers Dement 2017;3(3):416-31.
94. 94. Morris MC, Beckett LA, Scherr PA, et al. Vitamin E and vitamin C supplement use and risk of incident Alzhei-mer disease. Alzheimer Dis Assoc Disord 1998;12(3):121-6.
95. 95. Morris MC, Evans DA, Bienias JL, et al. Dietary intake of antioxidant nutrients and the risk of incident Alzheimer disease in a biracial community study. JAMA 2002;287(24):3230-7.
96. 96. Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's disease cooperative study. N Engl J Med 1997;336(17):1216-22.
97. 97. Petersen RC, Thomas RG, Grundman M, et al. Vitamin E and donepezil for the treatment of mild cognitive impair-ment. N Engl J Med 2005;352(23):2379-88.
98. 98. Arlt S, Müller-Thomsen T, Beisiegel U, Kontush A. Effect of one-year vitamin C- and E-supplementation on cerebrospinal fluid oxidation parameters and clinical course in Alzheimer's disease. Neurochem Res 2012;37(12):2706-14.
99. 99. Galasko DR, Peskind E, Clark CM, et al. Antioxidants for Alzheimer disease: A randomized clinical trial with cerebrospinal fluid biomarker measures. Arch Neurol 2012;69(7):836-41.
100. 100. Wang H, Li L, Qin LL, Song Y, Vidal-Alaball J, Liu TH. Oral vitamin B(12) versus intramuscular vitamin B(12) for vitamin B(12) deficiency. Cochrane Database Syst Rev 2018;3(3):Cd004655.
101. 101. Buesing S, Costa M, Schilling JM, Moeller-Bertram T. Vitamin B12 as a treatment for pain. Pain Physician 2019;22(1):E45-e52.
102. 102. Buluş D, Yasemin İ, Demet E, Andıran N. D vitamini intoksikasyonuna bağlı hiperkalsemi: Olgu sunumu. Türki-ye Çocuk Hastalıkları Dergisi 2016;10(4):277-9.