Vitamin D concentration and psychotic disorder: associations with disease status, clinical variables and urbanicity

C van der Leeuw*, L D de Witte, A Stellinga, C van der Ley, R Bruggeman, R S Kahn, J van Os, M Marcelis, for G.R.O.U.P.

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND: The association between schizophrenia and decreased vitamin D levels is well documented. Low maternal and postnatal vitamin D levels suggest a possible etiological mechanism. Alternatively, vitamin D deficiency in patients with schizophrenia is presumably (also) the result of disease-related factors or demographic risk factors such as urbanicity.

METHODS: In a study population of 347 patients with psychotic disorder and 282 controls, group differences in vitamin D concentration were examined. Within the patient group, associations between vitamin D, symptom levels and clinical variables were analyzed. Group × urbanicity interactions in the model of vitamin D concentration were examined. Both current urbanicity and urbanicity at birth were assessed.

RESULTS: Vitamin D concentrations were significantly lower in patients (B = -8.05; 95% confidence interval (CI) -13.68 to -2.42; p = 0.005). In patients, higher vitamin D concentration was associated with lower positive (B = -0.02; 95% CI -0.04 to 0.00; p = 0.049) and negative symptom levels (B = -0.03; 95% CI -0.05 to -0.01; p = 0.008). Group differences were moderated by urbanicity at birth (χ2 = 6.76 and p = 0.001), but not by current urbanicity (χ2 = 1.50 and p = 0.224). Urbanicity at birth was negatively associated with vitamin D concentration in patients (B = -5.11; 95% CI -9.41 to -0.81; p = 0.020), but not in controls (B = 0.72; 95% CI -4.02 to 5.46; p = 0.765).

CONCLUSIONS: Lower vitamin D levels in patients with psychotic disorder may in part reflect the effect of psychosis risk mediated by early environmental adversity. The data also suggest that lower vitamin D and psychopathology may be related through direct or indirect mechanisms.

Original languageEnglish
Article number0033291719001739
Pages (from-to)1680-1686
Number of pages7
JournalPsychological Medicine
Volume50
Issue number10
Early online date22 Jul 2019
DOIs
Publication statusPublished - Jul 2020

Keywords

  • Psychotic disorder
  • schizophrenia
  • urbanicity
  • vitamin D
  • D DEFICIENCY
  • D INSUFFICIENCY
  • INCREASED RISK
  • SCHIZOPHRENIA
  • IMMIGRANTS
  • METAANALYSIS
  • PREVALENCE
  • SYMPTOMS
  • MORTALITY
  • MIGRATION

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