Detection of vitamin B12 deficiency in patients with major depression (Major depresyon hastalarında vitamin B12 eksikliğinin tespiti)

Year 2016, Volume: 1 Issue: 1, 1 - 5, 15.08.2016

Muzaffer Keklik , Uğur Kalan Özerhan Özer , Ferhat Arık , Sevgi Bayram

Abstract

Amaç: Vitamin B12 tüm vitaminler
içindeki en karmaşık kimyasal yapıya sahip olanı olup, hematolojik ve sinirsel
sistemin normal fonksiyon görebilmesi için gereklidir. Dolayısıyla, vitamin B12 eksikliği tedavi
edilmediğinde depresyon gibi psikiyatrik belirtilere yol açabilir. Bu çalışmada
amacımız, majör depresyon tanılı hastalarda vitamin B12 eksikliği sıklığını
tespit etmekti.

Metod: 
Çalışmada Kayseri Eğitim ve Araştırma Hastanesi’nde DSM-5 kriterleri baz
alınarak majör depresyon tanısı konan 425 erişkin hastaya ait veriler
değerlendirildi. Tüm hastaların CBC, serum vitamin B12 ve folat düzeyleri ile
rutin biyokimyasal tetkikleri incelendi.

 

Bulgular: Toplam 425 depresif hastanın
verileri incelendi. Hastaların
%74.6’sı kadındı. Vitamin B12 eksikliği 93 hastada tespit edildi (% 21.9).
Kadınlarda vitamin B12 eksikliği % 22.7 iken, erkeklerde bu oran % 19.4 olarak
saptandı. Her iki cinsiyet grubunda da folik asit, Hb, PLT ve WBC sayılarında
anlamlı farklılık yoktu.

Sonuç: :

Bu çalışmanın sonuçları, majör
depresyon hastalarında vitamin B12 eksikliğinin nadir olmadığını göstermiştir.
Depresif semptomları olan hastalarda fizik

bulguları
değerlendirmek ve vitamin B12 eksikliğini saptamaya yönelik gerekli testleri
yapmak faydalı olabilir. 

Aim: Vitamin B12 has the most complex chemical structure of all vitamins and it is necessary for normal functioning of hematological and nervous
system. Thus, vitamin B12 deficiency could cause psychiatric symptoms such as
depression when it is untreated. Our aim was to determine vitamin B12
deficiency frequency of patients diagnosed with major depression.

Method: The present study included 425
adult patients with major depression based on Diagnostic and Statistical Manual
of Mental Disorders, fifth edition (DSM-5) criteria at Kayseri Education and Research Hospital.
In all patients, laboratory evaluations were performed: complete blood count
(CBC), serum vitamin         B12 and
folate levels, and routine biochemical tests.

Results:  The
results of 425 depressive patients were analyzed. Depression was prevelant among females (74.6%). Also, total 93
patients (21.9%) were vitamin B12 deficient. While in female patients vitamin
B12 deficiency was 22.7%, in male patients, the rate was 19.4%. There were
no significant differences between folate and hemoglobin
(Hb) levels, platelet (PLT) and white blood cell (WBC) counts.

Conclusion: The results of this study shown
that, the frequency of vitamin B12 deficiency among people is major depression
not uncommon. It would be beneficial to consider the physical symptoms and to
conduct the required examinations to determine vitamin B12 deficiency  among this patients.

 

Keywords

depression, depresyon, vitamin B12

References

• Hintikka, J., et al., High vitamin B12 level and good treatment outcome may be associated in major depressive disorder. BMC Psychiatry, 2003. 3: p. 17.
• 2. Tiemeier, H., et al., Vitamin B12, folate, and homocysteine in depression: the Rotterdam Study. Am J Psychiatry, 2002. 159(12): p. 2099-101.
• 3. Penninx, B.W., et al., Vitamin B(12) deficiency and depression in physically disabled older women: epidemiologic evidence from the Women's Health and Aging Study. Am J Psychiatry, 2000. 157(5): p. 715-21.
• 4. Syed, E.U., M. Wasay, and S. Awan, Vitamin B12 supplementation in treating major depressive disorder: a randomized controlled trial. Open Neurol J, 2013. 7: p. 44-8.
• 5. Araujo, D.A., et al., Low serum levels of vitamin B12 in older adults with normal nutritional status by mini nutritional assessment. Eur J Clin Nutr, 2016.
• 6. Kaner, G., et al., Evaluation of Nutritional Status of Patients with Depression. Biomed Res Int, 2015. 2015: p. 521481.
• 7. Hasin, D.S., et al., DSM-5 criteria for substance use disorders: recommendations and rationale. Am J Psychiatry, 2013. 170(8): p. 834-51.
• 8. de Benoist, B., Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull, 2008. 29(2 Suppl): p. S238-44.
• 9. Allen, L.H., How common is vitamin B-12 deficiency? Am J Clin Nutr, 2009. 89(2): p. 693s-6s.
• 10. Seppala, J., et al., Association between vitamin b12 levels and melancholic depressive symptoms: a Finnish population-based study. BMC Psychiatry, 2013. 13: p. 145.
• 11. Bell, I.R., et al., B complex vitamin patterns in geriatric and young adult inpatients with major depression. J Am Geriatr Soc, 1991. 39(3): p. 252-7.
• 12. Mischoulon, D., et al., Anemia and macrocytosis in the prediction of serum folate and vitamin B12 status, and treatment outcome in major depression. J Psychosom Res, 2000. 49(3): p. 183-7.
• 13. Kim, J.M., et al., Predictive value of folate, vitamin B12 and homocysteine levels in late-life depression. Br J Psychiatry, 2008. 192(4): p. 268-74.
• 14. Elsborg, L., T. Hansen, and O.J. Rafaelsen, Vitamin B12 concentrations in psychiatric patients. Acta Psychiatr Scand, 1979. 59(2): p. 145-52.
• 15. Ng, T.P., et al., Folate, vitamin B12, homocysteine, and depressive symptoms in a population sample of older Chinese adults. J Am Geriatr Soc, 2009. 57(5): p. 871-6.
• 16. Bottiglieri, T., et al., Homocysteine, folate, methylation, and monoamine metabolism in depression. J Neurol Neurosurg Psychiatry, 2000. 69(2): p. 228-32.
• 17. Lindeman, R.D., et al., Serum vitamin B12, C and folate concentrations in the New Mexico elder health survey: correlations with cognitive and affective functions. J Am Coll Nutr, 2000. 19(1): p. 68-76.
• 18. Sachdev, P.S., et al., Relationship of homocysteine, folic acid and vitamin B12 with depression in a middle-aged community sample. Psychol Med, 2005. 35(4): p. 529-38.