Vitamin D levels among adult psychiatric inpatients and the association with psychosis

Ann Clin Psychiatry. 2023 Nov;35(4):238-245. doi: 10.12788/acp.0126.

Abstract

Background: The association between low vitamin D levels and mental illness has been described in earlier research. The aim of our study was to examine the association between vitamin D levels with psychotic symptoms among hospitalized patients.

Methods: A total of 1,456 patient records from an academic psychiatric hospital were examined. Vitamin D levels were classified as normal (>30 ng/mL); insufficient (20 to 30 ng/mL); and deficient (<20 ng/mL). We then analyzed the association among vitamin D groups and symptoms of psychosis.

Results: The average vitamin D level in our sample was 23.59 ng/mL, with 76.2% of patients presenting with vitamin D levels <30 ng/mL. There was a significant association between vitamin D levels <20 ng/mL and symptoms of psychosis (P < .05). African American patients had lower mean vitamin D levels than White patients (15.6 ± 0.2 ng/mL vs 25.8 ± 0.4 ng/mL, P < .001). There was no sex difference in vitamin D levels (females: 23.3 ± 11.5 ng/mL; males: 23.9 ± 11.0 ng/mL).

Conclusions: Patients with vitamin D levels <30 ng/mL were 1.5 times more likely to have symptoms of psychosis. Patients who were African American, Hispanic, Asian, or biracial had lower vitamin D levels than patients who were White. Multivariate analysis found that after adjusting for age, sex, and race, the association between vitamin D and psychosis was not statistically significant. Possible explanations could include the known tendency to overdiagnose psychosis among individuals who are African American, referral bias, subgroup effect, or an epiphenomenon.

MeSH terms

  • Adult
  • Black or African American / psychology
  • Black or African American / statistics & numerical data
  • Female
  • Humans
  • Inpatients
  • Male
  • Psychotic Disorders* / epidemiology
  • Psychotic Disorders* / ethnology
  • Vitamin D
  • Vitamin D Deficiency* / complications
  • Vitamin D Deficiency* / epidemiology
  • Vitamin D Deficiency* / ethnology
  • White / psychology
  • White / statistics & numerical data

Substances

  • Vitamin D