Original Article

Serum Vitamin D, Mania and Depression-Related Scores: A Comparison among Mixed Bipolar, Mania, and Healthy Subjects

Abstract

Objective: Manic and mixed episodes of bipolar disorder are important episodes of this disorder. The aim of the current study was to assess serum vitamin D (SVD) levels in patients with mania and mixed bipolar disorder, compared to healthy subjects.
Method: The current cross-sectional study was conducted on 75 subjects, including healthy subjects (n = 25), patients with acute-phase mania (n = 25), and patients with mixed bipolar disorder (n = 25). The SVD levels were measured in all of the enrolled subjects. The Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), and Clinical Global Impression- Severity (CGI-S) were used to assess disease activity in patient groups. Data analysis was performed using SPSS version 18. For statistical analysis, analysis of variance (ANOVA), independent-sample t test, Pearson correlation, and Chi-square tests were utilized. P-values < 0.05 were considered statistically significant.
Results: The results showed that the mean of SVD was significantly lower in mania and mixed bipolar patients compared to healthy subjects (P < 0.05). In addition, the number of subjects with SVD ≥ 20 ng/ml was higher in the healthy group compared to the patient groups (P < 0.05). Also, SVD was negatively correlated with the CGI-S (r = -0.311; P = 0.028), YMRS (r = -0.464; P = 0.001), and HDRS (r = -0.393; P = 0.005) in the total patient subjects.
Conclusion: Prevalence of low SVD was considerably high in mania and mixed bipolar patients compared to healthy subjects. Additionally, meaningful negative correlations were found between SVD and disease activity-related variables including the HDRS, YMRS, and CGI-S.

1. Marazziti D, Mangiapane P, Carbone MG, Morana F, Arone A, Massa L, et al. Decreased Levels of Vitamin D in Bipolar Patients. Life (Basel). 2023;13(4).
2. Muneer A. Mixed States in Bipolar Disorder: Etiology, Pathogenesis and Treatment. Chonnam Med J. 2017;53(1):1-13.
3. Adan RAH, van der Beek EM, Buitelaar JK, Cryan JF, Hebebrand J, Higgs S, et al. Nutritional psychiatry: Towards improving mental health by what you eat. Eur Neuropsychopharmacol. 2019;29(12):1321-32.
4. Platzer M, Fellendorf FT, Bengesser SA, Birner A, Dalkner N, Hamm C, et al. The Relationship Between Food Craving, Appetite-Related Hormones and Clinical Parameters in Bipolar Disorder. Nutrients. 2020;13(1).
5. McAulay C, Hay P, Mond J, Touyz S. Eating disorders, bipolar disorders and other mood disorders: complex and under-researched relationships. J Eat Disord.
6. Nwosu BU, Meltzer B, Maranda L, Ciccarelli C, Reynolds D, Curtis L, et al. A potential role for adjunctive vitamin D therapy in the management of weight gain and metabolic side effects of second-generation antipsychotics. J Pediatr Endocrinol Metab. 2011;24(9-10):619-26.
7. Mulcahy KB, Trigoboff E, Opler L, Demler TL. Physician Prescribing Practices of Vitamin D in a Psychiatric Hospital. Innov Clin Neurosci. 2016;13(5-6):21-7.
8. Cereda G, Enrico P, Ciappolino V, Delvecchio G, Brambilla P. The role of vitamin D in bipolar disorder: Epidemiology and influence on disease activity. J Affect Disord. 2021;278:209-17.
9. Plantone D, Primiano G, Manco C, Locci S, Servidei S, De Stefano N. Vitamin D in Neurological Diseases. Int J Mol Sci. 2022;24(1).
10. Moretti R, Morelli ME, Caruso P. Vitamin D in Neurological Diseases: A Rationale for a Pathogenic Impact. Int J Mol Sci. 2018;19(8).
11. Altunsoy N, Yüksel RN, Cingi Yirun M, Kılıçarslan A, Aydemir Ç. Exploring the relationship between vitamin D and mania: correlations between serum vitamin D levels and disease activity. Nord J Psychiatry. 2018;72(3):221-5.
12. Boerman R, Cohen D, Schulte PF, Nugter A. Prevalence of Vitamin D Deficiency in Adult Outpatients With Bipolar Disorder or Schizophrenia. J Clin Psychopharmacol. 2016;36(6):588-92.
13. Chen WY, Huang MC, Chiu CC, Cheng YC, Kuo CJ, Chen PY, et al. The interactions between vitamin D and neurofilament light chain levels on cognitive domains in bipolar disorder. BJPsych Open. 2022;8(6):e207.
14. Regier DA, Kuhl EA, Kupfer DJ. The DSM-5: Classification and criteria changes. World Psychiatry. 2013;12(2):92-8.
15. Bertone-Johnson ER, Powers SI, Spangler L, Brunner RL, Michael YL, Larson JC, et al. Vitamin D intake from foods and supplements and depressive symptoms in a diverse population of older women. Am J Clin Nutr. 2011;94(4):1104-12.
16. Omranifard V, Abounoori M, Babakhanian M, Ebrahimi A, Akouchekian S, Shafiei K, et al. Translation and psychometric properties of the Persian version of the Health of the Nation Outcome Scales for Elderly People (HoNOS65+). Aging Med (Milton). 2021;4(2):135-45.
17. Ebrahimi A, Kheyr Z, Nasiri H, Barnamanesh A. Reliability, validity, factor and discrimination power analysis of young mania rating scale among unipolar, bipolar depression and healthy people. Jundishapur scientific medical journal. 2017;16(3):333-44.
18. Ahmadpanah M, Sheikhbabaei M, Haghighi M, Roham F, Jahangard L, Akhondi A, et al. Validity and test-retest reliability of the Persian version of the Montgomery-Asberg Depression Rating Scale. Neuropsychiatr Dis Treat. 2016;12:603-7.
19. Marsh WK, Penny JL, Rothschild AJ. Vitamin D supplementation in bipolar depression: A double blind placebo controlled trial. J Psychiatr Res. 2017;95:48-53.
20. Shen J, Tomar JS. Elevated Brain Glutamate Levels in Bipolar Disorder and Pyruvate Carboxylase-Mediated Anaplerosis. Front Psychiatry. 2021;12:640977.
21. Clinton SM, Meador-Woodruff JH. Abnormalities of the NMDA Receptor and Associated Intracellular Molecules in the Thalamus in Schizophrenia and Bipolar Disorder. Neuropsychopharmacology. 2004;29(7):1353-62.
22. Sikoglu EM, Navarro AA, Starr D, Dvir Y, Nwosu BU, Czerniak SM, et al. Vitamin D3 Supplemental Treatment for Mania in Youth with Bipolar Spectrum Disorders. J Child Adolesc Psychopharmacol. 2015;25(5):415-24.
23. Kaviani M, Nikooyeh B, Zand H, Yaghmaei P, Neyestani TR. Effects of vitamin D supplementation on depression and some involved neurotransmitters. J Affect Disord. 2020;269:28-35.
24. Vellekkatt F, Menon V, Rajappa M, Sahoo J. Effect of adjunctive single dose parenteral Vitamin D supplementation in major depressive disorder with concurrent vitamin D deficiency: A double-blind randomized placebo-controlled trial. J Psychiatr Res. 2020;129:250-6. 10.1016/j.jpsychires.2020.07.037.
25. Thiese MS, Ronna B, Ott U. P value interpretations and considerations. J Thorac Dis. 2016;8(9):E928-e31.
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IssueVol 19 No 3 (2024) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijps.v19i3.15803
Keywords
Bipolar Disorder Depression Mania Vitamin D

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1.
Nazeri Astaneh A, Jafari N, Sadighi G. Serum Vitamin D, Mania and Depression-Related Scores: A Comparison among Mixed Bipolar, Mania, and Healthy Subjects. Iran J Psychiatry. 2024;19(3):365-273.