Vitamin D supplements are not tied to mental health outcomes in psychosis in the first episode

December 30, 2021

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Information: Gaughran reports having received speeches honoraria from Otsuka Lundbeck outside of the work submitted. Please see the survey for all other authors’ relevant financial information.

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Vitamin D supplementation was not found to be associated with mental health or metabolic results after 6 months in people with psychosis in the first episode, according to the results of a randomized clinical trial published in JAMA Network Open.

“We report the results of the trial of DFEND (vitamin D supplementation compared to placebo in people with psychosis-neuroprotection design)” Fiona Gaughran, MD, of the Department of Psychosis Studies at King’s College London’s Institute of Psychiatry, Psychology and Neuroscience in the UK, and colleagues wrote. “We assumed that compared to placebo, patients with [first-episode psychosis] receiving vitamin D supplements would have a greater reduction in positive and negative syndrome scale (PANSS) scores over time, with PANSS subscores of global function and depression chosen as secondary outcomes. Finally, reflecting evidence for the association between neuroprogression and somatoprogression and the association between vitamin D deficiency, medical conditions, and mental disorders (eg, obesity, diabetes, and hypercholesterolemia), we included a number of biomarkers as secondary outcomes. ”

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The researchers randomly assigned 149 adults (mean age, 28.1 years; 59.7% men) from the UK aged 18 to 65 within 3 years after an initial presentation of a functional psychotic disorder that had no contraindication to vitamin D supplementation. . They received follow-up data from 104 participants after 6 months. The intervention consisted of a monthly increase of 120,000 IU cholecalciferol or placebo. Overall PANSS score after 6 months served as the primary outcome and overall PANSS score after 3 months as a secondary outcome. Additional secondary outcomes included PANSS positive, negative, and general psychopathological subscale score at 3 and 6 months, Global Assessment of Function Score for Symptoms and Disabilities, Calgary Depression Scale score, waiting range, BMI, and 6-month concentrations of glycated hemoglobin, total cholesterol, C-reactive protein and vitamin D. They also conducted a planned sensitivity analysis among individuals with inadequate baseline vitamin D levels.

The results showed no differences in the intention-to-treat analysis for total PANSS score after 6 months (mean difference, 3.57; 95% CI, 1.11 to 8.25) or the secondary results after 3 and 6 months. Furthermore, Gaughran and colleagues observed no significant differences in the global assessment of functional symptom score (mean difference, 0.02; 95% CI, 4.6 to 4.94), Global Assessment of Function handicap score (mean difference, 0.01; 95% CI, 5.25 to 5.23) or Calgary Depression Scale score (mean difference, 0.39; 95% CI, 2.05 to 1.26) after 6 months. The study group had significantly low vitamin D levels, especially black participants and those who identified as another underrepresented racial or ethnic group. The researchers noted the safety of the treatment and that it significantly increased the concentrations of 25-hydroxyvitamin D.

“Despite significant public interest in the link between vitamin D and various health outcomes, the results of RCTs have deflated these expectations,” Gaughran and colleagues wrote. “The results of the current study also do not provide evidence that vitamin D supplementation for 6 months shows benefits in the treatment of [first-episode psychosis] but highlight that only a few individuals in this group are loaded with vitamin D and therefore may benefit from special attention in future public health strategies. “

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