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

Published online by Cambridge University Press:  22 July 2019

C. van der Leeuw Open the ORCID record for C. van der Leeuw [Opens in a new window] ,
L. D. de Witte ,
A. Stellinga ,
C. van der Ley ,
R. Bruggeman ,
R. S. Kahn ,
J. van Os ,
M. Marcelis  and
for G.R.O.U.P.
C. van der Leeuw*
Affiliation:
Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands Mondriaan, Maastricht, the Netherlands
L. D. de Witte
Affiliation:
Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
A. Stellinga
Affiliation:
Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands University Center for Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
C. van der Ley
Affiliation:
Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
R. Bruggeman
Affiliation:
University Center for Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
R. S. Kahn
Affiliation:
Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
J. van Os
Affiliation:
Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
M. Marcelis
Affiliation:
Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
*
Author for correspondence: C. van der Leeuw, E-mail: c.vanderleeuw@maastrichtuniversity.nl
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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.

Keywords

Psychotic disorderschizophreniaurbanicityvitamin D
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 10 , July 2020 , pp. 1680 - 1686
Copyright
Copyright © Cambridge University Press 2019

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Footnotes

*

Membership of G.R.O.U.P. is provided in the Acknowledgements.

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