Silver H
Clinical Research Unit, Flugelman (Mazra) Psychiatric Hospital, Israel.
Isr J Psychiatry Relat Sci. 2000;37(1):41-5.
Deficiency of vitamin B12, a key component in the catabolism of monoamines, is associated with various neuropsychiatric disorders and may be more frequent in hospitalized patients.
We reviewed vitamin B12 assays performed in a laboratory of a large Israeli psychiatric hospital over a 23-month period to examine prevalence of low values and compared vitamin B12 deficient patients to those with normal levels on various parameters. In addition, vitamin levels in a random sample of in-patients whose nutritional intake was determined, were examined.
20% of 644 vitamin B12 assays were in the low (200 pg/ml) and 10% in the deficient (< 160 pg/ml) range. 24 selected vitamin B12 deficient patients (70.8% with diagnosis of schizophrenia) did not differ from controls (N = 35) in age, sex ratio, hemoglobin concentration, MCV, diagnostic distribution or number and length of hospitalizations, but had slightly lower (but normal) mean folate levels. Rates of vitamin B12 deficiency in the patient sample, whose nutritional intake was adequate, did not differ significantly from those in the laboratory survey.
Vitamin B12 deficiency is common in chronically ill psychotic patients with adequate nutrition and is not readily detected by routine hematology tests.
维生素B12是单胺分解代谢中的关键成分,其缺乏与多种神经精神疾病相关,在住院患者中可能更为常见。
我们回顾了以色列一家大型精神病医院实验室在23个月期间进行的维生素B12检测,以检查低值的患病率,并在各种参数上比较维生素B12缺乏患者与正常水平患者。此外,还检查了营养摄入量已确定的住院患者随机样本中的维生素水平。
644次维生素B12检测中,20%处于低水平(200 pg/ml),10%处于缺乏水平(<160 pg/ml)。24名选定的维生素B12缺乏患者(70.8%诊断为精神分裂症)在年龄、性别比例、血红蛋白浓度、平均红细胞体积、诊断分布或住院次数和住院时间方面与对照组(N = 35)没有差异,但平均叶酸水平略低(但正常)。营养摄入充足的患者样本中维生素B12缺乏率与实验室调查中的缺乏率没有显著差异。
维生素B12缺乏在营养充足的慢性病精神病患者中很常见,常规血液学检查不易检测到。