Becker Madeleine, Axelrod David J, Oyesanmi Olu, Markov Dimitri D, Kunkel Elisabeth J Shakin
Department of Psychiatry, Thomas Jefferson University, Philadelphia, PA, USA.
Psychiatr Clin North Am. 2007 Dec;30(4):739-59. doi: 10.1016/j.psc.2007.07.006.
Vitamin B12 deficiency is associated with problems in cognition, mood, psychosis, and less commonly, anxiety. Folate deficiency primarily is associated with problems in mood. Patients who have sickle cell disease, a disease of chronic pain, experience difficulties with depression, anxiety, stigma, and are at risk for substance abuse and dependence. Patients with hemophilia have benefited from advances in treatment; however, their morbidity and mortality were compounded in those who received blood products contaminated with HIV, or hepatitis B and C. Psychiatrists who practice psychosomatic medicine should expect to encounter patients with the above problems, as they are frequently seen in medical settings. Finally, most of the commonly used psychotropic medications have uncommon but potentially important hematologic side effects or may interact with the anticoagulants used in medically ill patients.
维生素B12缺乏与认知、情绪、精神病问题相关，较少与焦虑相关。叶酸缺乏主要与情绪问题相关。患有镰状细胞病（一种慢性疼痛疾病）的患者会经历抑郁、焦虑、污名化问题，并有药物滥用和依赖的风险。血友病患者从治疗进展中受益；然而，那些接受了被艾滋病毒、乙型肝炎和丙型肝炎污染的血液制品的患者，其发病率和死亡率更高。从事身心医学的精神科医生应该预料到会遇到有上述问题的患者，因为这些问题在医疗环境中很常见。最后，大多数常用的精神药物有不常见但可能很重要的血液学副作用，或者可能与内科疾病患者使用的抗凝剂相互作用。
