Fondation FondaMental, Créteil, France; Aix-Marseille Univ, Faculté de Médecine - Secteur Timone, Assistance Publique des Hopitaux de Marseille (AP-HM), EA 3279: CEReSS -Centre d'Etude et de Recherche sur les Services de Santé et la Qualité de vie, 27 Boulevard Jean Moulin, Marseille 13005, France.
Fondation FondaMental, Créteil, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris F-75013, France.
Psychiatry Res. 2018 Dec;270:104-110. doi: 10.1016/j.psychres.2018.09.024. Epub 2018 Sep 13.
Hypovitaminosis D has been associated with respectively major depressive disorder, schizophrenia (SZ) and cognitive disorders in the general population, and with positive and negative symptoms and metabolic syndrome in schizophrenia. The objectives were (i) to determine the prevalence of hypovitaminosis D and associated factors (with a focus on depression and cognition) in a national non-selected multicentric sample of community-dwelling SZ subjects (ii) to determine the rate of SZ patients being administered vitamin D supplementation and associated factors.
A comprehensive 2 daylong clinical and neuropsychological battery was administered in 140 SZ subjects included between 2015 and 2017 in the national FondaMental Expert Center (FACE-SZ) Cohort. Hypovitaminosis D was defined by blood vitamin D level <25 nM. Depressive symptoms were assessed by the Positive and Negative Syndrome Scale depressive subscore and current anxiety disorder by the Structured Clinical Interview for Mental Disorders.
Hypovitaminosis D has been found in 21.4% of the subjects and none of them had received vitamin D supplementation in the previous 12 months. In multivariate analysis, hypovitaminosis D has been significantly associated with respectively higher depressive symptoms (aOR = 1.18 [1.03-1.35], p = 0.02) and current anxiety disorder (aOR = 6.18 [2.15-17.75], p = 0.001), independently of age and gender. No association of hypovitaminosis D with respectively positive and negative symptoms, cognitive scores or other biological variables has been found (all p > 0.05), however, a trend toward significance has been found for metabolic syndrome (p = 0.06). Vitamin D supplementation has been administered during the previous 12 months in only 8.5% of the subjects but was associated with lower depressive symptoms (aOR = 0.67 [0.46-0.98], p = 0.04) and lower rate of current anxiety disorder (aOR = 0.06 [0.01-0.66], p = 0.02) compared to patients with hypovitaminosis D.
Hypovitaminosis D is frequent and associated with depressive symptoms and anxiety disorders in schizophrenia. Vitamin D supplementation is associated with lower depressive and anxiety symptoms, however patients with hypovitaminosis D remain insufficiently treated.
维生素 D 缺乏症与普通人群中的重度抑郁症、精神分裂症（SZ）和认知障碍有关，与 SZ 的阳性和阴性症状以及代谢综合征有关。目的是：（i）确定在全国非选择性多中心社区居住的 SZ 患者样本中，维生素 D 缺乏症及其相关因素（重点为抑郁和认知）的患病率；（ii）确定接受维生素 D 补充的 SZ 患者的比例及其相关因素。
在 2015 年至 2017 年期间，纳入全国 FondaMental Expert Center（FACE-SZ）队列的 140 例 SZ 患者进行了为期两天的全面临床和神经心理学检查。通过血液维生素 D 水平<25nM 来定义维生素 D 缺乏症。使用阳性和阴性症状量表的抑郁分量表评估抑郁症状，使用精神疾病诊断与统计手册的结构临床访谈评估当前焦虑障碍。
21.4%的患者存在维生素 D 缺乏症，在过去 12 个月内，他们均未接受维生素 D 补充。多变量分析表明，维生素 D 缺乏症与较高的抑郁症状（优势比[OR] = 1.18 [1.03-1.35]，p = 0.02）和当前的焦虑障碍（OR = 6.18 [2.15-17.75]，p = 0.001）显著相关，与年龄和性别无关。维生素 D 缺乏症与阳性和阴性症状、认知评分或其他生物学变量均无相关性（均 p > 0.05），但是代谢综合征呈显著相关趋势（p = 0.06）。在过去 12 个月中，只有 8.5%的患者接受了维生素 D 补充，但与维生素 D 缺乏症患者相比，维生素 D 补充与较低的抑郁症状（OR = 0.67 [0.46-0.98]，p = 0.04）和较低的当前焦虑障碍率（OR = 0.06 [0.01-0.66]，p = 0.02）相关。
维生素 D 缺乏症在 SZ 中较为常见，与抑郁症状和焦虑障碍有关。维生素 D 补充与较低的抑郁和焦虑症状相关，但维生素 D 缺乏症患者的治疗仍不充分。
