Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ordu University, Ordu, Turkey.
Department of Psychiatry, Faculty of Medicine, Ordu University, Ordu, Turkey.
Child Adolesc Ment Health. 2020 Nov;25(4):249-255. doi: 10.1111/camh.12387. Epub 2020 Apr 18.
Depression is a heterogeneous disorder and is thought to develop as a result of complex interactions between genetic and environmental factors. One-carbon metabolism that includes vitamin B12, folic acid, and homocysteine has been investigated in psychiatric disorders like depression. In recent years, vitamin D has also been considered to contribute to psychiatric disorders. In this study, serum levels of folate, vitamin B12, and homocysteine related to one-carbon metabolism and vitamin D were investigated in children and adolescents with depression and to assess possible roles in depression pathogenesis.
The study included 89 children and adolescents with depression (69 female, 20 male; mean age ± SD = 15.08 ± 1.46) and 43 control subjects (31 female, 12 male; mean age ± SD = 14.41 ± 2.32) without any DSM-5 diagnosis. Each subject completed a sociodemographic form, Childhood Depression Inventory, State-Trait Anxiety Inventory 1-2 and measured serum folate, vitamin B12, homocysteine, and 25-OH vitamin D levels.
There was no significant difference between the groups in terms of folate levels (p = .052). In the patient group, the vitamin B12 and vitamin D levels were clearly low (p values for both levels were <.001), while homocysteine levels were found to be remarkably high (p < .001). In addition, there was a negative correlation between depression severity and vitamin B12 and vitamin D, while a positive correlation was found with homocysteine.
The results of the study show that vitamin B12 deficiency or insufficiency and elevated homocysteine may contribute to the etiopathogenesis of depression. Additionally, it was shown that lower vitamin D levels may be associated with depression.
Depression of children and adolescents is associated with the interaction of environmental and genetic factors. Homocysteine, vitamin B12, and folate related to one-carbon metabolism are associated with psychiatric disorders such as depression in adulthood. Vitamin D also contributes to psychiatric disorders pathogenesis. There are not enough studies in the literature about these parameters in children with depression. Low vitamin B12 and vitamin D levels and increased homocysteine levels may play a role in the pathogenesis of depression in children and adolescents. Investigation of vitamin B12, folate, homocysteine, and vitamin D levels are recommended in children and adolescents with depression.
抑郁症是一种异质性疾病，被认为是遗传和环境因素复杂相互作用的结果。一碳代谢包括维生素 B12、叶酸和同型半胱氨酸，已在抑郁症等精神疾病中进行了研究。近年来，维生素 D 也被认为与精神疾病有关。在这项研究中，我们调查了患有抑郁症的儿童和青少年的与一碳代谢相关的叶酸、维生素 B12 和同型半胱氨酸以及维生素 D 的血清水平，并评估了它们在抑郁症发病机制中的可能作用。
该研究纳入了 89 名患有抑郁症的儿童和青少年（69 名女性，20 名男性；平均年龄 ± 标准差=15.08 ± 1.46）和 43 名无 DSM-5 诊断的对照组受试者（31 名女性，12 名男性；平均年龄 ± 标准差=14.41 ± 2.32）。每位受试者都完成了一份社会人口学表格、儿童抑郁量表、状态特质焦虑量表 1-2，并测量了血清叶酸、维生素 B12、同型半胱氨酸和 25-羟维生素 D 水平。
两组在叶酸水平方面无显著差异（p=0.052）。在患者组中，维生素 B12 和维生素 D 水平明显较低（两个水平的 p 值均<.001），而同型半胱氨酸水平则明显较高（p<.001）。此外，抑郁严重程度与维生素 B12 和维生素 D 呈负相关，而与同型半胱氨酸呈正相关。
研究结果表明，维生素 B12 缺乏或不足以及同型半胱氨酸升高可能导致抑郁症的发病机制。此外，结果还表明，维生素 D 水平较低可能与抑郁症有关。
儿童和青少年的抑郁症与环境和遗传因素的相互作用有关。与一碳代谢相关的同型半胱氨酸、维生素 B12 和叶酸与成年期的精神疾病如抑郁症有关。维生素 D 也有助于精神疾病的发病机制。关于儿童抑郁症患者这些参数的文献研究还不够充分。儿童和青少年抑郁症患者的维生素 B12 和维生素 D 水平较低和同型半胱氨酸水平升高可能在其发病机制中发挥作用。建议对患有抑郁症的儿童和青少年进行维生素 B12、叶酸、同型半胱氨酸和维生素 D 水平的检测。
