İmre Okan, Karaağaç Mustafa, Caglayan Cuneyt
Department of Psychiatry, Faculty of Medicine, Karamanoglu Mehmetbey University, Karaman 70200, Turkey.
Department of Psychiatry, Karaman Training and Research Hospital, Karaman 70200, Turkey.
Behav Sci (Basel). 2023 Sep 18;13(9):779. doi: 10.3390/bs13090779.
Bipolar disorder is a chronic psychiatric disorder with depression and manic episodes. It is one of the leading causes of disease-related disability worldwide. Despite the presence of various alternative drug options for bipolar disorder, some patients do not adequately benefit from the treatment. Therefore, possible underlying mechanisms need to be clarified. Recently, studies on the relationship between bipolar disorder and vitamin D (Vit D) have attracted attention. Although many studies have found an association between depression and Vit D deficiency, little is known about the relationship between manic episodes and Vit D. The aim of this study was to compare Vit D and related metabolites of bipolar manic episodes prior to treatment, bipolar remission after treatment, and healthy control groups.
This case-control study consisted of 34 bipolar manic episode patients and 34 healthy controls. Disease activity was evaluated with the Hamilton Depression Rating Scale (HAM-D) and Young Mania Rating Scale (YMRS). Firstly, serum 25-hydroxy vitamin D (25-OHD), calcium (Ca) and phosphorus (P) levels of patients in the bipolar manic episode were measured and compared with healthy control. Secondly, serum 25-OHD, Ca and P levels in the euthymic periods of the same patients were measured and compared with healthy control.
Bipolar manic episode Vit D levels were lower when compared to healthy controls; while there was no difference in terms of Ca and P levels. There was no significant difference between the bipolar euthymic period patients and the healthy control group in terms of 25-OHD, Ca and P levels.
Our results demonstrated low serum Vit D concentrations in the acute manic episode of bipolar disorder. Decreased Vit D level may play a role in the onset of the manic episode, or malnutrition and insufficient sunlight during the manic episode may have caused Vit D deficiency. Future studies are needed to exclude potential confounding factors and to compare all mood episodes.
双相情感障碍是一种伴有抑郁和躁狂发作的慢性精神疾病。它是全球疾病相关残疾的主要原因之一。尽管有多种治疗双相情感障碍的替代药物，但一些患者并未从治疗中充分获益。因此，需要阐明可能的潜在机制。最近，关于双相情感障碍与维生素D（Vit D）之间关系的研究受到关注。虽然许多研究发现抑郁与Vit D缺乏之间存在关联，但关于躁狂发作与Vit D的关系却知之甚少。本研究的目的是比较双相躁狂发作治疗前、治疗后双相缓解期以及健康对照组的Vit D及相关代谢产物。
本病例对照研究包括34例双相躁狂发作患者和34名健康对照者。采用汉密尔顿抑郁量表（HAM-D）和杨氏躁狂量表（YMRS）评估疾病活动度。首先，测量双相躁狂发作患者的血清25-羟维生素D（25-OHD）、钙（Ca）和磷（P）水平，并与健康对照者进行比较。其次，测量同一患者心境正常期的血清25-OHD、Ca和P水平，并与健康对照者进行比较。
与健康对照组相比，双相躁狂发作患者的Vit D水平较低；而Ca和P水平无差异。双相心境正常期患者与健康对照组在25-OHD、Ca和P水平方面无显著差异。
我们的结果表明双相情感障碍急性躁狂发作期血清Vit D浓度较低。Vit D水平降低可能在躁狂发作的发病中起作用，或者躁狂发作期间的营养不良和阳光照射不足可能导致了Vit D缺乏。未来需要进行研究以排除潜在的混杂因素，并比较所有的情绪发作。
