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Evaluation of Vitamin B12, Folic Acid, Ferritin and Vitamin D Levels in Obsessive Compulsive Disorder

Year 2023, Volume: 13 Issue: 5, 994 - 998, 30.09.2023
https://doi.org/10.16899/jcm.1335202

Abstract

Aims: Obsessive compulsive disorder (OCD) is a heterogeneous disorder characterized by obsessions and compulsions. Despite the studies, etiopathogenesis is not fully understood. Pharmacological and psychosocial interventions in OCD may be insufficient due to limited knowledge of etiopathogenesis. Therefore, it is important to find inexpensive and easily determined biochemical parameters related to etiopathogenesis. In this study, the relationship between OCD and vitamin B12 (VitB12), folic acid (FA), vitamin D (VitD) and ferritin was investigated.
Material and Method: 50 patients with OCD (12 female, 38 male) and 50 healthy controls (HC) (13 female, 37 male) were included in this retrospective study. Serum VitB12, FA, ferritin and 25-OH VitD levels of both groups were compared.
Results: VitB12 (p <0.001), FA (p =0.004) and 25-(OH)VitD (p =0.001) serum levels were significantly lower in the OCD group than in the HC group. There was no significant difference between the two groups in terms of ferritin values.
Conclusion: Our study shows that serum VitB12, FA and VitD deficiency can contribute to etiopathogenesis in OCD patients. This study may lead to research to find new pathways related to etiopathogenesis. For this, prospective studies with large participation are needed, including the post-treatment period.

References

  • 1. Goodman WK, Grice DE, Lapidus KAB, Coffey BJ. Obsessive-Compulsive Disorder. Psychiatr Clin North Am. 2014;37(3):257–67.
  • 2. Żerdziński M, Burdzik M, Żmuda R, Witkowska-Berek A, Dȩbski P, Flajszok-Macierzyńska N, et al. Sense of happiness and other aspects of quality of life in patients with obsessive-compulsive disorder. Front Psychiatry. 2022;21;13.
  • 3. Hollander E, Kwon JH, Stein DJ, Broatch J, Rowland CT, Himelein CA. Obsessive-compulsive and spectrum disorders: overview and quality of life issues. J Clin Psychiatry. 1996;57 Suppl 8:3–6.
  • 4. Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53–63.
  • 5. Fawcett EJ, Power H, Fawcett JM. Women Are at Greater Risk of OCD Than Men. J Clin Psychiatry. 2020;81(4).
  • 6. Fontenelle LF, Hasler G. The analytical epidemiology of obsessive–compulsive disorder: Risk factors and correlates. Prog Neuro-Psychopharmacology Biol Psychiatry. 2008;32(1):1–15.
  • 7. Bellia F, Vismara M, Annunzi E, et al. Genetic and epigenetic architecture of Obsessive-Compulsive Disorder: In search of possible diagnostic and prognostic biomarkers. J Psychiatr Res. 2021;137:554–71.
  • 8. Boileau B. A review of obsessive-compulsive disorder in children and adolescents. Dialogues Clin Neurosci. 2011;13(4):401–11.
  • 9. Middleton R, Wheaton MG, Kayser R, Simpson HB. Treatment Resistance in Obsessive-Compulsive Disorder. In: Treatment Resistance in Psychiatry. Singapore: Springer Singapore; 2019. p. 165–77.
  • 10. Jatoi S, Hafeez DA, Riaz SU, Ali A, Ghauri MI, Zehra M. Low Vitamin B12 Levels: An Underestimated Cause Of Minimal Cognitive Impairment And Dementia. Cureus, 2020, 12.2.
  • 11. Enderami A, Zarghami M, Darvishi-Khezri H. The effects and potential mechanisms of folic acid on cognitive function: a comprehensive review. Neurol Sci. 2018, 39: 1667-1675.
  • 12. Parkin PC, Koroshegyi C, Mamak E, et al. Association between Serum Ferritin and Cognitive Function in Early Childhood. J Pediatr. 2020,217:189-191.e2.
  • 13. Gáll Z, Székely O. Role of Vitamin D in Cognitive Dysfunction: New Molecular Concepts and Discrepancies between Animal and Human Findings. Nutrients. 2021,20;13(11):3672.
  • 14. Carmel R. Biomarkers of cobalamin (vitamin B-12) status in the epidemiologic setting: a critical overview of context, applications, and performance characteristics of cobalamin, methylmalonic acid, and holotranscobalamin II. Am J Clin Nutr. 2011;94(1):348S-358S.
  • 15. Türksoy N, Bilici R, Yalçıner A, et al. Vitamin B12, folate, and homocysteine levels in patients with obsessive-compulsive disorder. Neuropsychiatr Dis Treat. 2014;10:1671-1675.
  • 16. Stabler SP, Marcell PD, Podell ER, Allen RH, Savage DG, Lindenbaum J. Elevation of total homocysteine in the serum of patients with cobalamin or folate deficiency detected by capillary gas chromatography-mass spectrometry. J Clin Invest. 1988;81(2):466–74.
  • 17. Coşar A, İpçioğlu Om, Özcan Ö, Gültepe M. Folate and homocysteine metabolisms and their roles in the biochemical basis of neuropsychiatry. TURKISH J Med Sci. 2014;44:1–9.
  • 18. Boldyrev A, Bryushkova E, Mashkina A, Vladychenskaya E. Why Is Homocysteine Toxic for the Nervous and Immune Systems? Curr Aging Sci. 2013;6(1):29–36.
  • 19. Jadavji NM, Wieske F, Dirnagl U, Winter C. Methylenetetrahydrofolate reductase deficiency alters levels of glutamate and γ-aminobutyric acid in brain tissue. Mol Genet Metab Reports. 2015;3:1–4.
  • 20. Stanger O, Fowler B, Piertzik K., et al. Homocysteine, folate and vitamin B12 in neuropsychiatric diseases: review and treatment recommendations. Expert review of neurotherapeutics,2009; 9(9), 1393-1412.
  • 21. Kocabas R. Effect of Vitamin D on YKL-40: Rat Hypercholesterolemia Model. Korean Circ J [Internet]. 2023;53(2):92–102. https://e-kcj.org/DOIx.php?id=10.4070/kcj.2022.0282
  • 22. Kocabas Rahim. The Role of Vitamins in The Covid-19 Pandemic. In: Alp H, Rağbetli MÇ, Koksoy H, editors. Current Comprehensive Approach to Covid- 19. İzmir: Duvar; 2022. p.214 -20.
  • 23. Kocabas R, Akoz M. The effects of vitamin D supplementation on healthy and hypercholesterolemic rabbits on levels of OSI and paraoxonase. Turk J Biochem. 2018;43(5):549–56.
  • 24. Cannell JJ, Grant WB. What is the role of vitamin D in autism? Dermatoendocrinol. 2013;5(1):199–204. 25. Zhang N, Yu X, Xie J, Xu H. New Insights into the Role of Ferritin in Iron Homeostasis and Neurodegenerative Diseases. Mol Neurobiol. 2021;58(6):2812–23.
  • 26. Kurhan F, Kamis GZ, Alp HH, Akyuz Cim EF, Atli A. A Cross-Sectional Measurement of Endogenous Oxidative Stress Marker Levels in Obsessive Compulsive Disorder. Psychiatry Clin Psychopharmacol. 2022,3;32(3):215–21.
  • 27. Balandeh E, Karimian M, Behjati M, Mohammadi AH. Serum Vitamins and Homocysteine Levels in Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis. Neuropsychobiology. 2021;80(6):502–15.
  • 28. Yan S, Liu H, Yu Y, Han N, Du W. Changes of Serum Homocysteine and Vitamin B12, but Not Folate Are Correlated With Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis of Case-Control Studies. Front Psychiatry. 2022, 13: 754165
  • 29. Ozdemir O, Turksoy N, Bilici R, et al. Vitamin B12, folate, and homocysteine levels in patients with obsessive&amp;ndash;compulsive disorder. Neuropsychiatr Dis Treat. 2014;1671-1675
  • 30. Sagar R, Aggarwal N, Jose N. A Cross-Sectional Study of Serum Folate and Vitamin B12 Levels in Psychiatric Inpatients. Prim Care Companion CNS Disord. 2019, 10;21(5). 2019, 21.5: 23219
  • 31. Atmaca M, Tezcan E, Kuloglu M, Kırtas O, Ustundag B. Serum folate and homocysteine levels in patients with obsessive-compulsive disorder. Psychiatry Clin Neurosci. 2005;59(5):616–20.
  • 32. Karcı CK, Celik GG. Nutritional and herbal supplements in the treatment of obsessive compulsive disorder. General Psychiatry, 2020;33(2).
  • 33. Dar SA, Wani RA, Haq I. A Comparative Study of Aripiprazole, Olanzapine, and L-Methylfolate Augmentation in Treatment Resistant Obsessive-Compulsive Disorder. Psychiatr Q. 2021,8;92(4):1413–24.
  • 34. Yazici KU, Percinel Yazici I, Ustundag B. Vitamin D levels in children and adolescents with obsessive compulsive disorder. Nord J Psychiatry. 2018,3;72(3):173–8.
  • 35. Esnafoğlu E, Yaman E. Vitamin B12, folic acid, homocysteine and vitamin D levels in children and adolescents with obsessive compulsive disorder. Psychiatry Res. 2017;254:232–7.
  • 36. Soyak H, Karakükcü Ç. Investgation of vitamin D levels in obsessive-compulsive disorder. Indian J Psychiatry. 2022;64(4):349.
  • 37. Marazziti D, Barberi FM, Fontenelle L, et al. Decreased vitamin D levels in obsessive-compulsive disorder patients. CNS Spectr. 2021 Sep 23;1–8.
  • 38. Koo M-S, Kim E-J, Roh D, Kim C-H. Role of dopamine in the pathophysiology and treatment of obsessive–compulsive disorder. Expert Rev Neurother. 2010, 9;10(2):275–90.
  • 39. Lustberg D, Iannitelli AF, Tillage RP, Pruitt M, Liles LC, Weinshenker D. Central norepinephrine transmission is required for stress-induced repetitive behavior in two rodent models of obsessive-compulsive disorder. Psychopharmacology (Berl). 2020;20;237(7):1973–87.
  • 40. Kotapati VP, Khan AM, Dar S, et al. The Effectiveness of Selective Serotonin Reuptake Inhibitors for Treatment of Obsessive-Compulsive Disorder in Adolescents and Children: A Systematic Review and Meta-Analysis. Front Psychiatry. 2019; 6;10.
  • 41. Garcion E, Sindji L, Montero-Menei C, Andre C, Brachet P, Darcy F. Expression of inducible nitric oxide synthase during rat brain inflammation: Regulation by 1,25-dihydroxyvitamin D3. Glia. 1998;22(3):282–94.
  • 42. di Michele F, Siracusano A, Talamo A, Niolu C. N-Acetyl Cysteine and Vitamin D Supplementation in Treatment Resistant Obsessive-compulsive Disorder Patients: A General Review. Curr Pharm Des. 2018,11;24(17):1832–8.
  • 43. Örüm MH. Determination of vitamin B12, folate, and ferritin levels of inpatients in a psychiatry clinic: A one-year retrospective study. Istanbul Bilim Univ Florence Nightingale J Med. 2018,1;4(2):71–8.
  • 44. Ghosh D, Burkman E. Relationship of serum ferritin level and tic severity in children with Tourette syndrome. Child’s Nerv Syst. 2017, 3;33(8):1373–8.

Obsesif Kompulsif Bozuklukta B12 Vitamini, Folik Asit, Ferritin ve D Vitamini Düzeylerinin Değerlendirilmesi

Year 2023, Volume: 13 Issue: 5, 994 - 998, 30.09.2023
https://doi.org/10.16899/jcm.1335202

Abstract

Amaç: Obsesif kompulsif bozukluk (OKB), obsesyon ve kompulsiyonlarla karakterize heterojen bir bozukluktur. Yapılan çalışmalara rağmen etyopatogenezi tam olarak anlaşılamamıştır. OKB'de farmakolojik ve psikososyal müdahaleler, sınırlı etyopatogenez bilgisi nedeniyle yetersiz olabilir. Bu nedenle etiyopatogenez ile ilgili ucuz ve kolay saptanabilen biyokimyasal parametrelerin bulunması önemlidir. Bu çalışmada OKB ile B12 vitamini (VitB12), folik asit (FA), D vitamini (VitD) ve ferritin ilişkisi araştırıldı.
Gereç ve Yöntem: Bu retrospektif çalışmaya 50 OKB hastası (12 kadın, 38 erkek) ve 50 sağlıklı kontrol (SK) (13 kadın, 37 erkek) dahil edildi. Her iki grubun serum VitB12, FA, ferritin ve 25-OH VitD düzeyleri karşılaştırıldı.
Bulgular: VitB12 (p <0.001), FA (p =0.004) ve VitD (p =0.001) serum düzeyleri OKB grubunda HC grubuna göre anlamlı olarak düşüktü. Ferritin değerleri açısından iki grup arasında anlamlı fark yoktu.
Sonuç: Çalışmamız OKB hastalarında serum VitB12, FA ve VitD eksikliğinin etyopatogenez ile ilişkili olabileceğini göstermektedir. Bu çalışma, etiyopatogenez ile ilgili yeni araştırmalara öncülük edebilir. Bunun için tedavi sonrası dönemi de içeren geniş katılımlı prospektif çalışmalara ihtiyaç vardır.
Anahtar Kelimeler: Obsesyon, B12 vitamini, folik asit, ferritin ve D vitamini

References

  • 1. Goodman WK, Grice DE, Lapidus KAB, Coffey BJ. Obsessive-Compulsive Disorder. Psychiatr Clin North Am. 2014;37(3):257–67.
  • 2. Żerdziński M, Burdzik M, Żmuda R, Witkowska-Berek A, Dȩbski P, Flajszok-Macierzyńska N, et al. Sense of happiness and other aspects of quality of life in patients with obsessive-compulsive disorder. Front Psychiatry. 2022;21;13.
  • 3. Hollander E, Kwon JH, Stein DJ, Broatch J, Rowland CT, Himelein CA. Obsessive-compulsive and spectrum disorders: overview and quality of life issues. J Clin Psychiatry. 1996;57 Suppl 8:3–6.
  • 4. Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53–63.
  • 5. Fawcett EJ, Power H, Fawcett JM. Women Are at Greater Risk of OCD Than Men. J Clin Psychiatry. 2020;81(4).
  • 6. Fontenelle LF, Hasler G. The analytical epidemiology of obsessive–compulsive disorder: Risk factors and correlates. Prog Neuro-Psychopharmacology Biol Psychiatry. 2008;32(1):1–15.
  • 7. Bellia F, Vismara M, Annunzi E, et al. Genetic and epigenetic architecture of Obsessive-Compulsive Disorder: In search of possible diagnostic and prognostic biomarkers. J Psychiatr Res. 2021;137:554–71.
  • 8. Boileau B. A review of obsessive-compulsive disorder in children and adolescents. Dialogues Clin Neurosci. 2011;13(4):401–11.
  • 9. Middleton R, Wheaton MG, Kayser R, Simpson HB. Treatment Resistance in Obsessive-Compulsive Disorder. In: Treatment Resistance in Psychiatry. Singapore: Springer Singapore; 2019. p. 165–77.
  • 10. Jatoi S, Hafeez DA, Riaz SU, Ali A, Ghauri MI, Zehra M. Low Vitamin B12 Levels: An Underestimated Cause Of Minimal Cognitive Impairment And Dementia. Cureus, 2020, 12.2.
  • 11. Enderami A, Zarghami M, Darvishi-Khezri H. The effects and potential mechanisms of folic acid on cognitive function: a comprehensive review. Neurol Sci. 2018, 39: 1667-1675.
  • 12. Parkin PC, Koroshegyi C, Mamak E, et al. Association between Serum Ferritin and Cognitive Function in Early Childhood. J Pediatr. 2020,217:189-191.e2.
  • 13. Gáll Z, Székely O. Role of Vitamin D in Cognitive Dysfunction: New Molecular Concepts and Discrepancies between Animal and Human Findings. Nutrients. 2021,20;13(11):3672.
  • 14. Carmel R. Biomarkers of cobalamin (vitamin B-12) status in the epidemiologic setting: a critical overview of context, applications, and performance characteristics of cobalamin, methylmalonic acid, and holotranscobalamin II. Am J Clin Nutr. 2011;94(1):348S-358S.
  • 15. Türksoy N, Bilici R, Yalçıner A, et al. Vitamin B12, folate, and homocysteine levels in patients with obsessive-compulsive disorder. Neuropsychiatr Dis Treat. 2014;10:1671-1675.
  • 16. Stabler SP, Marcell PD, Podell ER, Allen RH, Savage DG, Lindenbaum J. Elevation of total homocysteine in the serum of patients with cobalamin or folate deficiency detected by capillary gas chromatography-mass spectrometry. J Clin Invest. 1988;81(2):466–74.
  • 17. Coşar A, İpçioğlu Om, Özcan Ö, Gültepe M. Folate and homocysteine metabolisms and their roles in the biochemical basis of neuropsychiatry. TURKISH J Med Sci. 2014;44:1–9.
  • 18. Boldyrev A, Bryushkova E, Mashkina A, Vladychenskaya E. Why Is Homocysteine Toxic for the Nervous and Immune Systems? Curr Aging Sci. 2013;6(1):29–36.
  • 19. Jadavji NM, Wieske F, Dirnagl U, Winter C. Methylenetetrahydrofolate reductase deficiency alters levels of glutamate and γ-aminobutyric acid in brain tissue. Mol Genet Metab Reports. 2015;3:1–4.
  • 20. Stanger O, Fowler B, Piertzik K., et al. Homocysteine, folate and vitamin B12 in neuropsychiatric diseases: review and treatment recommendations. Expert review of neurotherapeutics,2009; 9(9), 1393-1412.
  • 21. Kocabas R. Effect of Vitamin D on YKL-40: Rat Hypercholesterolemia Model. Korean Circ J [Internet]. 2023;53(2):92–102. https://e-kcj.org/DOIx.php?id=10.4070/kcj.2022.0282
  • 22. Kocabas Rahim. The Role of Vitamins in The Covid-19 Pandemic. In: Alp H, Rağbetli MÇ, Koksoy H, editors. Current Comprehensive Approach to Covid- 19. İzmir: Duvar; 2022. p.214 -20.
  • 23. Kocabas R, Akoz M. The effects of vitamin D supplementation on healthy and hypercholesterolemic rabbits on levels of OSI and paraoxonase. Turk J Biochem. 2018;43(5):549–56.
  • 24. Cannell JJ, Grant WB. What is the role of vitamin D in autism? Dermatoendocrinol. 2013;5(1):199–204. 25. Zhang N, Yu X, Xie J, Xu H. New Insights into the Role of Ferritin in Iron Homeostasis and Neurodegenerative Diseases. Mol Neurobiol. 2021;58(6):2812–23.
  • 26. Kurhan F, Kamis GZ, Alp HH, Akyuz Cim EF, Atli A. A Cross-Sectional Measurement of Endogenous Oxidative Stress Marker Levels in Obsessive Compulsive Disorder. Psychiatry Clin Psychopharmacol. 2022,3;32(3):215–21.
  • 27. Balandeh E, Karimian M, Behjati M, Mohammadi AH. Serum Vitamins and Homocysteine Levels in Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis. Neuropsychobiology. 2021;80(6):502–15.
  • 28. Yan S, Liu H, Yu Y, Han N, Du W. Changes of Serum Homocysteine and Vitamin B12, but Not Folate Are Correlated With Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis of Case-Control Studies. Front Psychiatry. 2022, 13: 754165
  • 29. Ozdemir O, Turksoy N, Bilici R, et al. Vitamin B12, folate, and homocysteine levels in patients with obsessive&amp;ndash;compulsive disorder. Neuropsychiatr Dis Treat. 2014;1671-1675
  • 30. Sagar R, Aggarwal N, Jose N. A Cross-Sectional Study of Serum Folate and Vitamin B12 Levels in Psychiatric Inpatients. Prim Care Companion CNS Disord. 2019, 10;21(5). 2019, 21.5: 23219
  • 31. Atmaca M, Tezcan E, Kuloglu M, Kırtas O, Ustundag B. Serum folate and homocysteine levels in patients with obsessive-compulsive disorder. Psychiatry Clin Neurosci. 2005;59(5):616–20.
  • 32. Karcı CK, Celik GG. Nutritional and herbal supplements in the treatment of obsessive compulsive disorder. General Psychiatry, 2020;33(2).
  • 33. Dar SA, Wani RA, Haq I. A Comparative Study of Aripiprazole, Olanzapine, and L-Methylfolate Augmentation in Treatment Resistant Obsessive-Compulsive Disorder. Psychiatr Q. 2021,8;92(4):1413–24.
  • 34. Yazici KU, Percinel Yazici I, Ustundag B. Vitamin D levels in children and adolescents with obsessive compulsive disorder. Nord J Psychiatry. 2018,3;72(3):173–8.
  • 35. Esnafoğlu E, Yaman E. Vitamin B12, folic acid, homocysteine and vitamin D levels in children and adolescents with obsessive compulsive disorder. Psychiatry Res. 2017;254:232–7.
  • 36. Soyak H, Karakükcü Ç. Investgation of vitamin D levels in obsessive-compulsive disorder. Indian J Psychiatry. 2022;64(4):349.
  • 37. Marazziti D, Barberi FM, Fontenelle L, et al. Decreased vitamin D levels in obsessive-compulsive disorder patients. CNS Spectr. 2021 Sep 23;1–8.
  • 38. Koo M-S, Kim E-J, Roh D, Kim C-H. Role of dopamine in the pathophysiology and treatment of obsessive–compulsive disorder. Expert Rev Neurother. 2010, 9;10(2):275–90.
  • 39. Lustberg D, Iannitelli AF, Tillage RP, Pruitt M, Liles LC, Weinshenker D. Central norepinephrine transmission is required for stress-induced repetitive behavior in two rodent models of obsessive-compulsive disorder. Psychopharmacology (Berl). 2020;20;237(7):1973–87.
  • 40. Kotapati VP, Khan AM, Dar S, et al. The Effectiveness of Selective Serotonin Reuptake Inhibitors for Treatment of Obsessive-Compulsive Disorder in Adolescents and Children: A Systematic Review and Meta-Analysis. Front Psychiatry. 2019; 6;10.
  • 41. Garcion E, Sindji L, Montero-Menei C, Andre C, Brachet P, Darcy F. Expression of inducible nitric oxide synthase during rat brain inflammation: Regulation by 1,25-dihydroxyvitamin D3. Glia. 1998;22(3):282–94.
  • 42. di Michele F, Siracusano A, Talamo A, Niolu C. N-Acetyl Cysteine and Vitamin D Supplementation in Treatment Resistant Obsessive-compulsive Disorder Patients: A General Review. Curr Pharm Des. 2018,11;24(17):1832–8.
  • 43. Örüm MH. Determination of vitamin B12, folate, and ferritin levels of inpatients in a psychiatry clinic: A one-year retrospective study. Istanbul Bilim Univ Florence Nightingale J Med. 2018,1;4(2):71–8.
  • 44. Ghosh D, Burkman E. Relationship of serum ferritin level and tic severity in children with Tourette syndrome. Child’s Nerv Syst. 2017, 3;33(8):1373–8.
There are 43 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Original Research
Authors

Okan İmre 0000-0002-2142-4916

Rahim Kocabaş 0000-0001-8006-284X

Publication Date September 30, 2023
Acceptance Date August 16, 2023
Published in Issue Year 2023 Volume: 13 Issue: 5

Cite

AMA İmre O, Kocabaş R. Evaluation of Vitamin B12, Folic Acid, Ferritin and Vitamin D Levels in Obsessive Compulsive Disorder. J Contemp Med. September 2023;13(5):994-998. doi:10.16899/jcm.1335202