title: Vitamin D deficiency and psychotic features in mentally ill adolescents: a cross-sectional study.
abstract: BACKGROUND
  Vitamin D deficiency is a re-emerging epidemic, especially in minority populations. Vitamin D is crucial not only for bone health but for proper brain development and functioning. Low levels of vitamin D are associated with depression, seasonal affective disorder, and schizophrenia in adults, but little is known about vitamin D and mental health in the pediatric population.
  
  
  METHODS
  One hundred four adolescents presenting for acute mental health treatment over a 16-month period were assessed for vitamin D status and the relationship of 25-OH vitamin D levels to severity of illness, defined by presence of psychotic features.
  
  
  RESULTS
  Vitamin D deficiency (25-OH D levels <20 ng/ml) was present in 34%; vitamin D insufficiency (25-OH D levels 20-30 ng/ml) was present in 38%, with a remaining 28% in the normal range. Adolescents with psychotic features had lower vitamin D levels (20.4 ng/ml vs. 24.7 ng/ml; p=0.04, 1 df). The association for vitamin D deficiency and psychotic features was substantial (OR 3.5; 95% CI 1.4-8.9; p <0.009). Race was independently associated with vitamin D deficiency and independently associated with psychosis for those who were Asian or biracial vs. white (OR=3.8; 95% CI 1.1‒13.4; p<0.04). Race was no longer associated with psychosis when the results were adjusted for vitamin D level.
  
  
  CONCLUSIONS
  Vitamin D deficiency and insufficiency are both highly prevalent in adolescents with severe mental illness. The preliminary associations between vitamin D deficiency and presence of psychotic features warrant further investigation as to whether vitamin D deficiency is a mediator of illness severity, result of illness severity, or both. Higher prevalence of vitamin D deficiency but no greater risk of psychosis in African Americans, if confirmed, may have special implications for health disparity and treatment outcome research.
authors.affiliation: Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, OH 43205, USA. Barbara.gracious@nationwidechildrens.org
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Gracious
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Finucane
authors.forename: Meriel
authors.initials: M
authors.lastname: Friedman-Campbell
authors.forename: Susan
authors.initials: S
authors.lastname: Messing
authors.forename: Melissa N
authors.initials: MN
authors.lastname: Parkhurst
mesh_terms: D000293:Adolescent; D001741:Black or African American; D001213:Asian; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D028642:Persons with Psychiatric Disorders; D011618:Psychotic Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D012720:Severity of Illness Index; D014808:Vitamin D Deficiency / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D044465:White People