title: The iron status of children and youth in a community mental health clinic is lower than that of a national sample.
abstract: OBJECTIVE
  Iron plays a key role in brain function, and a deficiency of iron has been implicated in various cognitive, motor, and psychiatric disorders. Because of recent evidence that iron deficiency may be related to attention-deficit/hyperactivity disorder (ADHD) and other psychiatric disorders, the goal of this study was to compare the iron status of children and youth seen in a community mental health clinic with a national sample of same-aged subjects.
  
  
  METHODS
  In this study, a consecutive series of 108 patients (79 males) referred to a community mental health clinic was compared with a National Health and Nutrition Examination Survey (NHANES) sample on measures of iron status. Wilcoxon sign rank and median tests were used to compare distributions of ferritin. Quantile regression was performed to compare the ferritin level in the two samples while adjusting for demographic differences. Chi squared (χ2) was used to compare rates of low hemoglobin in the two samples.
  
  
  RESULTS
  The iron status of the clinic sample, as measured by ferritin levels (median=23 μg/L), was significantly lower than that of the national sample (median=43 μg/L). After adjustment for age, gender, and race, the clinic sample was found to have 19.2 μg/L lower ferritin than the national sample (95% CI from 7.6 to 30.9, p value=0.001). There were also significantly more subjects in the clinic sample with low hemoglobin than in the national sample. There were no differences in ferritin levels between those patients in the clinic sample with and without an ADHD or other specific psychiatric diagnosis.
  
  
  CONCLUSIONS
  The ferritin levels of children and youth in a mental health clinic sample were significantly lower than those of the same-aged subjects in a national sample. Therefore, compromised iron status may be an additional biological risk factor for cognitive, behavioral, and psychiatric problems in pediatric populations served by the community mental health clinic.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Rhoda J
authors.initials: RJ
authors.lastname: Gottfried
authors.forename: Joan P
authors.initials: JP
authors.lastname: Gerring
authors.forename: Kyla
authors.initials: K
authors.lastname: Machell
authors.forename: Gayane
authors.initials: G
authors.lastname: Yenokyan
authors.forename: Mark A
authors.initials: MA
authors.lastname: Riddle
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000097:blood / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003155:Community Mental Health Centers; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000097:blood*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000097:blood*; D000090463:Iron Deficiencies; D008297:Male; D001523:Mental Disorders / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D009749:Nutrition Surveys; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric
chemical_list: D006454:Hemoglobins; D005293:Ferritins; D007501:Iron