title: Vitamin D deficiency in alcohol-use disorders and its relationship to comorbid major depression: a cross-sectional study of inpatients in Nepal.
abstract: BACKGROUND
  Mounting evidence suggests that deficiency of vitamin D may be associated with major health problems, including alcohol-use disorders (AUD) and major depression (MD). This study aimed to identify the vitamin D status of Nepalese inpatients with an AUD. We explored socio-demographic and alcohol-use related correlates and the relationship between vitamin D deficiency and comorbid MD.
  
  
  METHODS
  A cross-sectional study was conducted on AUD inpatients (N=174) at eight alcohol/drug treatment centres around Kathmandu. Structured questionnaires were administered to assess the socio-demographic and alcohol-use parameters and to establish DSM-IV diagnoses of AUD and MD. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25(OH)D) concentration of <50 nmol/L.
  
  
  RESULTS
  The prevalence of vitamin D deficiency was 64%. Higher age, having a stable job or business, shorter time since last alcohol intake and winter serum samples were related to having lower 25(OH)D levels. Several features of AUD severity were associated with low vitamin D levels: guilt about drinking, using alcohol as eye-opener, and history of relapse after alcohol treatment (p ≤ 0.03). Patients with a comorbid major depression, in particular secondarily depressed cases, were less likely to have vitamin D deficiency (X(2)=6.8; p=0.01).
  
  
  CONCLUSIONS
  This study confirms high rates of vitamin D deficiency in alcohol treatment sample and shows a positive association between vitamin D deficiency and severity of alcohol-use disorders. Competing risk and other confounders may help explain the vitamin D status among patients with alcohol-use disorders and comorbid major depression.
authors.affiliation: Norwegian Centre for Addiction Research (SERAF), University of Oslo, N-0407 Oslo, Norway. Electronic address: s.p.neupane@medisin.uio.no.
authors.forename: Sudan Prasad
authors.initials: SP
authors.lastname: Neupane
authors.forename: Lars
authors.initials: L
authors.lastname: Lien
authors.forename: Thor
authors.initials: T
authors.lastname: Hilberg
authors.forename: Jørgen G
authors.initials: JG
authors.lastname: Bramness
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000150:complications*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000150:complications*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D009752:Nutritional Status; D012959:Socioeconomic Factors; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications*; D014815:Vitamins / Q000097:blood; D055815:Young Adult
chemical_list: D014815:Vitamins; D014807:Vitamin D
keywords: Alcohol-use disorders; Comorbidity; Major depression; Nepal; Vitamin D deficiency