title: Vitamin D Deficiency and Depressive Symptomatology in Psychiatric Patients Hospitalized with a Current Depressive Episode: A Factor Analytic Study.
abstract: BACKGROUND
  Low vitamin D levels have been associated with depressive symptoms in population-based studies and non-clinical samples as well as with clinical depression. This study aimed to examine the association of vitamin D levels with the severity and dimensions of depressive symptoms in hospitalized patients with a current episode of depression taking into account confounding variables.
  
  
  METHODS
  We investigated 380 patients (mean age 47 ± 12 years, 70% women) who were consecutively hospitalized with a main diagnosis of an ICD-10 depressive episode. All patients self-rated depressive symptom severity with the Hospital Anxiety and Depression Scale (HADS-D), the Beck Depression Inventory-II (BDI-II), and the Brief Symptom Inventory. A principal component analysis was performed with all 34 items of these questionnaires and serum levels of 25-hydroxyvitamin D3 (25-OH D) were measured.
  
  
  RESULTS
  Vitamin D deficiency (< 50 nmol/l), insufficiency (50-75 nmol/l), and sufficiency (> 75 nmol/l) were present in 55.5%, 31.8% and 12.6%, respectively, of patients. Patients with vitamin D deficiency scored higher on the HADS-D scale and on an anhedonia symptom factor than those with insufficient (p-values ≤ 0.023) or sufficient (p-values ≤ 0.008) vitamin D. Vitamin D deficient patients also scored higher on the BDI-II scale than those with sufficient vitamin D (p = 0.007); BDI-II cognitive/affective symptoms, but not somatic/affective symptoms, were higher in patients with vitamin D deficiency (p = 0.005) and insufficiency (p = 0.041) relative to those with sufficient vitamin D. Effect sizes suggested clinically relevant findings.
  
  
  CONCLUSIONS
  Low vitamin D levels are frequent in hospitalized patients with a current episode of depression. Especially 25-OH D levels < 50 nmol/l were associated with cognitive/affective depressive symptoms, and anhedonia symptoms in particular.
authors.affiliation: Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland; Department of Neurology, Bern University Hospital, Inselspital, and University of Bern, Bern, Switzerland; Department of Clinical Research, University of Bern, Bern, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.affiliation: Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland.
authors.forename: Nasser
authors.initials: N
authors.lastname: Fardad
authors.affiliation: Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland.
authors.forename: Nadine
authors.initials: N
authors.lastname: Steurer
authors.affiliation: Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Horak
authors.affiliation: Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland.
authors.forename: Esther
authors.initials: E
authors.lastname: Hindermann
authors.affiliation: Psymeta GmbH, Schafisheim, Switzerland.
authors.forename: Franz
authors.initials: F
authors.lastname: Fischer
authors.affiliation: Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Gessler
mesh_terms: D003863:Depression / Q000097:blood* / Q000150:complications*; D005163:Factor Analysis, Statistical; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D014808:Vitamin D Deficiency / Q000097:blood* / Q000150:complications*