Abstract
BackgroundPsychiatric manifestations have been noted in patients with low serum vitamin B12 levels even in the absence of other neurologic and/or haematologic abnormalities. There is no literature on low serum B12 prevalence among Ugandans with psychiatric illnesses. The aim of this study was to establish the prevalence, risk factors, and clinical manifestations of low serum vitamin B12 among psychiatric patients admitted in a Mental Health Hospital in Uganda.MethodUsing a cross sectional descriptive study design, 280 in-patients selected by systematic sampling were studied using a standardized protocol. Low serum vitamin B12 was defined as a level < 240 pg /mL.ResultsWe found a prevalence of low serum B12 in 28.6% of the participants. Absent vibration sense which was significantly associated (58.3% Vs. 26.7%: OR = 3.84 (95% C.I. 1.18, 12.49); p-value = 0.025) with low vitamin B12 was observed among 12 participants. Macro-ovalocytes present among 23 participants on peripheral film were significantly associated with low serum levels (73.9% Vs. 26.2%: OR = 7.99 (95% C.I. 3.01, 21.19) p-value < 0.0001). Factors significantly associated with low serum B12 levels included psychiatric diagnosis of schizophrenia (AOR 1.74 (95% C.I. 1.00, 3.02); p-value = 0.049), duration of psychiatric illness > or = 3 years (AOR 2.27 (95% C.I. 1.29, 3.98); p-value = 0.004), and hospitalization < 3 weeks (AOR 4.01 (95% C.I. 1.02, 15.79); p-value = 0.047). Female participants were associated with protection from low serum levels (AOR 0.4 (95% C.I. 0.22, 0.73); p-value = 0.003).ConclusionLow serum B12 is common among hospitalized psychiatric patients with the majority having no haematological findings. Associated risk factors included having a psychiatric diagnosis of schizophrenia, a shorter duration of hospitalization and longer duration of psychiatric illness. Female participants were less likely to have low serum vitamin B12 levels. Routine screening for serum vitamin B12 levels should be adopted by all hospitals for admitted psychiatric patients.
Highlights
Psychiatric manifestations have been noted in patients with low serum vitamin B12 levels even in the absence of other neurologic and/or haematologic abnormalities
Previous studies have shown that malabsorption due to Giardia lamblia, duration of hospitalisation and psychiatric illness, history of gastro-intestinal surgery, HIV infection, older age and some drugs predispose to low vitamin B12 levels [7,8,13,14,15,16,17,18,19,20,21]
Female participants were associated with protection from low serum vitamin B12 levels (17% vs. 35.6%; OR = 0.35 (95% C.I. 0.20, 0.67); p-value = 0.001) compared to the males (Table 1)
Summary
Psychiatric manifestations have been noted in patients with low serum vitamin B12 levels even in the absence of other neurologic and/or haematologic abnormalities. The aim of this study was to establish the prevalence, risk factors, and clinical manifestations of low serum vitamin B12 among psychiatric patients admitted in a Mental Health Hospital in Uganda. Psychiatric manifestations can occur in the presence of low serum B12 levels but in the absence of the other well-recognized neurologic and haematologic abnormalities [2]. Previous studies have shown that malabsorption due to Giardia lamblia, duration of hospitalisation and psychiatric illness, history of gastro-intestinal surgery, HIV infection, older age and some drugs predispose to low vitamin B12 levels [7,8,13,14,15,16,17,18,19,20,21]. Low serum vitamin B12 levels may compromise total recovery of mental health in patients treated for mental illness [22]
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