Sleep Deprivation is Unusual in Vitamin-B12 Deficiency and is Probably due to other Causes

ObjectiveVitamin B12 is crucial for neurological functions and linked to various psychiatric disorders. Given its importance, this study explores the impact of vitamin B12 deficiency on sleep quality in Obsessive-Compulsive Disorder (OCD) patients, while also examining folate and homocysteine levels to explore their potential interactions with OCD symptoms and sleep quality.MethodsThis cross-sectional study included 52 patients with OCD and 42 healthy controls. Serum levels of vitamin B12, homocysteine, and folate were measured. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the severity of OCD symptoms and the quality of sleep, respectively. Correlations and mediating effects between these variables were also assessed.ResultsVitamin B12 levels were significantly lower in OCD patients compared to healthy controls, and scores for sleep disturbances were significantly higher in the OCD group. No significant differences were observed in the levels of folate and homocysteine between the groups. Correlation analysis indicated that lower levels of vitamin B12 were significantly associated with more severe OCD symptoms and poorer sleep quality. Further mediation analysis suggested that low levels of vitamin B12 partially mediated the relationship between OCD symptoms and sleep disturbances.ConclusionLower levels of vitamin B12 not only affect sleep quality but also partially mediate the impact of OCD symptoms on sleep disturbances. Future clinical attention to vitamin B12 deficiency is crucial for further assessing the relationship between OCD symptoms and sleep disorders.

Background: Obsessive–compulsive disorder (OCD) is a complex disorder with unclear aetiology. Vitamin B12, folate, and Homocysteine (HCY) are key to one-carbon metabolism and serotonin production. Aim: To investigate levels of Vitamin B 12, folic acid and HCY and explore their potential interactions with OCD symptomatology and sleep disturbances. Materials and Methods: This cross-sectional study was conducted among 73 patients with diagnosis of OCD and 71 age and gender matched healthy controls (HC). Blood levels of vitamin B12, folate, and HCY were assessed in all the participants. OCD severity and quality of sleep were assessed using Y-BOCS and Pittsburgh Sleep Quality Index (PSQI), respectively. Correlation and mediation analyses were performed. Results: Serum HCY was significantly higher, while folate and vitamin B12 levels were significantly lower in patients with OCD compared to HC ( P < 0.05). PSQI scores were also higher in the OCD group (13.47 ± 4.42 vs. 4.68 ± 2.56; t = 14.54, P < 0.001), indicating poorer sleep. Lower vitamin B12 levels were strongly associated with greater OCD severity ( r = −0.434, P < 0.001) and poorer sleep quality ( r = −0.396, P < 0.001), and showed a positive correlation with folate ( r = 0.462, P < 0.05). Homocysteine and folate levels were not significantly associated with OCD severity or sleep quality. Conclusion: Vitamin B12 deficiency is associated with increased OCD severity and poor sleep quality. It may partially mediate the link between OCD and sleep disturbances.

Reduced sleep quality defines a subtype of obsessive-compulsive disorder with lower Glx levels in the resting thalamus and worse response inhibition

Background Although the effect of obsessive-compulsive disorder (OCD) on sleep is not well-known, recent studies suggest an association between OCD and sleep quality. Aims We aimed to assess sleep quality in children and adolescents with OCD and to seek its association with OCD symptoms and OCD severity. Methods All of the subjects were assessed using DSM 5 and affective disorders and schizophrenia for school-age children – present and lifetime version, which is based on DSM-IV. The Yale-Brown obsessive-compulsive scale and children’s Yale-Brown obsessive-compulsive scale were applied to the subjects with OCD. Pittsburgh sleep quality index (PSQI) was used to assess sleep quality, and the Wechsler intelligence scale for children-revised (WISC-R) was used to measure their intelligence levels. Results PSQI total score was significantly higher in patients with OCD (p < 0.001), suggesting that patients with OCD have a significantly worse sleep quality. The presence of somatic disorders was also associated with worse sleep quality (p = 0.040). Sleep quality was not significantly associated with OCD severity (p = 0.152). Among patients with extreme OCD, the ‘sleep duration’ component of the PSQI was higher than those with moderate or severe OCD (p = 0.019). The patients with ‘contamination/cleaning’ symptom group had a lower total PSQI score compared with ‘symmetry/hoarding’ symptom group (p = 0.014). Conclusions The findings of the present study indicate that the sleep quality of children and adolescents with OCD is influenced, and there may be an association between sleep quality and OCD symptoms and severity in these patients.

Food-cobalamin malabsorption in the elderly

Objective: The purpose of this study was to investigate paraoxonase (PON) and arylesterase (ARES) enzyme activity in adults with vitamin B12 deficiency, and specific changes in the activities of these enzymes following vitamin B12 treatment.Methods: A total of 46 patients with vitamin B12 deficiency (aged 18–82 years) and 45 healthy volunteer controls (aged 19–64 years) participated in this study. Venous blood samples were collected, and serum vitamin B12, homocysteine (HCY), methylmalonic acid, PON1, and ARES levels were measured.Results: Paired comparison showed that pre- and post-treatment values for PON and ARES were similar between patients and controls (both P > 0.05). There was no statistically significant relationship between patients’ pre-/post-treatment PON or HCY levels and serum vitamin B12 levels, compared with those of the control group (P > 0.05).Discussion: The results of the present study do not support the hypothesis that the antioxidant enzymes PON and ARES have an underlying role in vitamin B12 deficiency and related hyperhomocysteinemia. Our findings suggest that PON and ARES do not play a role in the systemic effects of vitamin B12 deficiency.

Background: Macrocytosis refers to a condition in which red blood cells are larger than normal, with or without anemia. Macrocytic anemia occur due to variety of illnesses and requires further clinical and laboratory assessment. Both folate and vitamin B12 have been known to cause macrocytic anemia since the deficiencies of these two vitamins are very common in Pakistan, it would be imperative to investigate their role in causing megaloblastic anemia.Objective: To determine the frequency of vitamin B12 and folate deficiencies in cases of macrocytic anemia.Material and Methods: This is a descriptive cross-sectional study conducted in the | department of medicine of Abbasi Shaheed hospital from January 2012 to June 2012. A total of 95 patients (65 males and 30 females) with an age of above 13 years, who admitted with macrocytic anemia (MCV&gt;96) with hemoglobin &lt; 12 mg/dl in females and &lt; 13 mg/dl in males were enrolled and data pertaining to complete blood count, serum level of vitamin B12 and RBC folate were analyzed. Result: A total of 95 patients (65 males and 30 females) with hemoglobin &lt; 12 mg/dl in females and &lt; 13 mg/dl in males were taken. Mostly were non vegetarian and majority of the patients belongs to age group of 34-54 years. It was found that 69 patients (48 males and 21 females) from total of 95 had vitamin B12 deficiency which is 72.6% and 43 patients (20 males and 23 females) from total of 95 had folate deficiency which is 45.26%.Conclusion: Our study concludes that vitamin B12 is a major contributing factor of macrocytic anemia in our population. Dietary insufficiency, poor absorption and increase demand might be contributing to high prevalence of vitamin B12 deficiency in our population. Therefore our medical community should seriously consider the merit of early screening for vitamin B12 deficiency and take precautions against the clinical consequences of vitamin B12 deficiency.

Vitamin B₁₂ Deficiency Masquerading as Clozapine-Resistant Psychotic Symptoms in Schizophrenia

Introduction Obsessive-compulsive disorder (OCD) is a persistent psychiatric condition that causes significant clinical and functional impairments. Recent research suggests a link between deficiencies in micronutrients, particularly vitamin B12, folic acid, and elevated homocysteine, and the development of OCD. This study investigates the blood levels of these micronutrients and their relationship to OCD severity, with an emphasis on potential gender differences. Methods This cross-sectional study included300 drug-free OCD patients. Serum levels of vitamin B12, folic acid, and homocysteine were measured using established biochemical methods. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to assess clinical severity. Data were examined to determine relationships between micronutrient levels and OCD severity and differences between male and female patients. Results This study found that women had higher levels of vitamin B12 (405.3 ± 15.1 vs. 360.4 ± 14.3) and folic acid (7.18 ± 0.27 vs. 5.76 ± 0.25) but lower levels of homocysteine (9.35 ± 0.64 vs. 14.4 ± 0.60) compared to men. Higher folic acid levels were linked to study participants having higher levels of education (at a college or university, where subjects are studied at an advanced level) compared to those withprimary-level education. Lower vitamin B12 levels were linked to family mental health history and noncommunicable diseases. Women exhibited lower levels of substance use but higher rates of self-harm and suicide attempts. Elevated homocysteine levels were linked to longer illness duration and more severe OCD symptoms. Conclusion These findings suggest that imbalances in micronutrients, particularly vitamin B12, folic acid, and homocysteine, may contribute to OCD severity and treatment resistance. Gender-specific variations in micronutrient levels could provide valuable insights into personalized OCD therapy choices. Further longitudinal studies are needed to understand theserelationships and their potential as therapeutic targets.

BackgroundSeveral psychiatric disorders have been associated with vitamin B12 and folic acid deficiency, such as mood disorders and obsessive–compulsive disorder (OCD). Vitamin B12 and folic acid play a crucial role in the carbon transfer metabolism that is necessary to produce serotonin. Many studies found low vitamin B12 levels, and indifferent folic acid levels in patients with OCD. More research focusing on vitamin B12 and folic acid, as well as their roles, can be beneficial to establish their association with OCD that will help in the therapeutic process. This study aimed to compare the blood levels of B12 and folic acid between a group of OCD patients and a group of healthy controls.MethodsThis study is a cross-sectional analysis of 44 Egyptian patients diagnosed with OCD compared with 44 healthy control subjects. The comparison was based on demographics, clinical parameters, and B12 and folic acid levels. The diagnosis of OCD was based on the application of the structured clinical interview for DSM-IV Axis I Disorders. The Arabic version of the Yale-Brown Obsessive–compulsive Scale (Y-BOCS) was administered to assess the severity of OCD. Blood samples were collected from all participants to measure vitamin B12 and foliate levels.ResultsPatients with OCD exhibited significantly lower vitamin B12 levels compared to controls (P = 0.03), however, there was no statistically significant difference in folic acid levels between patients with OCD and the control group (P = 0.08). A strong inverse correlation was seen between Y-BOCS scores and vitamin B12 levels (P = 0.04).ConclusionsThere was a statistically significant association between lower vitamin B12 levels and OCD, this important finding could be an advance in the therapeutic process in patients with OCD. These findings suggest that vitamin B12 levels may be associated with OCD severity, warranting further investigation.

Background: Clinical evidence suggests an association between vitamin B12 deficiency and vasovagal syncope (VVS) in pediatric patients. This study investigated the association of vitamin B12 and folate deficiency with VVS in adults. Methods: In this case-control study, adult patients with VVS who presented to the tertiary syncope unit for head-up tilt table testing comprised the case group. Age- and sex-matched individuals without syncope history from the population-based Tehran Cohort Study served as the control group. Exclusion criteria included but were not limited to the use of vitamin B supplements, carbamazepine, or phenobarbital, and sleeve gastrectomy. Serum vitamin B12, folate, and homocysteine levels were measured and compared. Results: From February 2020 through February 2021, 44 patients comprised the case group, matched with 44 controls (mean age, 37.9 years; 23 [52.3%] females in each group). No statistically significant difference existed between the groups in vitamin B12 or folate deficiency or serum levels. Serum vitamin B12 levels were significantly lower in patients with frequent VVS (≥3 lifetime episodes) than in patients with infrequent VVS (&lt;3 lifetime episodes) (233.8 [80.7] vs 305.2 [118.1] pg/mL; P=0.042), and the association remained significant after adjustment for confounders (P=0.026). Conclusion: No association existed between vitamin B12 or folate deficiency or serum levels and VVS. Frequent VVS was associated with lower serum vitamin B12 levels than infrequent VVS.

Vitamin B₁₂Deficiency and Depression in the Elderly

Self-reported psychotic-like experiences in individuals with obsessive-compulsive disorder versus schizophrenia patients: Characteristics and moderation role of trait anxiety

Objective: The data about sleep quality and suicide relationship in patients with obsessive-compulsive disorder (OCD) is limited. In this study, we aimed to investigate the hypothesis that there might be a relationship between sleep quality and suicide in the OCD patients with compare the control group. Methods: A total of 50 patients with OCD (31 female, 19 male) and 40 healthy (24 female, 16 male) individuals as a control group were included in the study. A data form for sociodemographic features, one other forms for clinical characteristics of OCD and Yale Brown Obsessive Compulsive Scale (YB-OCS) have been filled by clinician. After the interview, all patients completed Pittsburgh Sleep Quality Index (PSQI) and Suicide Behavior Scale (SBS). Results: Six (12%) of the OCD patients had lifelong suicide attempts and twenty (40%) had lifelong suicide ideation. When OCD patients and healthy controls were compared, PSQI-2, PSQI-3, PSQI-5, PSQI-6, SBS-1, SBS-2, SBS3 and SBS total scores in patients with OCD were higher than healthy controls. In patients group with lifelong suicide ideations, PSQI-1 and PSQI-6 scores were higher. In patients group with lifelong suicide attempts, PSQI-6 scores were higher. In OCD patients, statistically significant correlations were detected between SBS-1 and PSQI-1, PSQI-6; SBS-3 and PSQI-6. This correlations were not observed in the control group. Conclusion: As a result of this study, it has been shown that the subjective sleep quality of the last 1 month in OCD patients and the intake of additional sleeping pills may be related to past suicidal thoughts and attempts. It may be appropriate to monitor OCD patients with subjective sleep quality impairment and use of additional medication more frequently in terms of suicide risk. In this issue, follow-up studies are needed to include more OCD patients.

Reversal Learning as a Neuropsychological Indicator for the Neuropathology of Obsessive Compulsive Disorder? A Behavioral Study