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2016 ; 53
(1
): 33-37
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Vitamin D Deficiency in Obsessive-Compulsive Disorder Patients with Pediatric
Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections: A
Case Control Study
#MMPMID28360763
Çelik G
; Ta? D
; Tahiro?lu A
; Avci A
; Yüksel B
; Çam P
Noro Psikiyatr Ars
2016[Mar]; 53
(1
): 33-37
PMID28360763
show ga
INTRODUCTION: Previous studies have indicated that vitamin D deficiency is common
in psychiatric patients, particularly in those with neuropsychiatric disorders
such as autism and schizophrenia. Vitamin D is an important neurosteroid hormone
and immunomodulatory agent that also has bone metabolic effects. There has been
an increasing interest in immune-related neuropsychiatric symptoms that are
triggered by group A beta-hemolytic streptococcal infections. In this study, we
aimed to compare the serum levels of vitamin D between obsessive-compulsive
disorder (OCD) patients with pediatric autoimmune neuropsychiatric disorders
associated with streptococcal infections (PANDAS) and control subjects. METHODS:
Thirty-three OCD patients with PANDAS and 20 healthy controls were enrolled in
the study. Serum 25-hydroxyvitamin D (25-(OH) D), calcium, phosphorus, alkaline
phosphatase, and parathormone levels of the two groups were compared. Serum
25-(OH) D levels of <15 ng/mL were classified as vitamin D deficiency. The
children's Yale-Brown Obsessive Compulsive Scale (YBOCS) and Clinical Global
Impression (CGI) were used to assess the severity of OCD symptoms. RESULTS: There
was no significant difference in serum 25-(OH) D levels between the patient and
control groups. However, vitamin D deficiency was significantly more frequent in
the patient group than in the control group (48.5% vs. 20.0%; p=0.038). Moreover,
OCD patients with vitamin D deficiency had higher rates of comorbid ADHD than
those without vitamin D deficiency (87.5% vs. 52.6%; p=0.027). While serum
phosphorus levels were negatively correlated with age as well as alkaline
phosphatase and ASO levels, they were positively correlated with the YBOCS total
score and global severity score. Serum parathormone levels were positively
correlated with the YBOCS total score, compulsion score, obsession score, and
global severity score. CONCLUSION: This study supports the hypothesis that an
association between vitamin D metabolism and PANDAS-related OCD exists. We
suggest that biochemical parameters predicting metabolic bone diseases are more
common in PANDAS patients. There is a need for prospective studies to show a
clear association between PANDAS and bone metabolic turnover based on autoimmune
mechanisms.