Nutrient Deficits and Clinical Correlates in First Episode Psychosis: A Systematic Review and Meta-Analysis

Poster A37, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Joseph Firth1; 1NICM Health Research Institute, University of Western Sydney, Sydney, Australia

Background: Meta-analyses of blood nutrient levels in schizophrenia to date have focused on individual nutrients, and only considered patients with long-term conditions. Therefore, we conducted a systematic review and meta-analysis of all published studies comparing blood levels of vitamins and/or mineral in first-episode psychosis (FEP) to healthy control samples Methods: Electronic databases were searched from inception to July 2017 for all studies examining blood levels (i.e. serum, plasma or whole blood) of nutrient levels in people with FEP compared to healthy controls. Our systematic search identified 28 eligible studies, examining blood levels of six vitamins and ten dietary minerals, across 2,612 individuals. Random effects meta-analyses compared nutrient levels in FEP to healthy controls. Clinical correlates of nutritional status in FEP samples were systematically reviewed. Results: Compared to healthy controls, individuals with FEP had large, significant reductions in blood levels of vitamin B9/folate (N=6, n=827, g=-0.624, 95% C.I.=-1.176 to -0.072, p=0.027), Vitamin-D (N=7, n=906, g=-1.055, 95% C.I.=-1.99 to -0.119, p=0.027) and Vitamin C (N=2, n=96, g=-2.207, 95% C.I.=-3.71 to -0.71, p=0.004). Systematic synthesis of clinical correlates showed that lower levels of both folate and vitamin D were associated with poorer mental health in FEP. Conclusions: Deficits in vitamin D and folate, previously observed in long-term schizophrenia, appear to exist from illness onset, and are associated with more severe symptoms. The extent and importance of these deficit suggests that routine screening for potential deficiencies should be considered. Furthermore, the potential benefits of nutritional interventions targeting these deficits in FEP should be explored.

Topic Area: First Episode Psychosis

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