Water-soluble vitamin insufficiency, deficiency and supplementation in children and adolescents with a psychiatric disorder: a systematic review and meta-analysis

ABSTRACT

Nutrition is fundamental for brain development, but relatively little is known about water-soluble vitamin (WSV) levels and the effect of supplementation on psychiatry symptoms in children and adolescents (CAD) with psychiatric disorders. Our team systematically reviewed all studies concerning WSV abnormalities or supplementation in CAD with any psychiatric disorder. We searched for original studies published between 1990 and 15/05/2020 which were not based on retrospective chart review and which included WSV blood level measurements or investigated the effect of WSV supplementation on psychiatric symptoms in psychiatric patients aged 18 or under. Forty-two articles were included, 69% of which (N = 29) examined Autism Spectrum Disorders (ASD), with most of these assessing folate or vitamin B₁₂ supplementation (N = 22, 75.9% of ASD studies). Meta-analyses showed significantly lower vitamin B₁₂ levels in ASD and ADHD patients vs. healthy controls (HC), while folate levels were higher in ADHD patients vs. HC. Most of the studies (9/10, 90%) showed a decrease in symptoms as measured by clinical scales after supplementation. There was significant heterogeneity between the studies, however many found different types of vitamin abnormalities in CAD with psychiatric disorders.

KEYWORDS:

• Vitamin
• nutrition
• children and adolescents
• psychiatric disorders
• psychopathology
• supplementation
• water-soluble vitamins
• folate
• B12

Acknowledgements

The authors thank Mr.A.D.Pierce for his English editorial assistance and Mr.R.Borras for his statistical advice.

Disclosure statement

NP has received economic assistance to attend conferences put on by Janssen, Otsuka-Lundbeck, and Pfizer, EV has received travel support from Otsuka-Lundbeck and Shire. IF has received travel support from Shire. IB has received honoraria or travel support from Angelini, Janssen and Otsuka-Lundbeck, as well as grants from the Spanish Ministry of Health, Instituto de Salud Carlos III. RD has no conflicts to declare.

Authors contributions

I.Baeza had the idea to do this review. She and N.Prades performed the literature search. They and I.Flamarique and E.Varela wrote the draft. All of the authors critically revised the work, read and approved the final manuscript.

Data availability statement

The data that support the findings of this systematic review are available on request from the corresponding author [IB].

Additional information

Funding

This work was supported by the Instituto de Salud Carlos lII ‘Health Research Fund' (F.I.S. PI/18/0242, INT19/00021), fondos FEDER ‘Una manera de hacer Europa’, as well as Generalitat de Catalunya (17SGR-881).