Retrospective comparison of vitamin b12 and folate levels of patients with first episode psychosis and first episode mania with healthy people

Although genetic, biopsychosocial, neurodevelopmental, neurochemical and psychoanalytic risk factors have been proposed in patients diagnosed with schizophrenia and patients with bipolar disorder, the etiology of these diseases has not been clearly explained. It is thought that the increase in homocysteine level, which develops secondary to deficient blood levels of vitamin B12 and folate, which are involved in single carbon metabolism, increases the sensitivity of neurons to oxidative stress, therefore, the susceptibility to these diseases increases with neurodegeneration. In our study, vitamin B12 and folate blood levels of patients diagnosed with schizophrenia in the first episode of psychosis and bipolar disorder were compared with healthy controls retrospectively. Sixty-seven volunteers between the ages of 18-65 without any additional psychiatric or organic diseases were recruited from all three groups. According to the statistical analysis, vitamin B12 blood level was found to be significantly lower in schizophrenia patients during the first episode of psychosis compared to healthy controls (p = 0.002). In male patients with schizophrenia, blood folate level was significantly lower in the first episode of psychosis than healthy male controls (p = 0.045). In bipolar disorder patients, although vitamin B12 and folate levels in the first episode manic period were lower than healthy controls, this difference was not statistically significant (p = 0.115 and p = 0.102). According to the chi-square analysis applied, the frequency of patients with a diagnosis of vitamin B12 deficiency (<189 pg / nm) in patients with schizophrenia and bipolar disorder was found to be significantly higher than healthy volunteers (p <0.001 and p = 0.025). Vitamin B12 blood level was found to have a predictive effect on the diagnosis of schizophrenia in patients diagnosed with schizophrenia according to the logistic regression model created (p = 0.009). It was also found that having a clinical diagnosis of vitamin B12 deficiency had a predictive effect on schizophrenia (p = 0.002). Although the folate blood level was lower in schizophrenia patients compared to healthy controls, no predictive effect was found on the disease. Vitamin B12 and folate blood levels did not have a predictive effect on the disease in bipolar disorder. According to the findings we obtained in our study based on the first attack of the disease in patients with schizophrenia and bipolar disorder, there is a decrease in the blood levels of vitamin B12 and folate in these diseases. The clinical presence of vitamin B12 deficiency in the first episode period, especially in schizophrenia patients, suggests that it may be a risk factor in the emergence of schizophrenia.