The Vitamins in Psychosis Study: A Randomized, Double-Blind, Placebo-Controlled Trial of the Effects of Vitamins B

Cognition Dietary Supplements Double-Blind Method Female Folic Acid / therapeutic use Humans Male Psychotic Disorders / psychology Vitamin B 12 / therapeutic use Vitamin B 6 / therapeutic use Young Adult
Attention B vitamins Early psychosis Folic acid Genetics Homocysteine

Journal

Biological psychiatry
ISSN: 1873-2402
Titre abrégé: Biol Psychiatry
Pays: United States
ID NLM: 0213264

Informations de publication

Date de publication:
01 07 2019
Historique:
received: 20 09 2018
revised: 04 12 2018
accepted: 21 12 2018
pubmed: 18 2 2019
medline: 11 6 2020
entrez: 18 2 2019
Statut: ppublish

Résumé

Elevated homocysteine is observed in schizophrenia and associated with illness severity. The aim of this study was to determine whether vitamins B A randomized, double-blind, placebo-controlled trial was used. A total of 120 patients with first-episode psychosis were randomized to an adjunctive B-vitamin supplement (containing folic acid [5 mg], B B-vitamin supplementation reduced homocysteine levels (p = .003, effect size = -0.65). B-vitamin supplementation had no significant effects on Positive and Negative Syndrome Scale total (p = .749) or composite neurocognition (p = .785). There were no significant group differences in secondary symptom domains. A significant group difference in the attention/vigilance domain (p = .024, effect size = 0.49) showed that the B-vitamin group remained stable and the placebo group declined in performance. In addition, 14% of the sample had elevated baseline homocysteine levels, which was associated with greater improvements in one measure of attention/vigilance following B-vitamin supplementation. Being female and having affective psychosis was associated with improved neurocognition in select domains following B-vitamin supplementation. Genetic variation did not influence B-vitamin treatment response. While 12-week B-vitamin supplementation might not improve overall psychopathology and global neurocognition, it may have specific neuroprotective properties in attention/vigilance, particularly in patients with elevated homocysteine levels, patients with affective psychosis, and female patients. Results support a personalized medicine approach to vitamin supplementation in first-episode psychosis.

Sections du résumé

BACKGROUND
Elevated homocysteine is observed in schizophrenia and associated with illness severity. The aim of this study was to determine whether vitamins B
METHODS
A randomized, double-blind, placebo-controlled trial was used. A total of 120 patients with first-episode psychosis were randomized to an adjunctive B-vitamin supplement (containing folic acid [5 mg], B
RESULTS
B-vitamin supplementation reduced homocysteine levels (p = .003, effect size = -0.65). B-vitamin supplementation had no significant effects on Positive and Negative Syndrome Scale total (p = .749) or composite neurocognition (p = .785). There were no significant group differences in secondary symptom domains. A significant group difference in the attention/vigilance domain (p = .024, effect size = 0.49) showed that the B-vitamin group remained stable and the placebo group declined in performance. In addition, 14% of the sample had elevated baseline homocysteine levels, which was associated with greater improvements in one measure of attention/vigilance following B-vitamin supplementation. Being female and having affective psychosis was associated with improved neurocognition in select domains following B-vitamin supplementation. Genetic variation did not influence B-vitamin treatment response.
CONCLUSIONS
While 12-week B-vitamin supplementation might not improve overall psychopathology and global neurocognition, it may have specific neuroprotective properties in attention/vigilance, particularly in patients with elevated homocysteine levels, patients with affective psychosis, and female patients. Results support a personalized medicine approach to vitamin supplementation in first-episode psychosis.

Identifiants

DOI: 10.1016/j.biopsych.2018.12.018 PMID: 30771856
pubmed: 30771856
pii: S0006-3223(19)30001-0
doi: 10.1016/j.biopsych.2018.12.018
pii:
doi:

Substances chimiques

Vitamin B 6 8059-24-3
Folic Acid 935E97BOY8
Vitamin B 12 P6YC3EG204

Banques de données

ClinicalTrials.gov
['NCT00202280']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

35-44

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Auteurs

Kelly Allott (K)

Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

Patrick D McGorry (PD)

Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

Hok Pan Yuen (HP)

Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

Joseph Firth (J)

Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia.

Tina-Marie Proffitt (TM)

Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; School of Psychology, University of Waikato, Hamilton, Waikato, New Zealand.

Gregor Berger (G)

Department of Child and Adolescent Psychiatry, Psychiatric University Clinic, Zurich, Switzerland.

Paul Maruff (P)

Department of Anatomy and Neuroscience, The University of Melbourne, Parkville, Victoria, Australia.

Michaela K O'Regan (MK)

Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

Alicia Papas (A)

Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

Timothy C B Stephens (TCB)

Orygen, The National Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.

Colin P O'Donnell (CP)

Department of Psychiatry, Donegal Mental Health Service, Letterkenny University Hospital, Letterkenny, Donegal, Republic of Ireland. Electronic address: drcolinodonnell@yahoo.com.

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Classifications MeSH

questionsmedicales.fr › Phénomènes psychologiques › Processus mentaux › Cognition › The Vitamins in Psychosis Study: A Randomized,...
questionsmedicales.fr › Aliments et boissons › Aliments › Compléments alimentaires › The Vitamins in Psychosis Study: A Randomized,...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Méthode en double aveugle › The Vitamins in Psychosis Study: A Randomized,...
questionsmedicales.fr › Composés hétérocycliques › Composés hétérocycliques à cycles fusionnés › Composés hétérobicycliques › Ptéridines › Acide folique › The Vitamins in Psychosis Study: A Randomized,...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The Vitamins in Psychosis Study: A Randomized,...
questionsmedicales.fr › Troubles mentaux › Schizophrénie et troubles avec traits psychotiques › Troubles psychotiques › The Vitamins in Psychosis Study: A Randomized,...
questionsmedicales.fr › Composés polycycliques › Composés macrocycliques › Tétrapyrroles › Corrinoïdes › Vitamine B12 › The Vitamins in Psychosis Study: A Randomized,...
questionsmedicales.fr › Composés hétérocycliques › Composés hétéromonocycliques › Pyridines › Picolines › Vitamine B6 › The Vitamins in Psychosis Study: A Randomized,...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Jeune adulte › The Vitamins in Psychosis Study: A Randomized,...