Skip to main content
Log in

Screening for vitamin B12 deficiency in psychiatric patients

  • Brief Reports
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

Psychiatric patients are frequently screened for vitamin B12 deficiency in the absence of hematologic or other neurologic findings. To determine the yield of this practice, 162 psychiatric inpatients were screened for vitamin B12 deficiency. Ten patients had initial low serum vitamin B12 levels, but only two had definite B12 deficiency on further evaluation. Three patients who had initially low B12 levels had normal levels subsequently during outpatient follow-up. When low serum vitamin B12 levels are discovered in psychiatric patients without hematologic or neurologic findings, a diagnosis of B12 deficiency should not be presumed without further evaluation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Stabler SP, Marcell PD, Podell ER, Allen RH, Lindenbaum J. Assay of methylmalonic acid in the serum of patients with cobalamin deficiency using capillary gas chromatography—mass spectrometry. J Clin Invest. 1986;77:1606–12.

    PubMed  CAS  Google Scholar 

  2. Stabler SP, Marcell PD, Podell ER, Allen RH, Savage DG, Lindenbaum J. Elevation of total homocysteine in the serum of patients with cobalamin or folate deficiency detected by capillary gas chromatography-mass spectrometry. J Clin Invest. 1988;81:466–74.

    Article  PubMed  CAS  Google Scholar 

  3. Lindenbaum J, Healton EB, Savage DG, et al. Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988;318:1720–8.

    Article  PubMed  CAS  Google Scholar 

  4. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders; 3rd edition, revised. Washington, DC: American Psychiatric Association, 1987.

    Google Scholar 

  5. Carmel R, Sinow RM, Siegel ME, Samloff M. Food cobalamin malabsorption occurs frequently in patients with unexplained low serum cobalamin level. Arch Intern Med. 1988;148:1715–9.

    Article  PubMed  CAS  Google Scholar 

  6. Holmes JM. Cerebral manifestations of vitamin-B12 deficiency. Br Med J. 1956;4:1394–8.

    Google Scholar 

  7. Smith ADM. Megaloblastic madness. Br Med J. 1960;2:1840–5.

    Article  PubMed  Google Scholar 

  8. Strachan RW, Henderson JG. Psychiatric syndromes due to avitaminosis B12 with normal blood and marrow. Q J Med. 1965;34:303–17.

    PubMed  CAS  Google Scholar 

  9. Goggans FC. A case of mania secondary to vitamin B12 deficiency. Am J Psychiatry. 1984;141:300–1.

    PubMed  CAS  Google Scholar 

  10. Evans DL, Edelsohn GA, Golden RN. Organic psychosis without anemia or spinal cord symptoms with vitamin B12 deficiency. Am J Psychiatry. 1983;140:218–21.

    PubMed  CAS  Google Scholar 

  11. Goodwin JS, Goodwin JM, Garry PJ. Association between nutritional status and cognitive functioning in a healthy elderly population. JAMA. 1983;249:2917–21.

    Article  PubMed  CAS  Google Scholar 

  12. Bell IR, Edman JS, Miller J, et al. Relationship of normal serum vitamin B12 and folate levels to cognitive test performance in subtypes of geriatric major depression. J Geriatr Psychiatry Neurol. 1990;3:98–105.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Received from the Department of Medicine, New England Deaconess Hospital, and Harvard Medical School, Boston, Massachusetts.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brett, A.S., Roberts, M.S. Screening for vitamin B12 deficiency in psychiatric patients. J Gen Intern Med 9, 522–524 (1994). https://doi.org/10.1007/BF02599226

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02599226

Key words

Navigation