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.
References
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.
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.
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.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders; 3rd edition, revised. Washington, DC: American Psychiatric Association, 1987.
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.
Holmes JM. Cerebral manifestations of vitamin-B12 deficiency. Br Med J. 1956;4:1394–8.
Smith ADM. Megaloblastic madness. Br Med J. 1960;2:1840–5.
Strachan RW, Henderson JG. Psychiatric syndromes due to avitaminosis B12 with normal blood and marrow. Q J Med. 1965;34:303–17.
Goggans FC. A case of mania secondary to vitamin B12 deficiency. Am J Psychiatry. 1984;141:300–1.
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.
Goodwin JS, Goodwin JM, Garry PJ. Association between nutritional status and cognitive functioning in a healthy elderly population. JAMA. 1983;249:2917–21.
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.
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Received from the Department of Medicine, New England Deaconess Hospital, and Harvard Medical School, Boston, Massachusetts.
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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
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DOI: https://doi.org/10.1007/BF02599226