Abstract
Little is known about the nutritional status of pregnant women with severe mental illness. We therefore carried out a systematic review to investigate whether pregnant women and childbearing aged women with severe mental illness have significantly greater nutritional deficiencies compared with pregnant women and childbearing aged women with no mental illness. We carried out a search using MEDLINE, EMBASE and PsycINFO from January 1980 to January 2011 for studies on nutritional status of childbearing aged women with psychotic disorders. Identification of papers and quality rating of papers (using a modified version of the Newcastle–Ottawa scale) was carried out by two reviewers independently. We identified and screened 4,130 potentially relevant studies from the electronic databases. Fifteen studies met the inclusion criteria (n = 587 women). There were no studies of pregnant women. There was some evidence of low serum folate and vitamin B12 levels and elevated homocysteine levels in childbearing aged women with psychotic disorders. Further research into the nutritional status of childbearing aged women with severe mental illness is needed. Maternal nutrition has a profound impact on foetal outcome, is a modifiable risk factor and therefore needs prioritising in the care of all childbearing aged women with severe mental illness.
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Abu-Saad K, Fraser D (2010) Maternal nutrition and birth outcomes. Epidemiol Rev 32(1):5–25
Baker PN, Wheeler SJ, Sanders TA, Thomas JE, Hutchinson CJ, Clarke K, Berry JL, Jones RL, Seed PT, Poston L (2009) A prospective study of micronutrient status in adolescent pregnancy. Am J Clin Nutr 89:1114–24
Barnes TR, Halstead SM, Little PW (1992) Relationship between iron status and chronic akathisia in an inpatient population with chronic schizophrenia. Br J Psychiatry 161:791–796. doi:10.1192/bjp. 161.6.791
Bennedsen BE, Mortensen PB, Olesen AV, Henriksen TB (2001) Congenital malformations, stillbirths, and infant deaths among children of women with schizophrenia. Arch Gen Psychiatry 58:674–679
Black RE, Allen LH, Bhutta Z, Caulfield L, de Onis M, Ezzati M, Mathers C, Rivera J (2008) Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 371(9608):243–260
Chauvet E, Youssef M, Boukhari R, Guind WE, Carles G (2009) Symptoms of HELLP syndrome due to vitamin B12 deficiency: report of seven cases. J Gynecol Obstet Biol Reprod 38:226–230
Coverdale JH, Turbott SH, Roberts H (1997) Family planning needs and STD risk behaviours of female psychiatric out-patients. Br J Psychiatry 171:69–72
Dias VV, Brissos S, Cardoso C, Andreazza AC, Kapczinski F (2009) Serum homocysteine levels and cognitive functioning in euthymic bipolar patients. J Affect Disord 113(3):285–90. doi:10.1016/j.jad.2008.05.011
DiGirolamo AM, Ramirez-Zea M (2009) Role of zinc in maternal and child mental health. Am J Clin Nutr 89(3):940S–945S
Elmslie JL, Mann JI, Silverstone JT, Williams SM, Romans SE (2001) Determinants of overweight and obesity in patients with bipolar disorder. J Clin Psychiatry 62(6):486–91
Freeman MP, Hibbeln JR, Wisner KL, Davis JM, Mischoulon D, Peet M, Keck PE Jr, Marangell LB, Richardson AJ, Lake J, Stoll AL (2006) Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. J Clin Psychiatry 67(12):1954–67
Goff DC, Bottiglieri T, Arning E, Shih V, Freudenreich O, Eden Evins A, Henderson DC, Baer L, Coyle J (2004) Folate, homocysteine, and negative symptoms in schizophrenia. Am J Psychiatry 161(9):1705–1708. doi:10.1176/appi.ajp. 161.9.1705
Gluckman PD, Hanson MA, Cooper C, Thornburg KL (2008) Developmental pathways to future health and disease. N Engl J Med 359:61–73
Haidemenos A, Kontis D, Gazi A, Kallai E, Allin M, Lucia B (2007) Plasma homocysteine, folate and B12 in chronic schizophrenia. Prog Neuro-Psychopharmacol Biol Psychiatry 31(6):1289–96. doi:10.1016/j.pnpbp. 2007.05.011
Henderson DC, Copeland PM, Nguyen DD, Borba CP, Cather C, Eden Evins A, Freudenreich O, Baer L, Goff DC (2006) Homocysteine levels and glucose metabolism in non-obese, non-diabetic chronic schizophrenia. Acta Psychiatr Scand 113:121–125. doi:10.1111/j.1600-0447.2005.00621.x
Heseker H (2011) Folic acid and other potential measures in the prevention of neural tube defects. Ann Nutr Metab 59(1):41–5
Hibbeln JR, Makino KK, Martin CE, Dickerson F, Boronow J, Fenton WS (2003) Smoking, gender, and dietary influences on erythrocyte essential fatty acid composition among patients with schizophrenia or schizoaffective disorder. Biol Psychiatry 53:431–441. doi:10.1016/S0006-3223(02)01549-4
Hofmann M, Seifritz E, Botschev C, Kräuchi K, Müller-Spahn F (2000) Serum iron and ferritin in Acute neuroleptic akathisia. Psychiatry Res 93(3):201–7. doi:10.1016/S0165-1781(00)00115-3
Howard L (2005) Fertility and pregnancy in women with psychotic disorders. Eur J Obstet Gyn RB 119(1):3–10
Howard LM, Croker H (2012) Obesity and mental health. In: Gillman M, Poston L (eds) Maternal obesity. Cambridge University Press, Cambridge, UK. (in press)
Howard LM, Kumar C, Thornicroft G (2001) The psychosocial characteristics of mothers with psychotic disorders. Br J Psychiatry 178:427–432
Koo LC (1997) Diet and lung cancer 20 years later: more questions than answers? Int J Cancer 10:22–29
Ma YY, Shek CC, Wong MC, Yip KC, Ng RM, Nguyen DG, Poon TK (2009) Homocysteine levels in schizophrenia patients. Aust N Z J Psychiatry 43(8):760–5. doi:10.1080/00048670903001935
MacCabe JH, Martinsson L, Lichtenstein P, Nilsson E, Cnattingius S, Murray RM, Hultman C (2007) Adverse pregnancy outcomes in mothers with affective psychosis. Bipolar Disord 9(3):305–309
McCreadie R, Macdonald E, Blacklock C, Tilak-Singh D, Wiles D, Halliday J, Paterson J (1998) Dietary intake of schizophrenic patients in Nithsdale, Scotland: case–control study. BMJ 183:534–539. doi:10.1136/bmj.317.7161.784
McCreadie R (2003) Diet smoking and cardiovascular risk in people with schizophrenia: a descriptive study. Br J Psychiatry 183:534–539. doi:10.1192/bjp. 183.6.534
McGrath JJ, Hearle J, Jenner L, Plant K, Drummond A, Barkla JM (1999) The fertility and fecundity of patients with psychoses. Acta Psychiatr Scand 99(6):441–446
McNamara RK, Jandacek R, Rider T, Tso P, Stanford KE, Hahn CG, Richtand NM (2008) Deficits in docosahexaenoic acid and associated elevations in the metabolism of arachidonic acid and saturated fatty acids in the postmortem orbitofrontal cortex of patients with bipolar disorder. Psychiatry Res 160(3):285–299. doi:10.1016/j.psychres.2007.08.021
Muthayya S, Kurpad AV, Duggan CP, Bosch RJ, Dwarkanath P, Mhaskar A, Mhaskar R, Thomas A, Vaz M, Bhat S, Fawzi WW (2006) Low maternal vitamin B12 status is associated with intrauterine growth retardation in urban South Indians. Eur J Clin Nutr 60(6):791–801
National Institute for Health and Clinical Excellence (NICE) (2008) Improving the nutrition of pregnant and breastfeeding mothers and children in low-income households. National Institute for Health and Clinical Excellence (NICE). www.nice.org.uk/nicemedia/pdf/PH011guidance.pdf. Accessed 16 December 2011
Ray JG, Wyatt PR, Thompson MD et al (2007) Vitamin B12 and the risk of neural tube defects in a folic-acid-fortified population. Epidemiol 18(3):362–366
Reif A, Pfuhlmann B, Lesch KP (2005) Homocysteinemia as well as methylenetetrahydrofolate reductase polymorphism are associated with affective psychoses. Prog Neuropsychopharmacol Biol Psychiatry 29(7):1162–8. doi:10.1016/j.pnpbp. 2005.06.027
Reznikoff-Etiévant MF, Zittoun J, Vaylet C, Pernet P, Milliez J (2002) Low vitamin B12 level as a risk factor for very early recurrent abortion. Eur J Obstet Gynecol Reprod Biol 104(2):156–159
Ryan-Harshman M, Aldoori W (2008) Vitamin B12 and health. Can Fam Phy 54(4):536–41
Stahl Z, Belmaker RH, Friger M, Levine J (2005) Nutritional and life style determinants of plasma homocysteine in schizophrenia patients. Eur Neuropsychopharmacol 15(3):291–5. doi:10.1016/j.euroneuro.2004.12.003
Strassnig M, Brar JS, Ganguli R (2003) Nutritional assessment of patients with schizophrenia: a preliminary study. Schizophr Bull 29(2):393–397
Taylor MJ, Carney S, Geddes J, Goodwin G (2003). Folate for depressive disorders. Cochrane Database Syst Rev. (2):CD003390
Taylor MJ, Geddes J (2004) Folic acid as ultimate in disease prevention: folate also improves mental health. BMJ 328(7442):768–9
Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS (2008) Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry 65(7):805–815
Vollset SE, Refsum H, Irgens LM, Emblem BM, Tverdal A, Gjessing HK, Monsen ALB, Ueland PM (2000) Plasma total homocysteine, pregnancy complications, and adverse pregnancy outcomes: the Hordaland Homocysteine Study. Am J Clin Nutr 71(4):962–968
Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, Tugwell P (2000) The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 6 May 2011
Webb R et al (2005) Mortality in offspring of parents with psychotic disorders: a critical review and meta-analysis. Am J Psychiatry 162(6):1045–56, Review
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McColl, H., Dhillon, M. & Howard, L.M. A systematic review of the nutritional status of women of a childbearing age with severe mental illness. Arch Womens Ment Health 16, 39–46 (2013). https://doi.org/10.1007/s00737-012-0315-x
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DOI: https://doi.org/10.1007/s00737-012-0315-x