Vitamin B12, folate, and homocysteine levels in patients with obsessive–compulsive disorder

Abstract

Nuray Türksoy,1 Rabia Bilici,2 Altan Yalçiner,3 Y Özay Özdemir,2 Ibrahim Örnek,4 Ali Evren Tufan,5 Ayşe Kara6 1Simurg Psychiatry and Psychotherapy Center, Istanbul, 2Erenköy State Hospital for Psychiatric and Neurological Diseases, Istanbul, 3Düzen Laboratories, Istanbul, 4Florence Nightingale Hospital, Istanbul, 5Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University, Bolu, 6Bakırköy State Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey Abstract: It is known that elevated serum homocysteine, decreased folate, and low vitamin B12 serum levels are associated with poor cognitive function, cognitive decline, and dementia. Current literature shows that some psychiatric disorders, mainly affective and psychotic ones, can be related to the levels of vitamin B12, folate, and homocysteine. These results can be explained by the importance of vitamin B12, folate, and homocysteine in carbon transfer metabolism (methylation), which is required for the production of serotonin as well as for other monoamine neurotransmitters and catecholamines. Earlier studies focused on the relationship between folate deficiency, hyperhomocysteinemia, and depressive disorders. Although depressive and anxiety disorders show a common comorbidity pattern, there are few studies addressing the effect of impaired one-carbon metabolism in anxiety disorders – especially in obsessive–compulsive disorder (OCD). This study aimed to measure the levels of vitamin B12, folate, and homocysteine specifically in order to see if eventual alterations have an etiopathogenetic significance on patients with OCD. Serum vitamin B12, folate, and homocysteine concentrations were measured in 35 patients with OCD and 22 controls. In addition, the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision, Yale–Brown Obsessive Compulsive Scale, Hamilton Rating Scale for Depression, and Hamilton Rating Scale for Anxiety were conducted for each patient. It was found that vitamin B12 levels were decreased and homocysteine levels were increased in some OCD patients. Homocysteine levels were positively correlated with Yale–Brown compulsion and Yale–Brown total scores. In conclusion, findings of this study suggest that some OCD patients might have vitamin B12 deficiency and higher homocysteine levels. Keywords: obsessive–compulsive disorder, vitamin B12, folate, homocysteine, obsession, compulsion