Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-05-05T05:44:30.241Z Has data issue: false hasContentIssue false
  • English
  • Français

Serum B12 and Folate Concentrations in Mental Patients

Published online by Cambridge University Press:  29 January 2018

Richard Hunter ,
Muriel Jones ,
T. G. Jones  and
D. M. Matthews
Richard Hunter
Affiliation:
National Hospital, Queen Square; Friern and Whittington Hospitals, London, N
Muriel Jones
Affiliation:
Friern Hospital, London, N
T. G. Jones
Affiliation:
Westminster Medical School, London, S.W.1
D. M. Matthews
Affiliation:
Westminster Medical School, London, S.W.1
Get access Rights & Permissions [Opens in a new window]

Extract

In a leading article on mental symptoms in vitamin B12 deficiency (Lancet, 1965), it was pointed out that “though mental illness due to vitamin B12 deficiency is uncommon, it is readily treated, and, as in general paralysis of the insane, its protean manifestations and uncertain physical signs call for an easily applied screening test comparable to the Wassermann reaction”. In the correspondence which followed it was suggested that in psychiatric practice today mental symptoms were likely to be found more frequently in association with vitamin B12 deficiency than with a positive serological test for syphilis (owing in part to the increasing number of patients with deficiency syndromes following gastro-intestinal surgery); and that estimation of serum B12 concentration should be performed much more readily without waiting for clear-cut haematological evidence or neurological complications of megaloblastic anaemia (Hunter and Matthews, 1965). This was emphasized by the evidence of Strachan and Henderson (1965) who described three patients with psychiatric syndromes attributed to vitamin B12 deficiency in whom not only peripheral blood but also bone marrow was normal; and the report from a mental hospital in Norway by Edwin et al. (1965) that of 396 patients over the age of thirty years admitted over a twelve months period, 23 (5·8 per cent.) had serum B12 concentrations below the critical level of 100 μμg. per ml. as estimated by Euglena gracilis assay. This finding was challenged by Herbert et al. (1965), who suggested that drugs of the phenothiazine group administered to the patients might have suppressed the growth of the organism, but this was disputed by Edwin et al. (1966).

Type
Research Article
Information
The British Journal of Psychiatry , Volume 113 , Issue 504 , November 1967 , pp. 1291 - 1295
Copyright
Copyright © Royal College of Psychiatrists, 1967 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brody, E. A., Estren, S., and Herbert, V. (1966). “Coexistent pernicious anaemia and malabsorption.” Arm. int. Med., 64, 1246–1251.Google Scholar
Edwin, E., Holten, K., Norum, K. R., Schrumpf, A., and Skaug, O. E. (1965). “Vitamin B12 hypovitaminosis in mental diseases.” Acta med. Scand., 177, 689–699.Google Scholar
Edwin, E., Holten, K., Norum, K. R., Schrumpf, A., and Skaug, O. E. (1966). “Serum vitamin B12and chlorpromazine.” Lancet, i, 316–317.Google Scholar
Ekins, R. P., and Sgherzi, A. M. (1965). “The microassay of vitamin B12 in human plasma by the saturation assay technique.” In: Radiochemical Methods of Analysis. Vol. 2, p. 239–256. International Atomic Energy Agency, Vienna.Google Scholar
Emerson, P. M. (1965). Personal communication.Google Scholar
Henderson, J. G., Strachan, R. W., Beck, J. S., Dawson, A., and Daniel, M. (1966). “The antigastricantibody test as a screening procedure for vitamin B12deficiency in psychiatric practice.” Lancet, ii, 809–813.Google Scholar
Herbert, V. (1964). “Studies of folate deficiency in man.” Proc. roy. Soc. Med., 57, 377–384.Google Scholar
Herbert, V., Gottlieb, C. W., and Altschule, M. D. (1965). “Apparently low serum-vitamin B12 levels associated with chlorpromazine.” Lancet, ii, 1052–1053.Google Scholar
Hunter, R., Earl, C. J., and Thornicroft, S. (1964). “An apparently irreversible syndrome of abnormal movements following phenothiazine medication.” Proc. Roy. Soc. Med., 57, 24–28.Google Scholar
Hunter, R., Earl, C. J., and Matthews, D. M. (1965). “Mental symptoms in vitamin B12 deficiency.” Lancet, ii, 738.Google Scholar
Hunter, R., Jones, M., and Matthews, D. M. (1967). “Postgastrectomy vitamin B12 deficiency in psychiatric practice.” Ibid., i, 47.Google Scholar
Hutner, S. H., Bach, M. K., and Ross, G. I. M. (1956). “A sugar-containing basal medium for vitamin B12assay with Euglena; application to body fluids.” J. Protozool., 3, 101–112.CrossRefGoogle Scholar
Klipstein, F. A. (1964). “Subnormal serum folate and macrocytosis associated with anticonvulsant drug therapy.” Blood, 23, 68–86.Google Scholar
Lancet (1965). “Mental symptoms in vitamin B12deficiency.” Lancet, ii, 628–629.Google Scholar
Malpas, J. S., Spray, G. H., and Witts, L. J. (1966). “Serum folic-acid and vitamin B12 levels in anticonvulsant therapy.” Brit. med. J., i, 955–957.Google Scholar
Maslow, W. C., Donnelly, W. J., Koppel, D. M., and Schwartz, S. O. (1957). “Observations on the use of Co-60 labeled vitamin B12 in the urinary excretion test.” Acta haemat. Basel, 18, 137–147.Google Scholar
Matthews, D. M. (1962). “Observations on the estimation of serum vitamin B12 using Lactobacillus leich-mannii.” Clin. Sci., 22, 101–111.Google Scholar
Matthews, D. M., and Beckett, A. G. (1962). “Serum vitamin B12 in renal failure.” J. clin. Path., 15, 456–458.Google Scholar
Mollin, D. L., and Read, A. (1966). Personal communication.Google Scholar
Mollin, D. L., and Ross, G. I. M. (1952). “The vitamin B12 concentrations of serum and urine of normals and of patients with megaloblastic anaemias and other diseases.” J. clin. Path., 5, 129–139.Google Scholar
Reynolds, E. H., Milner, G., Matthews, D. M., and Chanarin, I. (1966). “Anticonvulsant therapy, megaloblastic haemopoiesis and folic acid metabolism.” Quart. J. Med., 35, 521–537.Google Scholar
Reynolds, E. H., Chanarin, I., Milner, G., and Matthews, D. M. (1967). “Anticonvulsant therapy, folic acid and B12 metabolism and mental symptoms.” Epilepsia, Amsterdam, 7, 261–270.Google Scholar
Shinton, N. K. (1959). “Total serum B12 concentration in normal adult serum assayed by Euglena gracilis.” Clin. Sci., 18, 389–398.Google Scholar
Spray, G. H. (1962). “The estimation and significance of the level of vitamin B12 in serum.” Postgrad. med. J., 38, 35–40.Google Scholar
Strachan, R. W., and Henderson, J. G. (1965). “Psychiatric syndromes due to avitaminosis B12 with normal blood and marrow.” Quart. J. Med., NS 34, 303–317.Google Scholar
Varley, H. (1962). Clinical Biochemistry. 3rd edition. p. 396. London.Google Scholar
Waters, A. H., and Mollin, D. L. (1961). “Studies on the folic acid activity of human serum.” J. clin. Path., 14, 335–344.Google Scholar
Wilkinson, J. H. (1962). An Introduction to Diagnostic Enzymology, pp. 143–176. London.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.