berk-vitamindsupplementation-2020.pdf (794.71 kB)
Vitamin D supplementation compared to placebo in people with First Episode psychosis - Neuroprotection Design (DFEND): a protocol for a randomised, double-blind, placebo-controlled, parallel-group trial
journal contributionposted on 2020-01-01, 00:00 authored by F Gaughran, D Stringer, Michael BerkMichael Berk, S Smith, D Taylor, E Whiskey, S Landau, R Murray, P McGuire, P Gardner-Sood, G Wojewodka, S Ciufolini, H Jordan, J Clarke, L Allen, A Krivoy, B Stubbs, P Lowe, M Arbuthnott, S Rathod, A Boardman, M Firdosi, J J McGrath
Background: People experiencing their first episode of psychosis are often deficient in vitamin D. Observational studies have reported an association between low vitamin D concentrations and poorer subsequent health outcomes in psychosis. A vitamin D deficiency in neonates and children has been linked to a later increased risk of schizophrenia and psychotic-like experiences. This trial aims to examine the effect of high-dose vitamin D supplementation on outcomes in early psychosis. We hypothesise that vitamin D supplementation will be associated with better mental health outcomes. Methods/design: The DFEND study is a multicentre double-blind placebo-controlled parallel-group trial of vitamin D supplementation in people with early psychosis. Patients with an ICD-10 diagnosis of functional psychosis will be randomised in a 1:1 ratio to receive either 120,000 IU/month of vitamin D (cholecalciferol) or a matched placebo for 6 months. The primary outcome is the total Positive and Negative Syndrome Scale (PANSS) score at the 6-month follow-up for all patients. Secondary outcomes include assessment of mood (Calgary Depression Scale), general function (Global Assessment of Functioning), cardiovascular risk (body mass index, waist circumference, C-reactive protein, cholesterol and HbA1c) and vitamin D levels at the 6-month follow-up. Additionally, 3- and 6-month total PANSS scores will be analysed for those with inadequate vitamin D levels at the baseline. Discussion: The DFEND study is the first trial to examine whether vitamin D supplementation in early psychosis is associated with better mental health outcomes. The findings of this study may help to resolve the clinical equipoise regarding the benefits and cost-effectiveness of routine vitamin D supplementation in people with psychosis. Trial registration: ISRCTN, ISRCTN12424842. Registered on 25 February 2015.
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Science & TechnologyLife Sciences & BiomedicineMedicine, Research & ExperimentalResearch & Experimental MedicinePsychosisFirst episodeVitamin D25OHDRandomised controlled trialPositive and Negative Syndrome ScaleMental healthDEPRESSION RATING-SCALED DEFICIENCYGLOBAL ASSESSMENTMETABOLIC SYNDROMEMENTAL-ILLNESSSCHIZOPHRENIAMETAANALYSISVALIDITYRISKRELIABILITY