Objective: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood. Prevalence of ADHD varies from country to country. According to DSM-5, prevalence of ADHD is up to 13% in follow-up studies involved school-age children. Vitamin B12 deficiency is a medical condition which may be associated with many psychiatric disorders such as depression, schizophrenia, bipolar disorder and cognitive decline. Poor intake or malabsorption causes vitamin B12 deficiency. It is known that socioeconomic factors may influence dietary quality and vitamin intakes. In the present study, we planned to examine the association between socioeconomic status of ADHD patients and their vitamin B12 blood level.
Methods: Patients between the ages of 3 and 17 years who were first diagnosed with ADHD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria were approached for this study. Patients who were on vitamin B12 deficiency treatment were excluded from the study. All patients were divided into two groups: low and high socioeconomic status. The catchment area of Mersin State Hospital consists of low-income families. The low socioeconomic status group involved 350 patients who were chosen from Mersin State Hospital, while the high socioeconomic status group involved 253 patients from Mersin University Hospital. Cut-off points for the diagnosis of vitamin B12 deficiency were determined 187 pg/ml for Mersin State Hospital and 197 pg/ ml for Mersin University Hospital. PASW v.18 program was used in the statistical analyses. Independent Samples t test was applied for comparing the groups in terms of continuous variables. Chi-square or Fisher’s Exact were applied for categorical variables.
Results: The sample consisted of 603 children and adolescents (412 boys, 191 girls) between 3 and 17 years of age (mean±SD=10.10±3.45 for the state hospital, mean±SD=9.89±3.30 for the university hospital). In this study, there were no differences in B12 blood levels by gender. In the high socioeconomic group, B12 blood levels were detected to be higher than in the low socioeconomic group. There were positive correlations between socioeconomic level and vitamin B12 blood level. Vitamin B12 deficiency in Mersin State Hospital (16.3%) was seen more common than at Mersin University (5.1%).
Conclusion: This report emphasizes the importance of assessment of vitamin B12 in ADHD patients. A study in general psychiatric inpatients reports the incidence of vitamin B12 deficiency to be 4–6%. Omega-3, vitamins and minerals have been linked to developmental outcomes including attention deficit hyperactivity disorder. Adolescents who have a borderline level of vitamin B12 can develop signs of cognitive changes. A combined vitamin, mineral, amino acid treatment may be effective in improving attention and self-control in children with ADHD. Vitamin B12 deficiency which is one of the preventable and treatable medical condition, must be given attention especially in ADHD patients with low socioeconomic status. It can be useful to investigate vitamin B12 deficiency for patients with an ADHD diagnosis and treatment process.