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Frequency Of Depression In Patients With Vitamin B12 Deficiency

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Fatima A, Shah F, Khan HS, Rauf K, Ali S, Khan SA. Frequency Of Depression In Patients With Vitamin B12 Deficiency. JRMC [Internet]. 2023 Jun. 24 [cited 2024 Mar. 2];27(2). Available from:


Objective: To determine the frequency of depression in patients with vitamin B12 deficiency.

Methodology: This cross-sectional study was carried out from January 2020 to March 2021 on a total sample size of n=100 patients (age 49.84 ± 0.91 years) using a simple random sampling technique, visiting the medical department of the federal government polyclinic hospital, in Islamabad. Patients presenting with macrocytic anaemia secondary to vitamin B12 deficiency were included while the patients with previously diagnosed depression were excluded from the study. Serum vitamin B12 levels were measured through the ELISA technique. Patient Healthcare Questionnaire-9 (PHQ-9) was designed and presented to patients with vitamin B12 deficiency for depression assessment. Patients with PHQ-9 score ≤5 were rated as having no depression and the patients with score ≥5 were rated as having depression. Data were analyzed using GraphPad Prism and the correlation coefficient was measured through non-linear fit and linear regression curves while ordinary ANOVA (non-parametric) was applied for study variables.

Results: The average level of vitamin B12 in the serum and PHQ-9 score were recorded as 158 ± 4.94 (pg/uL) and 5.85 ± 0.30, respectively. Vitamin B12 levels and PHQ-9 score depicted an inverse correlation, however, no association was found between gender and PHQ-9 score.

Conclusion: Data depicted that the patients presenting low levels of vitamin B12 in their serum have shown corresponding high PHQ-9 scores which is an indicator of depression. However, depression prevails in all age groups without any discrimination of gender.


Denissen KF, Heil SG, Eussen SJ, Heeskens JP, Thijs C, Mommers M, et al. Intakes of vitamin B-12 from dairy food, meat, fish and shellfish are independently and positively associated with vitamin b-12 biomarker status in pregnant Dutch women. 2019;149(1):131-8. DOI:

Markun S, Gravestock I, Jäger L, Rosemann T, Pichierri G, Burgstaller JMJN. Effects of vitamin B12 supplementation on cognitive function, depressive symptoms, and fatigue: a systematic review, meta-analysis, and meta-regression. 2021;13(3):923. DOI:

Sangle P, Sandhu O, Aftab Z, Anthony AT, Khan SJC. Vitamin B12 supplementation: preventing the onset and improving prognosis of depression. 2020;12(10). DOI:

Cicero A, Minervino AJERMPS. Combined action of SAMe, Folate, and Vitamin B12 in the treatment of mood disorders: a review. 2022;26(7):2443-59. DOI:

Khosravi M, Sotoudeh G, Amini M, Raisi F, Mansoori A, Hosseinzadeh MJBp. The relationship between dietary patterns and depression mediated by serum levels of Folate and vitamin B12. 2020;20(1):1-8. DOI:

O’Connor DM, Laird EJ, Carey D, O’Halloran AM, Clarke R, Kenny R, et al. Plasma concentrations of vitamin B12 and folate and global cognitive function in an older population: cross-sectional findings from The Irish Longitudinal Study on Ageing (TILDA). 2020;124(6):602-10. DOI:

Dhiman P, Pillai RR, Wilson AB, Premkumar N, Bharadwaj B, Ranjan VP, et al. Cross-sectional association between vitamin B12 status and probable postpartum depression in Indian women. 2021;21(1):1-11. DOI:

Tan Y, Zhou L, Huang J, Chen X, Wu Y, Song X, et al. Vitamin B12, Folate, Homocysteine, Inflammatory Mediators (Interleukin-6, Tumor Necrosis Factor-α and C-Reactive Protein) Levels in Adolescents with Anxiety or Depressive Symptoms. 2023:785-800. DOI:

Azzini E, Raguzzini A, Polito AJIjoms. A brief review on vitamin B12 deficiency looking at some case study reports in adults. 2021;22(18):9694. DOI:

Sahu P, Thippeswamy H, Chaturvedi SK. Neuropsychiatric manifestations in vitamin B12 deficiency. Vitamins and Hormones. 119: Elsevier; 2022. p. 457-70. DOI:

Amin M, Jahan Sardar MN, Huma S, Gulzar M, Rasheed M, Khan MIJPJoM, et al. Frequency of Vitamin B12 Deficiency Amongst Elderly Patients Presenting with Dementia. 2022;16(06):705-. DOI:

Gupta K, Mamidi PJIJoY-P, Psychology, Parapsychology. Pitru grahonmada: Vitamin B12 deficiency-induced neuropsychiatric manifestations? 2021;9(2):59. DOI:

Yeum T-S, Maggiolo NS, Gupta CT, Davis BJ, Nierenberg AA, Sylvia LGJPA. Adjunctive nutrition therapy for depression. 2019;49(1):21-5. DOI:

Riley RD, Ensor J, Snell KI, Harrell FE, Martin GP, Reitsma JB, et al. Calculating the sample size required for developing a clinical prediction model. 2020;368. DOI:

Feraco P, Incandela F, Franceschi R, Gagliardo C, Bellizzi MJPR. Clinical and brain imaging findings in a child with vitamin B12 deficiency. 2021;13(4):583-8. DOI:

Jain JK, Sharma G, Bhatt D, Bairwa AL, Meena ILJIJoCH. Study of clinical profile of infantile tremor syndrome and its correlation with serum Vitamin B12 level. 2019:345-8. DOI:

Ryan KM, Allers KA, Harkin A, McLoughlin DMJB, Behavior,, Immunity-Health. Blood plasma B vitamins in depression and the therapeutic response to electroconvulsive therapy. 2020;4:100063. DOI:

Jeffries M. Vitamin Deficiency and Depression. 2021. DOI:

Jaffe DH, Rive B, Denee TRJBp. The humanistic and economic burden of treatment-resistant depression in Europe: a cross-sectional study. 2019;19(1):1-11. DOI:

Greenberg PE, Fournier A-A, Sisitsky T, Simes M, Berman R, Koenigsberg SH, et al. The economic burden of adults with major depressive disorder in the United States (2010 and 2018). 2021;39(6):653-65. DOI:

Bailey RK, Mokonogho J, Kumar AJNd, treatment. Racial and ethnic differences in depression: current perspectives. 2019;15:603. DOI:

Keyes KM, Gary D, O’Malley PM, Hamilton A, Schulenberg JJSp, epidemiology p. Recent increases in depressive symptoms among US adolescents: trends from 1991 to 2018. 2019;54(8):987-96. DOI:

Maser B, Danilewitz M, Guérin E, Findlay L, Frank EJAM. Medical student psychological distress and mental illness relative to the general population: a Canadian cross-sectional survey. 2019;94(11):1781-91. DOI:

García-Montero C, Ortega MA, Alvarez-Mon MA, Fraile-Martinez O, Romero-Bazán A, Lahera G, et al. The problem of malnutrition associated with major depressive disorder from a sex-gender perspective. 2022;14(5):1107. DOI:

Islam M, Disu TR, Farjana S, Rahman MMJBg. Malnutrition and other risk factors of geriatric depression: a community-based comparative cross-sectional study in older adults in rural Bangladesh. 2021;21(1):1-11. DOI:

Arévalo SP, Scott TM, Falcón LM, Tucker KLJNn. Vitamin B-6 and depressive symptomatology, over time, in older Latino adults. 2019;22(9):625-36. DOI:

Skarupski KA, Tangney C, Li H, Ouyang B, Evans DA, Morris MCJTAjocn. Longitudinal association of vitamin B-6, folate, and vitamin B-12 with depressive symptoms among older adults over time. 2010;92(2):330-5. DOI:

Ridley M, Rao G, Schilbach F, Patel VJS. Poverty, depression, and anxiety: Causal evidence and mechanisms. 2020;370(6522): eaay0214. DOI:

Smith MV, Mazure CMJARoCP. Mental health and wealth: depression, gender, poverty, and parenting. 2021;17:181-205. DOI:

Kamrava SK, Tavakol Z, Talebi A, Farhadi M, Jalessi M, Hosseini SF, et al. A study of depression, partnership and sexual satisfaction in patients with post-traumatic olfactory disorders. 2021;11(1):20218. DOI:

Cho Y, Lee JK, Kim D-H, Park J-H, Choi M, Kim H-J, et al. Factors associated with quality of life in patients with depression: A nationwide population-based study. 2019;14(7):e0219455. DOI:

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