Osteomalacia and vitamin D deficiency in a psychiatric rehabilitation unit: case report and survey
Rudolf N Cardinal1, Carol A Gregory
1Behavioural and Clinical Neurosciences Institute and Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK. rudolf.cardinal@pobox.com
Background:
Vitamin D deficiency is common and predisposes to many serious diseases, yet often goes unrecognized.
Findings:
We describe a case of severe vitamin D deficiency with osteomalacia in a patient resident in a psychiatric hospital for more than 35 years, and discuss causes and complications. We assayed the serum 25-hydroxyvitamin D levels of all patients under our care on one old-age psychiatry rehabilitation unit. Ten of twelve (83%) of patients had vitamin D deficiency, and 92% had suboptimal vitamin D levels. Vitamin D status was strongly predicted by dietary supplementation. Of those not on vitamin D supplements, 100% had vitamin D deficiency, with vitamin D levels significantly below those of historical controls. Age, sex, and duration of admission did not predict vitamin D status in this group.
Conclusion:
We advocate vitamin D screening in all patients admitted to psychogeriatric units, and discuss treatment options given the current problems affecting high-dose vitamin D supply to the United Kingdom.
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