Acute Psychosis as Presenting Symptoms of Vitamin B12 Deficiency: A Case Series

Vitamin B12 deficiency is a prevalent condition affecting a significant proportion of India's population, with implications for mental health. Despite its established link to psychiatric symptoms, vitamin B12 deficiency often remains underdiagnosed. The aim of this study is to highlight the association between vitamin B12 deficiency and acute psychosis, emphasizing the importance of early detection and treatment.

This is a retrospective case series with inclusion criteria of diagnosis of Acute and Transient Psychotic Disorder (ATPD) and associated vitamin B12 Deficiency over the past five years. Patients with comorbid psychiatric illnesses and substance use other than nicotine, hematological and neurological symptoms associated with vitamin B12 deficiency and significant life stressors prior to onset of illness were excluded from the study. A review of electronic medical records of all these patients was done. Out of these patients, eight cases satisfied the study selection criteria.

Sociodemographic, investigation, and treatment details of all eight patients are presented. All of them received low-dose antipsychotics and vitamin B12 replacement therapy, resulting in significant improvement. Vegetarian dietary habits were identified as a common risk factor.

Vitamin B12 deficiency can manifest solely as ATPD, particularly in individuals following vegetarian diets. Early detection and treatment are crucial to prevent irreversible psychiatric and neurological damage. Routine vitamin B12 level assessments are recommended in patients with mental and psychiatric disturbances.