Vitamin B12 and folate deficiencies, elevated homocysteine and their roles in the biochemical basis of neuropsychiatric diseases in children and adolescents: Case series, review and recommendations

Abstract

Vitamin B12 and folate deficiencies can be frequently seen in children and adolescents and may manifest with neuropsychiatric symptoms. Vitamin B12 and folate deficiencies and the associated increase in homocysteine are related to one-carbon metabolism (OCM) and may play a role in the pathogenesis of childhood and adolescent psychiatric disorders. Therefore, a case series and review on OCM will be presented here. Twelve cases with vitamin B12 and folate deficiency and increased homocysteine among those admitted to the child and adolescent psychiatry clinic were retrospectively examined. It was found that vitamin B12 and folate deficiency and increased homocysteine may cause depressive symptoms, anxiety disorders, obsessive compulsive disorder, anger control problems, self-harming behaviors, suicidal thoughts and attempts in children and adolescents. According to these data, vitamin B12 and folate deficiency and the resulting increase in homocysteine may cause psychiatric symptoms in some children and adolescents. In addition, literature on OCM has been reviewed. The diagnosis and treatment methods for vitamin B12 and folate deficiencies are summarized for clinicians.