A Chart Review Comparison of Rates of Abnormal Vitamin D Results in New Zealand & United States Mental Health Samples

Kopacz, D.; Traxler, M.P.; Karatela, S.
Published in Mental Health in Family Medicine 2016: Volume 12, Issue 3


Background: Epidemiological studies have shown associations between vitamin D and its role in improving health outcomes. Vitamin D levels vary according to sun exposure and skin pigmentation. While there is little doubt that vitamin D levels effect bone health, there has been controversy and growing interest in the role of vitamin D in mental health population. 

Objective: The purpose of this study was to identify and compare vitamin D levels within the mental health population using samples from a United States city, Champaign, Illinois, and a New Zealand city, Auckland. 

Method: A retrospective chart review of 64 participants was conducted within two mental health clinics (Champaign, Illinois, United States: n=32; Auckland, New Zealand: n=32). 25-hydroxyvitamin vitamin D concentration was obtained through blood samples within this population. 

Results: New Zealand patients had lower levels of vitamin D than United States patients (p = .0017), but this difference appears to be due to differences in skin pigmentation between the two samples. Within the New Zealand sample, people with higher pigmentation had lower vitamin D levels (p < .001) than those with lower pigmentation. Among higher pigmented individuals, 87% (New Zealand laboratory Guidelines) and 100% (United States laboratory Guidelines) had vitamin D abnormalities. Even amongst New Zealand lower pigmented individuals, 47% (New Zealand laboratory Guidelines) or 65% (United States laboratory Guidelines) had vitamin D abnormalities.

Conclusion: High levels of vitamin D abnormalities were found in two ambulatory mental health populations in two different hemispheres, Champaign, Illinois, United States and Auckland, New Zealand. Any degree of skin pigmentation beyond Caucasian was associated with greater vitamin D deficiency. The implications of these findings for the mental and physical health of mental health patients with abnormal vitamin D levels remain unknown, but highlight a discrepancy between lab guidelines and abnormal test results.