الفهرس 
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Abstract
I
n addition to the long known critical function of vitamin D in calcium metabolism and its role in proliferation, differentiation and immunomodulation, there is a handful of evidence that vitamin D plays an important role for brain and nervous system health and disease (De Luca et al., 2013).
For instance, vitamin D is the only vitamin listed as a hormone and assists in the absorption of calcium and activates genes that regulate the immune system and releases neurotransmitters that affect brain function and development.
Fifteen years ago it was suggested that vitamin D was the “forgotten neurosteroid” (McGrath et al., 2001).
Vitamin D deficiency, diagnosed when the serum 25-hydroxyvitamin D (calcidiol, 25(OH)D3) concentration is less than 20 ng/ml, is highly prevalent worldwide and thought to potentiate a variety of chronic disease states, including diabetes, cancer, and depression.
In the last few years, many reports demonstrating an important role for vitamin D in brain development and functions and aetiopathogenesis of neuropsychiatric disorders have been published (Eyles et al., 2012; Harms et al., 2011; McCann and Ames, 2008).
Studies from around the world have shown that vitamin deficiencies may have a profound effect on how the medications themselves are absorbed in our brain and how the key chemicals that keep one stable may be severely compromised when there is a deficiency in one or multiple hormones in our bodies (Greenblatt, 2018).
Vitamin D deficiency can also contribute to development of depression and anxiety disorders (Anglin et al., 2013; Berk et al., 2007; Bertone-Johnson, 2009; Bicikova et al., 2015; Milaneschi et al., 2013).
In contrast to the reports on vitamin D association with depression, fewer contributions have been published on the association of obsessive-compulsive disorder with the levels of vitamin D (Armstrong et al., 2007).
Some of them even deny the relation of vitamin D deficiency with anxiety or stress (Black et al., 2014).
Aim of the work:
1- This study aims to investigate vitamin D serum level in patients diagnosed with obsessive-compulsive disorder (OCD)
2- Comparing patients to healthy controls regarding vitamin D serum level, sociodemographic factors and clinical correlation
3- The correlation of OCD symptoms and severity with vitamin D serum level.
Patients and methods:
Study design:
This is a Case-Control study conducted in the outpatient Psychiatric clinic, institute of psychiatry, Ain Shams University
Subjects:
The targeted population are Obsessive Compulsive Disorder patients, to be diagnosed by Structured Clinical Interview for DSM-IV Axis 1, symptoms and severity were assessed using Yale-Brown Obsessive Compulsive scale, serum vitamin D level was assessed by blood sample which is compared to that of healthy controls group equal in age and sex.
Criteria for selection:
Inclusion criteria:
1- Males
2-Age ranging from 18-40 years old
Exclusion criteria:
-Females
-Other psychiatric disorders
Methods:
• This study was approved from the ethical committee of neuropsychiatry department, faculty of medicine, Ain Shams University.
• Selected patients agreed to the informed consent provided for participation in the study
• Patients were diagnosed with Obsessive Compulsive Disorder using Structured Clinical Interview for DSM-IV Axis 1
• Types of obsessions, compulsions and severity of symptoms were assessed using Yale-Brown Obsessive-Compulsive scale
• Blood sample was taken from patients to assess Vitamin D serum level
• Blood samples were taken from healthy controls equal to patients group in age and gender
• Comparing Vitamin D serum level in patients to healthy controls
• Correlating Vitamin D serum level to symptoms and its severity in patients
Results:
Our study shows that both case and control groups (25 participants each) are equal in gender and age as they are of only males gender with nearly equal age group (27.04 ± 3.91) for control group and (28.68 ± 7.11) for case group.
Regarding smoking 17 (68%) of controls were non-smokers while 8(40 %) of cases were smokers with no other special habits of medical importance while for controls 10 (40%) are non-smokers with 15 (60%) are smokers.
In controls 19(76%) were highly educated while 6(24%) were middle level of education while in cases17 (68%) were highly educated, 6(24%) were of middle education and 2(8%) below middle education.
Regarding marital status 10(40%) are married while 15(60%) are single. In controls while in cases 13 (52%) are married, 11(44%) are single, 1(4%) are divorced.
Our study does not show statistically significant relation between age, gender,smoking or marital status to vitamin D level.
But there was a statistically significant between vitamin D and level of education.
Case group are diagnosed as OCD while control groups were not found having any obsessive symptoms using SCID I.
Our study shows that there is statistically significant difference between cases and controls regarding vitamin D level as mean vitamin D level in control group was (21.14 ± 8.78) ranging from (5-40) with 10 (40.0%) participants with deficient vitamin d level, 13 (52.0%)participants with insufficient vitamin D level and 2 (8.0%) participants with sufficient vitamin D level while mean vitamin D level in case group was (16.08 ± 6.61) ranging from (6.5-30) with 18 (72.0%) participants with deficient vitamin D level, 7 (28.0%) participants with insufficient vitamin D level, with no participants having sufficient levels.
Our study shows that participants of case group are having range of obsessions 1-2 while having 0-2 compulsions and for severity 2 (8%) participants have extremely severe symptoms, 9 (36%) have severe symptoms, 10 (40%) have moderate severity, 4 (16%) have mild symptoms with no participants with very mild severity.
Our study does not show statistically significant relation regarding vitamin D level and OCD symptom severity
Our study does not show statistically significant difference between participants of case group with low vitamin D levels (deficient and insufficient) in relation to OCD symptoms and severity.
CONCLUSION
F
rom the findings of the present study, we can conclude that there is a relation between low vitamin D serum level and Obsessive compulsive disorder.
We didn’t find a relation between vitamin D serum level, symptoms or severity of Obsessive compulsive disorder.