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Iron deficiency and internalizing symptom severity in unmedicated adolescents: a pilot study

Published online by Cambridge University Press:  16 December 2021

Malak Abbas ,
Kellen Gandy ,
Ramiro Salas ,
Sridevi Devaraj  and
Chadi A. Calarge
Malak Abbas
Affiliation:
The Rockefeller University, New York, NY 10065, USA
Kellen Gandy
Affiliation:
St. Jude Children's Research Hospital, Houston, Texas 77027, USA
Ramiro Salas
Affiliation:
Baylor College of Medicine – Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston, Texas 77030, USA
Sridevi Devaraj
Affiliation:
Baylor College of Medicine, Houston, Texas 77030, USA
Chadi A. Calarge*
Affiliation:
Baylor College of Medicine – The Menninger Department of Psychiatry and Behavioral Sciences, 1102 Bates Ave, Suite 790, Houston, Texas 77030, USA
*
Author for correspondence: Chadi A. Calarge, E-mail: chadi.calarge@bcm.edu
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Abstract

Background

Iron plays a key role in a broad set of metabolic processes. Iron deficiency is the most common nutritional deficiency in the world, but its neuropsychiatric implications in adolescents have not been examined.

Methods

Twelve- to 17-year-old unmedicated females with major depressive or anxiety disorders or with no psychopathology underwent a comprehensive psychiatric assessment for this pilot study. A T1-weighted magnetic resonance imaging scan was obtained, segmented using Freesurfer. Serum ferritin concentration (sF) was measured. Correlational analyses examined the association between body iron stores, psychiatric symptom severity, and basal ganglia volumes, accounting for confounding variables.

Results

Forty females were enrolled, 73% having a major depressive and/or anxiety disorder, 35% with sF < 15 ng/mL, and 50% with sF < 20 ng/mL. Serum ferritin was inversely correlated with both anxiety and depressive symptom severity (r = −0.34, p < 0.04 and r = −0.30, p < 0.06, respectively). Participants with sF < 15 ng/mL exhibited more severe depressive and anxiety symptoms as did those with sF < 20 ng/mL. Moreover, after adjusting for age and total intracranial volume, sF was inversely associated with left caudate (Spearman's r = −0.46, p < 0.04), left putamen (r = −0.58, p < 0.005), and right putamen (r = −0.53, p < 0.01) volume.

Conclusions

Brain iron may become depleted at a sF concentration higher than the established threshold to diagnose iron deficiency (i.e. 15 ng/mL), potentially disrupting brain maturation and contributing to the emergence of internalizing disorders in adolescents.

Keywords

Adolescentsanxiety disordersbasal gangliaferritiniron deficiencymajor depressive disorder
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 6 , April 2023 , pp. 2274 - 2284
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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