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BMC Psychiatry. 2019 Oct 22;19(1):305. doi: 10.1186/s12888-019-2269-2.

Serum folate levels in bipolar disorder: a systematic review and meta-analysis.

Author information

1
Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, No.130, Kaisyuan 2nd Rd., Lingya Dist, Kaohsiung City, 802, Taiwan.
2
Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, No.130, Kaisyuan 2nd Rd., Lingya Dist, Kaohsiung City, 802, Taiwan. edcrfvm45@gmail.com.
3
WinShine Clinics in Specialty of Psychiatry, Kaohsiung City, Taiwan. ducktseng@gmail.com.
4
Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan. ducktseng@gmail.com.

Abstract

BACKGROUND:

Bipolar disorder (BD) is a major psychiatric illness, however its physiopathology is unclear. The role of folate in the physiopathology of BD is controversial. We conducted this systematic review and meta-analysis to investigate the effect of folate in BD patients.

METHODS:

We performed a thorough literature study of the PubMed, Embase, ScienceDirect, ClinicalKey, Cochrane Library, ProQuest, Web of Science, and ClinicalTrials.gov databases until December 21st, 2018. Random effects meta-analysis was conducted.

RESULTS:

Six articles involving 481 patients with BD and 760 controls were included. The meta-analysis results suggested that serum folate levels in the patients with BD were significantly lower than those in the controls (Hedges' g = - 0.211, 95% confidence interval = - 0.391 to - 0.031, p = 0.021).

CONCLUSION:

The current meta-analysis show it might be association between lower serum folate levels and patient with BD. However, we could not distinguish the potentially confounding effects of mood states on the folate levels. Further prospective studies including subjects with different mood states and possible physiopathology are warranted to investigate the association between folate deficiency and the etiology of BD.

KEYWORDS:

Biomarker; Bipolar disorder; Folate; Folic acid; Meta-analysis

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