Abstract
BACKGROUND: Adolescent mental health disorders represent a growing concern in India, with potential links to nutritional factors remaining underexplored. OBJECTIVE: This pilot study aimed to investigate the association between micronutrient deficiencies (vitamin B12, ferritin, folate, vitamin D, and calcium) and psychosocial impairment (defined as Youth Pediatric Symptom Checklist (Y-PSC) score ≥30) among Indian adolescents attending a tertiary care hospital in Delhi. METHODS: A cross-sectional analytical study was conducted over six months at a tertiary care hospital in Delhi. A total of 96 adolescents aged 11-18 years were enrolled through consecutive sampling. Psychosocial functioning was assessed using the Y-PSC, with scores ≥30 indicating impairment. Venous blood samples were analyzed for hemoglobin, serum ferritin, vitamin B12, folic acid, 25-hydroxyvitamin D, and total calcium levels. RESULTS: Psychosocial impairment was found in 15.6% (15/96) of participants. Adolescents with psychosocial impairment (n=15) had significantly lower mean serum vitamin B12 levels (191.86±63.00 pg/mL) compared to those without impairment (291.09±207.02 pg/mL), with P=0.039 for vitamin B12. Median serum ferritin levels were significantly lower in the impaired group (28.50 ng/mL, IQR: 21.00-42.00) compared to the non-impaired group (45.00 ng/mL, IQR: 24.00-78.00; Mann-Whitney U test, P=0.041). Vitamin B12 deficiency was present in 80% (12/15) of adolescents with psychosocial impairment versus 23.4% (19/81) in those without impairment (P<0.001). In unadjusted analyses, both vitamin B12 deficiency (OR=13.11; 95% CI: 3.35-51.28; P<0.001) and lower ferritin levels were significantly associated with psychosocial impairment. Multivariable logistic regression analysis identified vitamin B12 as significantly associated with psychosocial impairment (OR=0.985; 95% CI: 0.972-0.997; P=0.017), while the association with ferritin did not reach statistical significance in the adjusted model (OR=0.976; 95% CI: 0.948-1.004; P=0.098). CONCLUSIONS: Preliminary associations were observed between psychosocial impairment and deficiencies in vitamin B12 and ferritin among Indian adolescents in this pilot study. While causality cannot be established from this cross-sectional design, these findings suggest the potential value of incorporating micronutrient screening into routine psychosocial assessments and warrant further investigation in larger, adequately powered prospective studies.