Stewart & Lewis Reference Stewart and Lewis1 have shown that adolescent psychiatric in-patients typically have vitamin D deficiency and hypothesise that this may be due to reduced exposure to sunlight. This may well be true, but it is much more likely that the reduced vitamin D levels are due to changes in the immune system linked with psychiatric disorders. For example, it is now well known that depression is associated with inflammation Reference Berk, Williams, Jacka, O'Neill, Pasco and Moylan2 and that immune markers are typically raised. What is less well known is that vitamin D is a negative acute-phase reactant, Reference Waldron, Ashby, Cornes, Bechervaise, Razavi and Thomas3 which means that its levels drop in response to inflammation. Therefore, a low level may not indicate a deficiency, but rather the presence of inflammation. It would be interesting to reanalyse the data and see whether there are any links with particular diagnoses.
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