A CONTROLLED-STUDY OF FOLATE LEVELS IN CHINESE INPATIENTS WITH MAJOR DEPRESSION IN HONG-KONG

Background: Although Western and, in particular, British studies have revealed a substantial rate of hypofolatemia in patients with depressi on, few such studies have been conducted in Asian populations. Methods : A group of 117 newly admitted inpatients with DSM-III-R major depres sion and 72 healthy controls underwent blood investigations and psycho metric assessments. Results: Patients had a significantly lower mean s erum folate level (24.6+/-10.2 vs. 30.3+/-11.4 nmol/l, P < 0.001) but a higher mean erythrocyte folate level (801.8+/-284.6 nmol/l vs. 699.5 +/-248.7 nmol/l, P < 0.01) than control subjects. No patient or contro l subjects had low folate, while only four patients (3.4%) and six con trol subjects (8.3%) had low erythrocyte folate. Folate levels were no t related to patients' age, duration of illness, Hamilton Depression R ating Scale, Beck Depression Inventory and Global Assessment Scale sco res, and prior psychotropic drug usage. Both patients and control subj ects revealed a high intake of green vegetables. Conclusion: Patients' lower serum folate level was likely to be secondary to their depressi on but, being well in the normal range, should not have aggravated the ir depressive symptoms. Culturally patterned health beliefs and dietar y practices can influence the connection between folate status:and dep ression in different societies. Limitations: Patients were not drug-fr ee, while the lack of detailed dietary analysis and longitudinal data on folate level and psychiatric outcome tempered the above conclusion. Clinical relevance: Since normofolatemia is normative in Hong Kong, t he routine screening of folate levels in Chinese depressive patients i s not indicated. However, a double-blind, placebo-controlled trial may be useful for finding out whether Chinese patients will still benefit from folate pharmacotherapy. (C) 1998 Elsevier Science B.V.