Abstract
Objective: Aim of this study was to investigate relation between serum 25 (OH) vitamin D or B12 levels and depressive symptoms in children and adolescents with tension-type headache (TTH).

Methods: Electronic records of children and adolescents diagnosed with TTH in a training and research hospital child neurology department between March 2018 and August 2018 were retrospectively reviewed. Among them, subjects with depression diagnosed based on DSM-5 criteria and its symptoms obtained via Children depression inventory (CDI) and Beck depression inventory (BDI) found in records were collected. Vitamin D deficiency is defined if its serum levels are below 20 ng/mL, and Vitamin B12 deficiency as below 203 pg/mL. SPSS 17.0 was used for analyses and p<.05 was considered as significant.

Results: Of 74 subjects with TTH were included. Mean age of all was 14.3 years (9-17) and 81.1% of all were girls. Of 16.2% of them had depression based on DSM-5 criteria. The mean CDI scale was 12.9 (2-32) and BDI scale was 19.3 (9-40). Mean serum level of vitamin D was 14.4 ng/mL (range= 3.80-46.6 ng/mL) and 73% of them had Vitamin D deficiency. Mean serum vitamin B12 levels were 291.3 pg/mL (range= 123.5-792) and 20.3% of them had its “deficiency”. There was no significant relation between vitamin deficiencies and having depression or being adolescent (for all variables p>.05). There was also not any significant correlation between two vitamin levels and depressive symptoms based on CDI and BDI. There was, however, a relation between being girl and vitamin deficiencies, which 88.9% of all vitamin D deficient cases (48/54, 2(1) = 7.192, p = .016, Fisher’s exact test), and 60% of vitamin B12 deficient subjects (9/15, 2(1) = 5.451, p = .030, Fisher’s exact test) were girls. Correlation analyses revealed that age (years) has significant negative correlation with vitamin B12 (Spearman rho=-.352, p= .002), and positive correlation with CDI (Spearman rho=.282, p=.039). There was another negative correlation found between vitamin D and BDI (Spearman rho=-.499, p=.041).

Conclusions: Girls with TTH would be evaluated for vitamin D and B12 levels. Being adolescents might have effect on vitamin B12 intake and on depression symptoms.

Key words: TTH, vitamin D, B12, adolescent, depression, DSM-5