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A Chart Review Comparison of Rates of Abnormal Vitamin D
Results in a New Zealand and US Mental Health Population

Clinical Audits as New Research

Presented with Mary Pat Traxler, Ph.D. at The Royal Australian & New Zealand College of Psychiatrists
Annual Conference
Hobart, Tasmania, Australia | May 22, 2012

Abstract: RANZCP guidelines for maintaining certification in Psychiatry recommend yearly clinical practice audits. This is to assure that individual practice is consistent with evidence-based guidelines. A dilemma arises when there are no clear guidelines for specific practices. In these cases, the findings of the audits of individual clinicians can identify areas that require future research. These audit results raise the question of whether there should be routine testing of Vitamin D levels, given that the majority of clients tested had abnormal Vitamin D levels.

The current study compares retrospective clinical audits of two different mental health populations: a community mental health sample in New Zealand and a private practice sample in the United States. In the New Zealand sample of 88 clients, 32 were tested for Vitamin D, with 66% having abnormalities in Vitamin D. In the US sample of 114 clients, 32 were tested for Vitamin D, and 53% of clients had abnormal levels. These high levels of Vitamin D abnormalities could have clinical implications.

The findings of these audits raise a number of questions that require future research: do these findings differ from general population data; should Vitamin D be tested on a routine basis in mental health populations; are there subgroups who are at greater risk of Vitamin D abnormalities; what is the implication of abnormal Vitamin D levels for the physical and mental health in these populations; does correcting Vitamin D abnormalities have a positive effect on the acute and long-term physical and mental health of clients?

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