Food and Behaviour Research

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20 Aug 2015 - Medscape - Omega-3 Treatment Shows Long-term Psychosis Prevention

by Nancy A. Melville

FAB RESEARCH COMMENT:

The findings from thie long-term follow-up study of young people at very high risk for psychosis, who were treated seven years ago for just 12 weeks with either long-chain omega-3 fatty acids or placebo, are nothing short of astounding. For full details of this research, see
Not only did omega-3 supplementation for 12 weeks appear to protect these young people from developing full-blown psychosis over the following 12 months, as reported in the original study.  It also appears to have protected them against developing other mental health problems over a full seven-year follow-up period.

It obviously seems rather extraordinary that such a short-term intervention could have such long-term benefits. However, in their discussion, the authors point out that adolescence is a period of extraordinary brain 'plasticity' and re-organisation. Existing evidence supports the critical importance of long-chain omega-3 in the 're-modelling' of brain connections and networks, so there is at least a plausible theoretical and mechanistic rationale.

As the authors emphasise - further randomised controlled trials are of course essential to find out if these protective effects can be confirmed. New trials are already ongoing, but will inevitably take time to complete.

In the meanwhile, given the safety and general health benefits of long-chain omega-3, there seems little reason for professionals and parents/carers not to encourage any young people showing similar problems to increase their intakes of these key nutrients.

Adolescents and young adults considered to be at high risk for psychosis show significant reductions in progression to psychotic disorder 7 years after a brief, 12-week intervention of omega-3 polyunsaturated fatty acids (PUFAs) compared with a group receiving placebo, a new study shows.

"This is the first study to show, to the best of our knowledge, that a 12-week intervention with omega-3 PUFAs prevented transition to full-threshold psychotic disorder and led to sustained symptomatic and functional improvements in young people with an at-risk mental state for [a median of] 7 years," the authors, led by G. Paul Amminger, MD, of the University of Melbourne, Australia, conclude.

The new research was published online August 11 in Nature Communications.

For the double-blind study, 81 patients (mean age, 16.5 years) who were considered to be at "ultra-high" risk for psychosis were treated for 12 weeks with daily supplementation of either fish oil capsules, providing omega-3 PUFAs of 700 mg of eicosapentaenoic acid (EPA) and 480 mg of docosahexaenoic acid (DHA) (n = 41), or placebo capsules matched in appearance and flavor with the active treatment (n = 40).

An earlier assessment of the patients at 12 months showed that those receiving the omega-3 intervention had a reduced risk for transition to psychotic disorder compared with those receiving placebo (P = .007).

In the new analysis, following up 71 of the original 81 patients at a median of 6.7 years from baseline, the cumulative conversion rate to psychosis was 9.8% in the omega-3 PUFA group, compared with 40% in the placebo group, with a more rapid conversion time in the placebo group among those who did develop psychosis (P < .0002).

Changes in scores on the Positive and Negative Syndrome Scale were significantly greater for the omega-3 PUFA group in the longer-term follow-up in terms of total scores (P = .003), positive and general scores (each P = .002), and, to a lesser degree, negative scores (P = .02).

Differences in the Montgomery-Åsberg Depression Rating Scale were not statistically significant (P = .117), and the omega-3 PUFA group had significantly higher functioning than the group receiving placebo, as reflected in Global Assessment of Functioning scores (P = .01).

The proportion of patients who reported being prescribed antipsychotic medication at the time of long-term follow-up was 29.4% in the omega-3 PUFA group, compared with 54.3% in the placebo group (P = .04).

Among those in the placebo group, 82.9% met the criteria for at least one DSM-IV Axis I disorder during the long-term follow-up period, compared with 52.9% in the omega-3 PUFA group (P = .008).

Even when ultra-high-risk patients do not convert to psychosis, research suggests their functioning outcomes can be poor. However, in looking at the patients with attenuated psychosis in the omega-3 PUFA group, only 6.7% had severe functional impairment, and as many as 70% were employed full-time, the authors note.

"The majority of the individuals from the omega-3 group did not show severe functional impairment, were employed full-time, and no longer experienced attenuated psychotic symptoms at follow- up," they note