Thursday, August 13, 2015

Omega-3s May Reduce Long-Term Risk of Progression to Psychotic Disorder

A 12-week intervention with omega-3 polyunsaturated fatty acids (PUFAs) reduced the risk of transition to full-threshold psychotic disorder in young people at high risk of psychosis for seven years, according to a study published this week in Nature Communications. The findings suggest a possible longer-term prevention strategy for young people at risk of psychosis.

Omega-3s are known to play a key role in brain development and function. Nearly a decade ago, researchers from the University of Melbourne and the Medical University of Austria tracked a group of 81 adolescents and young adults (aged 13 to 25) at ultra-high risk of psychotic disorder for 40 weeks after they received fish oil capsules containing omega-3 fatty acids (700mg of eicosapentaenoic acid and 480mg of docosahexaenoic acid) or placebo daily for 12 weeks. At the end of the trial, the authors reported that the 12-week intervention reduced the transition rate to psychosis and led to significant symptomatic and functional improvements.

In the current study, the authors followed up with 71 of the original 81 study participants nearly seven years later. Based on interviews with the study participants, next of kin, and hospital records, the researchers compared the conversion rate to psychosis between those who originally took omega-3s with those who took placebo. The cumulative conversion rate to psychosis at the longer-term follow-up was 9.8% (4/41) of subjects in the omega-3 group, and 40% (16/40) of subjects in the placebo group. The difference between the groups in the cumulative risk of progression to psychosis was 30.2%.

Additional analysis revealed that the omega-3 group had significantly higher functioning than the placebo group at longer-term follow-up (based on the Global Assessment of Functioning score) and lower scores than the placebo group on all Positive and Negative Syndrome Scale measures.

“This is a well-conducted study with stunning results at year one and a carefully conducted study at seven year follow-up,” William Carpenter, M.D., a professor of psychiatry and pharmacology at the University of Maryland School of Medicine and editor of Schizophrenia Bulletin, told Psychiatric News. “If the results are valid, it will represent the most important advance related to psychosis treatment and prevention since chlorpromazine was introduced over 60 years ago.”

However, Carpenter cautioned that more research is needed to confirm the results. “Everything depends on replication, and oral presentation of preliminary results from a multi-center trial by these investigators was not encouraging,” he said. “If final analysis of the full cohort fails to support efficacy, an attempt to identify a treatment-responsive subgroup will be justified.”

For related information on treating people at high risk for psychosis, see the Psychiatric News article “Early Intervention Trial in Youth at Risk for Psychosis Shows Improved Symptoms.”

(Image: stevemart/


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