Study: fish oil prevents psychosis
Study: fish oil prevents psychosis
Reference
Amminger GP, Schäfer MR, Schlögelhofer M, Klier CM, McGorry PD. Long-term outcome in the prevention of psychotic disorders from the Viennese Omega-3 study. nat commun . 2015; 6: 7934.
Design
Long-term follow-up of a randomized, double-blind, placebo-controlled study
participant
81 people seeking treatment were included in the study; 41 were assigned to the experimental Pufa Group and 40 of a placebo group. At the beginning of the first study, the participants were 13 to 25 years old (average age 16.4) and met the criteria for one or more of the 3 groups of risk factors for psychoses: "weakened positive psychotic symptoms; temporary psychosis; and/or genetic risk plus functional reduction." Both treatment groups were comparable in terms of age, gender, body mass index (BMI), recording criteria for the study, consumption of illegal drugs, psychiatric symptoms and functionality as well as erythrocyte fatty acid levels. The patients were blinded, randomized and judged after 4, 8 and 12 weeks and then checked after the 12-week treatment for 6 months, 12 months and 7 years after the start of the course.
medication and dosage study
Fish oil capsules with 700 mg eicosapentaen acid (EPA) and 480 mg Docosahexaenoic acid (DHA) per day for 12 weeks compared to placebo.
target parameter
Primary endpoint was the conversion to a psychotic disorder. Secondary endpoints were dimensions of psychosocial functionality.
The positive and negative syndrome scale (panns) and the Montgomery-Asberg Depression rating scale were used to examine psychiatric symptoms. The Global Assessment of Functioning (GAF) Score was used as a measure of functionality, and the DSM-IV-TR Axis I Disorders (SCID-I/P) was used to make psychiatric diagnoses. The primary endpoint of the study was the conversion into a psychiatric disorder with persistent symptoms for at least one week. The exit criteria marked the threshold, from which treatment with antipsychotic drugs began.
important knowledge
This data was previously published. This publication showed that during the first 12-month follow-up observation, the risk of progressing a psychotic disorder in study participants who received fish oil was reduced. This current report comes to a median of 6.7 years after the initial intervention.
Seventy-one (87.7 %) People were successfully followed by the 7-year brand to Baseline. The cumulative conversion rate in psychosis in long-term follow-up was 9.8 % (4/41 in the Omega-3 group) and 40 % (16/40 in the placebo group). The difference between the groups in the cumulative risk of progression was 30.2 % (95 % confidence interval).
Psychosocial function was measured as a secondary end point, regardless of the conversion into a psychosis. In 69 people (85.2 %, 69/81), a GAF score could be determined as a functional at the end of the study. The Omega-3 group had a significantly better function compared to the placebo group, measured by the long-term aftercare examinations.
practice implications
The understanding of the complexity of diagnosis, treatment and prevention of psychotic disorders continues to present doctors for challenges. Early intervention was associated with better results in both risk opists and patients with a new diagnosis. Earlier studies on neuroanatomical changes that have been observed in endangered people who progress to psychotic conditions show an active biological process that increases the possibility of understanding the critical role of intervention therapies, in particular the role of nutrition, in preventing psychotic symptoms.
More than 40 % of all people with the diagnosis of schizophrenia end up in supervised group accommodation, nursing homes or hospitals.
Despite the fact that schizophrenia affects only about 1 % of the US population-about three times as many people suffer from Parkinson's disease-the economic burden of this disease is considerable: an estimated $ 60 billion a year. 1 This is largely due to the fact that it is a disease that is typically in adolescence or in the early Adulthood manifested. More than 40 % of all people with the diagnosis of schizophrenia end up in supervised group accommodation, nursing homes or hospitals. Another 6 % end up in prison and an equal share ends up on the street.
schizophrenia is characterized by hallucinations, delusions and cognitive problems. While the majority of the people affected experience a slow or gradual beginning clinically significant symptoms, some of them are abrupt. Apart from the fact that their mental health is affected, people with schizophrenia often die more than a decade earlier than the general population of complications that are largely due to cardiometabolic diseases.
Since the use of antipsychotics for the prevention of psychotic disorders is at best controversial, and exploring clinicians continue to seek new therapeutic agents. Although early treatment strategies are associated with better results, current treatments focus on controlling symptoms with drugs instead of preventing their development. A recently carried out meta -analysis of 2,502 risk operations showed that the cumulative rate of transition to psychosis increased over time, whereby 18 %, 22 % and 36 % of a psychotic disorder after 6 months, 1, 2 and 2 made an early intervention of crucial importance.
In the past two decades, clinicians and researchers have tirelessly worked on identifying people with protromal symptoms of psychosis. This clinical syndrome has been referred to as a "mental risk state", and criteria for "ultra -hole risk" were developed to help identify young people in whom there is a high risk of developing psychosis. Current research strategies focus on risk opera, which often develop psychosis after the first 24 months of the initial presentation if the risk of transition to a psychotic state is greatest. In this time window, nutrition intervention can be the key to prevention.
This is not the first time that we see data from this cohort. The first report on this study with omega-3 fatty acids compared to placebo in a 12-week intervention study. It is assumed that the positive clinical effect of polyunsaturated fatty acids (PUFAS) is corrected by a defect. It has been shown that the cell membrane barriers are reduced from both omega-3 and omega-6-pufas in patients with schizophrenia compared to a healthy population.
Since antipsychotic drugs can be used to assess the severe psychotic phenomena, this study examined the proportion of people in the study that medication had to be prescribed. The percentage of the people who needed antipsychotics during the follow-up examination was 29.4 % (10/34) in the Omega-3 group and 54.3 % (19/35) in the placebo group. Only 2 people in the Omega-3 group stated that they had taken fish oil capsules for more than 1 month during the follow-up period, which indicates that early nutritional intervention and not continuing treatment are the key to the success of treatment. The initial 12-week intervention played an important role in preventing the transition to a fully threshold psychotic disorder and also led to a persistent symptomatic and functional improvement.
This study as well as previous studies on omega-3 fatty acids and psychoses show the potential of long-chain pufas as a safe and effective strategy for the prevention of psychotic conditions in risk opera. In view of the fact that Omega-3-Pufas have no clinically significant side effects and generally regarded as health-promoting, supplementation with omega-3 fatty acids should be regarded as ideal early nutrition intervention.
- What is schizophrenia? Website of the National Institute for Mental Health. (Link away). Accessed on November 2, 2015.
- Correll Cu, Robinson DG, Schooler No., et al. Cardiometabolic risk in patients with first pisodes of schizophrenia spectrum diseases: Baseline results from the Raise ETP study. Jama Psychiatry . 2014; 71 (12): 1350-1363.
- Fusar-Poli P., Bonoldi I., Yung Ar, et al. Prediction of psychoses: meta -analysis of transition results in people with high clinical risk. Arch gen psychiatry . 2012; 69 (3): 220-229.
- Amminger GP, Schäfer MR, Papageorgiou K, et al. Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: a randomized, placebo-controlled study. Arch gen psychiatry . 2010; 67 (2): 146-154.