Abstract
Review question/objective What is the effectiveness of polyunsaturated fatty acids (PUFA) in reducing the clinical symptoms of paediatric bipolar disorder (PBD) in children and adolescents? The objectives of this systematic review are to: • Evaluate the effectiveness of different types of PUFA in reducing the clinical symptoms of PBD. • Evaluate the effectiveness of PUFA supplementation as either monotherapy or as adjuvant treatment to reduce clinical symptoms of PBD. Inclusion criteria Types of participants This review will consider studies that include a focus on children and adolescents (aged 6-18 y) with diagnosis of all types of PBD based on DSM-IV criteria (BD I, BD II and BD NOS), who have had an episode of mania, hypomania or mixed mania. Studies that include any other population group or any other mental health condition except PBD will be excluded unless data relating to participants who meet this review's inclusion criteria have been reported separately. Types of intervention(s) This review will consider studies that evaluate the effectiveness of PUFA supplementation to reduce clinical symptoms of PBD or look at the correlation between low PUFA intake in diet and PBD in children and adolescents. Poly Unsaturated Fatty Acids supplementation will include Omega-3 supplementation (either EPA, DHA or combination of two fatty acids), Omega-6 supplementation (alpha linolenic acid, linoleic acid), fish-oil supplementation and flax oil. Any types of PUFA supplementation as monotherapy or adjunctive to standard care will be included. Studies exploring the effectiveness of other dietary factors and nutrients on PBD will be excluded. Types of outcomes This review will consider studies that include the following outcome measures: change in the severity of the clinical symptoms in PBD, both for mania and depression. In particular the primary outcomes will be symptom severity, to include symptoms of mania, depression and clinical global impression of psychiatric symptoms. These are likely to be measured with the: • Global Assessment of Functioning Scale (GAF) • Young Mania Rating Scale (YMRS) • Brief Psychosis Rating Scale (BPRS), • Children's Depression Rating Scale (CDRS) • Clinical Global Impressions Scale (CGI) • Hamilton Depression Rating Scale (HAM-D) TRUNCATED AT 350 WORDS
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