Abstract

BackgroundThe prevalence of mood disorders in children is a growing global concern. Omega-3 fatty acids (FA) are emerging as a promising adjuvant therapy for depressive disorder (DD) in paediatric patients. The primary objective of this pilot, single-centre, randomized, double-blind controlled study was to compare the efficacy of an Omega-3 FA fish oil emulsion with a control oil emulsion alongside standard treatment for depressive symptoms in children and adolescents suffering from depressive disorder (DD) and mixed anxiety depressive disorder (MADD).Methods38 children (12 patients were treated and diagnosed for at least 1 month before enrolment, 26 patients were first-time diagnosed as DD) aged 11–17 years were randomised 1:1 to the intervention (Omega-3 FA, 19 patients) or active comparator (Omega-6 FA, 19 patients) groups. Children’s depression inventory (CDI) ratings were performed at baseline, every 2 weeks for a 12-week intervention period and at 4-week post-intervention. 35 patients (17 in Omega-3 and 18 in Omega-6 groups) who completed the whole intervention period were evaluated. Patients from Omega-3 group were stratified according to diagnosis into two subgroups (DD—10/17 and mixed anxiety depressive disorder (MADD)—7/17 patients) and in the Omega-6 group into DD—10/18 and MADD—8/18 patients. Groups were evaluated separately. Differences between-groups were tested with the Student´s t test or non-parametric Mann–Whitney U test. Two-way ANOVA with repeated measures and Friedman test were used to analyse the Treatment effect for response in CDI score. p < 0.05 was considered significant in all statistical analyses.ResultsSignificant reductions in CDI scores in 35 analysed patients who completed 12 weeks intervention were observed after 12 weeks of intervention only in the Omega-3 group (p = 0.034). After stratification to depressive disorder and mixed anxiety depressive disorder subgroups, the DD subgroup receiving the Omega-3 FA fish oil showed statistically greater improvement (score reduction after 8 week treatment of −9.1 CDI, p = 0.0001) when compared to the MADD subgroup (score reduction after 8 week treatment −4.24 CDI, p = 0.271).ConclusionsCDI scores were reduced in the Omega-3 group and the depression subgroup had greater improvement than the mixed depressive/anxiety group. An Omega-3 fatty acid rich fish oil emulsion may be an effective adjuvant supplement during the treatment of depressive disorders in children.Trial registration ISRCTN81655012

Highlights

  • The prevalence of mood disorders in children is a growing global concern

  • The increased incidence of DD in people of Western countries has been associated with drastic changes in dietary habits over the century in which the consumption of Omega-3 fatty acids (FA) in the form of fish, grain and vegetables has been replaced by the Omega-6 FA from cereal oils

  • In order to determine whether omega-3 shows an improvement in the depressive symptoms rating as Children’s depression inventory (CDI) score, we analyzed the data of the patients who fully underwent the intervention

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Summary

Introduction

The prevalence of mood disorders in children is a growing global concern. Omega-3 fatty acids (FA) are emerging as a promising adjuvant therapy for depressive disorder (DD) in paediatric patients. Mood disorders in children and adolescents are a serious global problem in child psychiatry and its incidence is shifting to younger years of age. The ratio of Omega-3 FA to Omega-6 FA in the diet has shifted from 1:1 to 1:15 and this switch has coincided with a strong rise in the rates of depression in recent decades [5]. This has led to the hypothesis that Omega-3 FA supplementation could represent an approach for treating depression and other mood disorders [6,7,8]

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