Abstract
BackgroundDespite omega-3 polyunsaturated fatty acids (PUFA) supplementation in depressed patients have been suggested to improve depressive symptomatology, previous findings are not univocal.ObjectivesTo conduct an updated meta-analysis of randomized controlled trials (RCTs) of omega-3 PUFA treatment of depressive disorders, taking into account the clinical differences among patients included in the studies.MethodsA search on MEDLINE, EMBASE, PsycInfo, and the Cochrane Database of RCTs using omega-3 PUFA on patients with depressive symptoms published up to August 2013 was performed. Standardized mean difference in clinical measure of depression severity was primary outcome. Type of omega-3 used (particularly eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and omega-3 as mono- or adjuvant therapy was also examined. Meta-regression analyses assessed the effects of study size, baseline depression severity, trial duration, dose of omega-3, and age of patients.ResultsMeta-analysis of 11 and 8 trials conducted respectively on patients with a DSM-defined diagnosis of major depressive disorder (MDD) and patients with depressive symptomatology but no diagnosis of MDD demonstrated significant clinical benefit of omega-3 PUFA treatment compared to placebo (standardized difference in random-effects model 0.56 SD [95% CI: 0.20, 0.92] and 0.22 SD [95% CI: 0.01, 0.43], respectively; pooled analysis was 0.38 SD [95% CI: 0.18, 0.59]). Use of mainly EPA within the preparation, rather than DHA, influenced final clinical efficacy. Significant clinical efficacy had the use of omega-3 PUFA as adjuvant rather than mono-therapy. No relation between efficacy and study size, baseline depression severity, trial duration, age of patients, and study quality was found. Omega-3 PUFA resulted effective in RCTs on patients with bipolar disorder, whereas no evidence was found for those exploring their efficacy on depressive symptoms in young populations, perinatal depression, primary disease other than depression and healthy subjects.ConclusionsThe use of omega-3 PUFA is effective in patients with diagnosis of MDD and on depressive patients without diagnosis of MDD.
Highlights
Omega-3 polyunsaturated fatty acids (PUFA) eicosapentaeoic acid (EPA) and docosahexaenoic acid (DHA) have been demonstrated to be effective in cardiovascular disease (CVD) prevention due to their anti-inflammatory and cardio-protective effects [1]
The use of omega-3 PUFA is effective in patients with diagnosis of major depression disorder (MDD) and on depressive patients without diagnosis of MDD
Despite a full understanding of the processes leading to the depressive status is lacking, primary psychiatric disorders, such as major depression disorder (MDD) and bipolar disorders, are specific psychiatric conditions as recognized in the American Psychiatric Association’s revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) [17], marking out specific depressive symptoms that should be present as inclusion criteria to determine MDD diagnosis
Summary
Omega-3 polyunsaturated fatty acids (PUFA) eicosapentaeoic acid (EPA) and docosahexaenoic acid (DHA) have been demonstrated to be effective in cardiovascular disease (CVD) prevention due to their anti-inflammatory and cardio-protective effects [1]. The overall analysis of these studies from previous meta-analyses suggested a general benefit of omega-3 PUFA on depressive symptoms, despite certain variability in results weakened the possible validity of the findings. The mental health examination may include the use of rating scales, such as the Hamilton Rating Scale for Depression [18], the Beck Depression Inventory [19], or the MARDS [20] for MDD, and the bipolar spectrum diagnostic scale [21] for bipolar disorders These psychiatric diseases have specific biological causes and are often known to be treated with and respond to different pharmacological interventions [22]. Despite omega-3 polyunsaturated fatty acids (PUFA) supplementation in depressed patients have been suggested to improve depressive symptomatology, previous findings are not univocal
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
