Short-term supplementation of acute long-chain omega-3 polyunsaturated fatty acids may alter depression status and decrease symptomology among young adults with depression: A preliminary randomized and placebo controlled trial
Introduction
Depression affects 350 million people worldwide, making it one of the most common mental disorders (World Health Organization, 2012). American College Health Association (2012) recently found that 30% of undergraduate students have felt so depressed that it hindered their ability to function and 6% seriously considered suicide in the 12 months prior to the survey. Despite the prevalence, over 33% of cases in developed countries and 66% of cases among undergraduate students do not receive proper treatment (Demyttenaere et al., 2004, Active Minds, 2014). Therefore, it is crucial to assess and develop appropriate treatment interventions that are accessible to the general public.
Long-chain omega-3 polyunsaturated fatty acids (LCPUFAs) have shown promise in reducing depressive symptoms among those with major depressive disorder (Grosso et al., 2014a, Grosso et al., 2014b; Lin and Su, 2007). However, some suggest that the complexity of combining LCPUFAs with antidepressant therapies makes it difficult to interpret these results (Appleton et al., 2007). Research examining the influence of LCPUFAs on depressed individuals not currently taking anti-depressants is limited to a middle-age population and has produced mixed results (Rogers et al., 2008, Lucas et al., 2009). LCPUFAs have shown some benefit in reducing depression (Fontani et al., 2005) and fatigue (Antypa et al., 2009) in healthy undergraduate students. However, there has been scant research examining how LCPUFAs influence depressive symptoms in undergraduate students who currently meet criteria for depression.
The aim of the current study was to examine the psychological effects of acute and low-dose, equivalent of adding two fatty fish meals per week to their diet, LCPUFAs supplementation on undergraduate students with BDI scores indicative of depression who were not receiving any other treatment.
Section snippets
Participants
Twenty-three undergraduate students (age range 18–21 years; 78% female) with a score of 10 or above on the Beck Depression Inventory (BDI) were included in the present study. Participants were recruited through flyers placed across the college campus and announcements in Introductory Psychology courses during the summer and beginning of fall and spring semesters. Advertisements, which were also used as recruitment for a larger study, asked for healthy young adult volunteers. Participants were
Results
Twenty-one of the 23 participants completed the study. Two participants did not return for the follow-up testing, one from the LCPUFA group and one from the placebo group. Therefore, the final analysis included 21 participants, LCPUFA (n=12, %female=62) and placebo (n=9, %female=100).
Discussion
The present double-blind, placebo controlled study examined the psychological effects of a short-term and low dose LCPUFAs supplementation (1.4 g, 1000 mg EPA and 400 mg DHA) on unmedicated and untreated undergraduate students with symptoms of depression. The results demonstrated that LCPUFAs, but not placebo, were successful in reducing depressive symptomology and depression below clinically indicated levels. The reduction in overall depressive symptoms was driven by a decrease in the
Acknowledgment
The authors would like to thank Siera Goodnight, Josh Sesek, and Mia Symoniak for their assistance with participant recruitment and data collection and Gretchen Vannice for her assistance with coordinating manufacture and delivery of supplements and placebos. The authors gratefully acknowledge the Grant support from T32HL07560.
References (49)
- et al.
Psychometric properties of the beck depression inventory: twenty-five years of evaluation
Clin. Psychol. Rev.
(1988) - et al.
Dietary fish oil affects monoaminergic neurotransmission and behavior in rats
J. Nutr.
(1998) - et al.
Long-chain omega-3 fatty acid intake is associated positively with corticolimbic gray matter volume in healthy adults
Neurosci. Lett.
(2007) - et al.
Reporting of missing data and methods used to accommodate them in recent analgesic clinical trials: ACTTION systematic review and recommendations
Pain
(2014) - et al.
Preliminary evidence that acute long-chain omega-3 supplementation reduces cardiovascular reactivity to mental stress: a randomized and placebo controlled trial
Biol. Psychol.
(2012) - et al.
Segregated neural representation of psychological and somatic–vegetative symptoms in severe major depression
Neurosci. Lett.
(2009) - et al.
Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial
Brain Behav. Immun.
(2011) - et al.
Omega-3 supplementation lowers inflammation in healthy middle-aged and older adults: a randomized controlled trial
Brain Behav. Immun.
(2012) - et al.
Cognitive/affective and somatic/affective symptom dimensions of depression are associated with current and future inflammation in heart failure patients
J. Affect. Disord.
(2012) Impact of inflammation on neurotransmitter changes in major depression: an insight into the action of antidepressants.
Prog. NeuroPsychopharmacol. Biol. Psychiatry.
(2014)
Ethyl-eicosapentaenoic acid for the treatment of psychological distress and depressive symptoms in middle-aged women: a double-blind, placebo-controlled, randomized clinical trial
Am. J. Clin. Nutr.
Omega-3 fatty acid deficiency during perinatal development increases serotonin turnover in the prefrontal cortex and decreases midbran tryptophan hydroxylase-2 expression in adult female rats: dissociation from estrogenic effects
J. Psychiatry. Res.
Omega-3 fatty acid deficiency increases constitutive pro-inflammatory cytokine production in rats: relationship with central serotonin turnover
Prostaglandins Leukot. Essent. Fat. Acid.
Relationship between omega-3 fatty acids and plasma neuroactive steroids in alcoholism, depression and controls
Prostaglandins Leukot. Essent. Fat. Acid.
Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial
Eur. Neuropsychopharmacol.
American College Health Association-National College Health Assessment II: Reference Group Executive Summary Fall 2011
Omega-3 fatty acids (fish-oil) and depression-related cognition in healthy volunteers
J. Psychopharmacol.
Depressed mood and n-3 polyunsaturated fatty acid intake from fish: non-linear or confounded association?
Soc. Psychiatry. Epidemiol.
Fish oil supplementation reduces cortisol basal levels and perceived stress: a randomized, placebo-controlled trial in abstinent alcoholics
Mol. Nutr. Food Res.
Manual for the Beck Depression Inventory-II
Incorporation of fatty acids by concanavalin A-stimulated lymphocytes and the effect on fatty acid composition and membrane fluidity
Biochem. J.
High omega-6 and low omega-4 fatty acids are associated with depressive symptoms and neuroticism
Psychosom. Med.
The predictive value of somatic and cognitive depressive symptoms for cytokine changes in patients with major depression
Neuropsychiatr. Dis. Treat.
Cited by (22)
Dose- and time-dependent increase in circulating anti-inflammatory and pro-resolving lipid mediators following eicosapentaenoic acid supplementation in patients with major depressive disorder and chronic inflammation
2021, Prostaglandins Leukotrienes and Essential Fatty AcidsCitation Excerpt :Resolution of inflammation is a highly regulated process, mediated in part by lipid molecules called specialized pro-resolving lipid mediators (SPMs), that are derived endogenously from omega-3 (n-3) fatty acids such as eicosapentaenoic acid (EPA, 20:5 n-3) and docosahexaenoic acid (DHA, 22:6 n-3) [7,8,9]. Possibly due to the well-documented anti-inflammatory effects of EPA [10], some randomized clinical intervention trials of EPA supplementation in MDD patients have shown significant reductions in depressive symptoms [11,12,13]. Recently, an expert panel from the International Society for Nutritional Psychiatry Research (ISNPR) supported clinical use of n-3 fatty acids in MDD, particularly as augmentation therapy [14], and a meta-analysis demonstrated the clinical benefits of EPA, but not DHA, supplementation in MDD [15].
Interventions for common mental health problems among university and college students: A systematic review and meta-analysis of randomized controlled trials
2018, Journal of Psychiatric ResearchCitation Excerpt :The included papers had considerably high quality. Seven of 51 papers met all criteria for low risk of bias (Beard and Amir, 2008; Sloan et al., 2011; Penton-Voak et al., 2012; Lee and Kwon, 2013; Ginty and Conklin, 2015; Yang et al., 2015; Norton and Abbott, 2016). As shown in Fig. 4, 57.0% of ESs adopted low risk of sequence generation, and 46.8% of ESs adopted low risk of allocation.
The role of n-3 polyunsaturated fatty acids (n-3PUFAs) in affective disorders
2017, Journal of Affective DisordersCitation Excerpt :On the other hand, a recent RCT comparing EPA versus DHA as monotherapy for MDD vs placebo failed to demonstrate a superior antidepressive effect of either n-3PUFAs (DHA and EPA) or placebo (Mischoulon et al., 2015). Furthermore, it has been shown that the combined effect of higher dose of EPA with lower dose of DHA (e.g., at 2–4:1 or higher) was effective in reducing depressive symptoms in MDD (Rondanelli et al., 2010; Rizzo et al., 2012) whereas the opposite combination (lower EPA and higher DHA) resulted ineffective (Silvers et al., 2005; Su et al., 2003; Grenyer et al., 2007; Park et al., 2015; Rogers et al., 2008; Ginty et al., 2015). This result was also confirmed by a meta-analysis reporting that supplements of n-3PUFAs with the proportion of EPA≥60% of the total EPA and DHA content ( in a dose range of 200–2200 mg EPA in excess of DHA) were effective against depressive episodes alone or in comorbidity with other medical conditions (Sublette et al., 2011).