Rice Simon M, Hickie Ian B, Yung Alison R, Mackinnon Andrew, Berk Michael, Davey Christopher, Hermens Daniel F, Hetrick Sarah E, Parker Alexandra G, Schäfer Miriam R, McGorry Patrick D, Amminger G Paul
Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia.
headspace Centre of Excellence in Youth Mental Health, Melbourne, Australia.
Early Interv Psychiatry. 2016 Aug;10(4):290-9. doi: 10.1111/eip.12166. Epub 2014 Aug 13.
US authorities have recommended 'black-box' warnings for antidepressants because of the increased risk of suicidality for individuals up to age 25. There is thus a clinical and ethical imperative to provide effective treatment for youth depression with an acceptable risk-benefit balance. Long-chain omega-3 polyunsaturated fatty acids (PUFAs) play an important role in a range of physiological processes in living organisms. Supplementation with omega-3 PUFAs has been shown to have a range of beneficial effects on both physical and mental health, and results of previous trials suggest that omega-3 PUFAs may be a safe and effective treatment for depression. However, conclusions from these trials have been limited by their relatively small sample sizes.
This trial will test the effectiveness of a 12-week parallel group, double-blind, randomized, placebo-controlled trial of 1.4 g day(-1) omega-3 PUFAs in help seeking 15- to 25-year-olds (N = 400) presenting with major depressive disorder. The primary hypothesis is that young people will show greater improvement of depressive symptoms after 12 weeks of treatment with omega-3 PUFAs plus cognitive behavioural case management compared with treatment with placebo plus cognitive behavioural case management.
Because of using a large sample, results from this study will provide the strongest evidence to date to inform the use of omega-3 PUFAs as first-line therapy in young people presenting with major depressive disorder. The study also heralds an important step towards indicated prevention of persistent depression, which may reduce the burden, stigmatization, disability and economic consequences of this disorder.
由于25岁及以下个体自杀风险增加,美国当局已建议对抗抑郁药使用“黑框”警告。因此,在可接受的风险效益平衡下为青少年抑郁症提供有效治疗在临床和伦理上势在必行。长链ω-3多不饱和脂肪酸(PUFAs)在生物体的一系列生理过程中发挥着重要作用。补充ω-3 PUFAs已被证明对身心健康有一系列有益影响,先前试验的结果表明ω-3 PUFAs可能是一种安全有效的抑郁症治疗方法。然而,这些试验的结论受到样本量相对较小的限制。
本试验将对1.4克/天ω-3 PUFAs进行一项为期12周的平行组、双盲、随机、安慰剂对照试验,以测试其对15至25岁患有重度抑郁症且寻求帮助的人群(N = 400)的有效性。主要假设是,与接受安慰剂加认知行为个案管理治疗相比,年轻人在接受ω-3 PUFAs加认知行为个案管理治疗12周后,抑郁症状会有更大改善。
由于采用了大样本,本研究结果将提供迄今为止最有力的证据,为在患有重度抑郁症的年轻人中使用ω-3 PUFAs作为一线治疗提供依据。该研究还标志着在针对性预防持续性抑郁症方面迈出了重要一步,这可能会减轻这种疾病的负担、污名化、残疾和经济后果。