Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
IRCCS "E. Medea" Scientific Institute, San Vito al Tagliamento, Italy.
J Affect Disord. 2017 Dec 15;224:32-47. doi: 10.1016/j.jad.2016.12.034. Epub 2016 Dec 30.
Among emerging treatments for depressive disorders several studies suggested that n-3 polyunsaturated fatty acids (n-3PUFAs) supplementation can be used. However, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) differ in terms of biochemistry, metabolism and therapeutic effects. Therefore, a clear picture of their specific and different role on affective disorders has not yet emerged.
To investigate the effects of n-3PUFAs on affective disorders including major depression, bipolar disorder and perinatal depression.
a comprehensive search on PUBMED, Medline and PsychINFO of all RCTs using n-3PUFAs patients with depressive symptoms published up to April 2016 was performed. We included trials that examined unipolar or bipolar disorder and trials that investigated depressive symptoms in relation to pregnancy. Trials were excluded if the depressive symptomatology was related to other primary organic diseases.
264 RCT studies were identified but only 36 met the inclusion criteria. First, it has been reported that n-3PUFAs supplementation might have clinical benefits on depressive symptoms. Second, EPA supplement, rather than DHA, seems to be more effective in treating major depression. Third, n-3PUFAs can have beneficial effects in bipolar depression but not in perinatal depression.
there are only some evidence on the efficacy of n-3PUFAs in affective disorders especially to unipolar and bipolar depression not powered enough to confirm a therapeutic effect for affective disorder. Therefore, further studies with larger and more homogeneous samples, are required to confirm these effects.
在治疗抑郁症的新兴方法中，有几项研究表明，补充 n-3 多不饱和脂肪酸（n-3PUFAs）可能有用。然而，二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）在生化、代谢和治疗效果方面存在差异。因此，它们在情感障碍方面的具体和不同作用还没有明确的结论。
研究 n-3PUFAs 对情感障碍（包括重度抑郁症、双相情感障碍和围产期抑郁症）的影响。
对 PUBMED、Medline 和 PsychINFO 进行全面检索，检索截至 2016 年 4 月所有使用 n-3PUFAs 治疗有抑郁症状的患者的 RCT 研究。我们纳入了检查单相或双相情感障碍的试验，以及调查与妊娠相关的抑郁症状的试验。如果抑郁症状与其他原发性器质性疾病有关，则排除试验。
共确定了 264 项 RCT 研究，但只有 36 项符合纳入标准。首先，有报道称 n-3PUFAs 补充可能对抑郁症状有临床益处。其次，EPA 补充剂似乎比 DHA 更有效治疗重度抑郁症。第三，n-3PUFAs 对双相抑郁可能有有益的影响，但对围产期抑郁没有作用。
目前仅有一些关于 n-3PUFAs 在情感障碍中的疗效的证据，特别是对单相和双相抑郁，还没有足够的证据来证实对情感障碍的治疗效果。因此，需要进一步进行更大、更同质的样本研究来证实这些效果。
