Effectiveness of Omega-3 Fatty Acids Versus Placebo in Subjects at Ultra-High Risk for Psychosis: The PURPOSE Randomized Clinical Trial.

nutrition psychosis prevention treatment

Journal

Schizophrenia bulletin
ISSN: 1745-1701
Titre abrégé: Schizophr Bull
Pays: United States
ID NLM: 0236760

Informations de publication

Date de publication:
25 Oct 2024
Historique:
medline: 25 10 2024
pubmed: 25 10 2024
entrez: 25 10 2024
Statut: aheadofprint

Résumé

In the past 2 decades, substantial effort has been put into research on therapeutic options for people at ultra-high risk (UHR) for developing a first episode of psychosis (FEP), focusing on omega-3 polyunsaturated fatty acids (PUFAs) in preventing transition to psychosis. Despite an initial positive finding, subsequent studies failed to find a beneficial effect. The current study aimed to further investigate the effect of omega-3 PUFAs in UHR, to determine whether this line of research is worth pursuing. A double-blind, randomized, placebo-controlled study testing the efficacy of 6-month treatment with omega-3 PUFAs in 135 subjects at UHR for FEP, aged 13 to 20 years on the prevention of a transition to psychosis, followed up for 18 months post-treatment. The trial was conducted at 16 general hospitals and psychiatric specialty centers located in 8 European countries and Israel. There was no beneficial effect of treatment with omega-3 PUFAs compared to placebo; the rate of transition over 2 years did not differ between treatment arms nor was there a difference in change in symptom severity after 6-month treatment. Dropout rates and serious adverse events were similar across the groups. This is the third study that fails to replicate the original finding on the protective effect of omega-3 PUFAs in UHR subjects for transition to psychosis. The accumulating evidence therefore suggests that omega-3 PUFAs do not reduce transition rates to psychosis in those at increased risk at 2 years follow-up. This trial is registered with ClinicalTrials.gov (NCT02597439; Study Details | Placebo-controlled Trial in Subjects at Ultra-high Risk for Psychosis With Omega-3 Fatty Acids in Europe | ClinicalTrials.gov).

Sections du résumé

BACKGROUND AND HYPOTHESES UNASSIGNED
In the past 2 decades, substantial effort has been put into research on therapeutic options for people at ultra-high risk (UHR) for developing a first episode of psychosis (FEP), focusing on omega-3 polyunsaturated fatty acids (PUFAs) in preventing transition to psychosis. Despite an initial positive finding, subsequent studies failed to find a beneficial effect. The current study aimed to further investigate the effect of omega-3 PUFAs in UHR, to determine whether this line of research is worth pursuing.
STUDY DESIGN METHODS
A double-blind, randomized, placebo-controlled study testing the efficacy of 6-month treatment with omega-3 PUFAs in 135 subjects at UHR for FEP, aged 13 to 20 years on the prevention of a transition to psychosis, followed up for 18 months post-treatment. The trial was conducted at 16 general hospitals and psychiatric specialty centers located in 8 European countries and Israel.
STUDY RESULTS RESULTS
There was no beneficial effect of treatment with omega-3 PUFAs compared to placebo; the rate of transition over 2 years did not differ between treatment arms nor was there a difference in change in symptom severity after 6-month treatment. Dropout rates and serious adverse events were similar across the groups.
CONCLUSIONS CONCLUSIONS
This is the third study that fails to replicate the original finding on the protective effect of omega-3 PUFAs in UHR subjects for transition to psychosis. The accumulating evidence therefore suggests that omega-3 PUFAs do not reduce transition rates to psychosis in those at increased risk at 2 years follow-up.
CLINICAL TRIALS RESULTS
This trial is registered with ClinicalTrials.gov (NCT02597439; Study Details | Placebo-controlled Trial in Subjects at Ultra-high Risk for Psychosis With Omega-3 Fatty Acids in Europe | ClinicalTrials.gov).

Identifiants

pubmed: 39450759
pii: 7841513
doi: 10.1093/schbul/sbae186
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02597439']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Stanley Medical Research Institute
ID : 14T-002
Organisme : Neither Stanley Medical Research Institute

Investigateurs

Miriam Ayora (M)
Jill Bjarke (J)
Linn Marie Elise Aaberg (LME)
Egil Anders Haugen (EA)
Valentina Ciullo (V)
Mauro Ferrara (M)
Alessia Maffucci (A)
Valeria Mammarella (V)
Federica Piras (F)
Daniela Vecchio (D)
Margarita Miguel Corredera (MM)
Jana Gonzalez Gomez (JG)
Rosa Ayesa-Ariola (R)
Joaquín Galvañ (J)
Manuel Durán-Cutilla (M)
Alan Apter (A)
Liem Baldinger (L)
Elena Müller (E)
Annette Conzelmann (A)
Gottfried Maria Barth (GM)
Fabian Probst (F)
Elena de la Serna (E)
Gisela Sugranyes (G)
Adriana Fortea (A)
Jordina Tor Fabra (JT)
Elena Aschauer (E)
Kathrin Kollndorfer (K)
Klara Györbiro (K)

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

Auteurs

Inge Winter-van Rossum (I)

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, United States.

Margot I E Slot (MIE)

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.

Hendrika H van Hell (HH)

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.

Matthijs G Bossong (MG)

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.

Gregor Berger (G)

Department of Child and Adolescent Psychiatry and Psychotherapy of the Psychiatric University Hospital, University of Zurich, Zurich, Switzerland.

Harald Aschauer (H)

BioPsyC Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.

Arija Maat (A)

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Psychiatry, Spaarne Gasthuis Haarlem, Haarlem, The Netherlands.

Susanne Walitza (S)

Department of Child and Adolescent Psychiatry and Psychotherapy of the Psychiatric University Hospital, University of Zurich, Zurich, Switzerland.

Orly Lavan (O)

Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.

Inmaculada Baeza (I)

Child and Adolescent Psychiatry and Psychology Department, SGR2021-01319, Hospital Clínic de Barcelona, Barcelona, Spain.
FCRB-IDIBAPS, CIBERSAM-ISCIII, Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain.

Montserrat Dolz (M)

Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain.

Elena Monducci (E)

Human Neuroscience, Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Rome, Italy.

Paolo Fiori Nastro (P)

Department of Human Neuroscience, U.O.D. of Psychotherapy "Villa Tiburtina," Sapienza University of Rome, Rome, Italy.

Rune Andreas Kroken (RA)

Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.

Stephen M Lawrie (SM)

Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland.

Covadonga Martinez Díaz-Caneja (CM)

Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, ISCIII, School of Medicine, Universidad Complutense, Madrid, Spain.

Tobias Renner (T)

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Tuebingen, Center for Mental Health, University Hospital of Tuebingen, Tuebingen, Germany.
German Center for Mental Health (DZPG), Partner Site Tuebingen, Tuebingen, Germany.

Monika Schlögelhofer (M)

BioPsyC Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.

Christian Scharinger (C)

BioPsyC Biopsychosocial Corporation, Non-profit association for Research Funding Ltd., Vienna, Austria.
Department of Child and Youth Psychiatry, Medical University of Vienna, Vienna, Austria.

Gianfranco Spalletta (G)

Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy.

Nerisa Banaj (N)

Laboratory of Neuropsychiatry, Santa Lucia Foundation IRCCS, Rome, Italy.

Soraya Otero (S)

Child and Adolescent Psychiatry and Psychology Unit, University Hospital Marques de Valdecilla, Institute of Research Valdecilla Hospital IDIVAL, Santander, Spain.

Maria Schipper (M)

Department of Datascience and Biostatistics, Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands.

Dorieke Brink- Kwakkel (DB)

Department of Datascience and Biostatistics, Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands.

Rene S Kahn (RS)

Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, United States.

Classifications MeSH