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In a randomized, placebo-controlled study of 81 teenagers and young adults at high risk for schizophrenia, omega-3 polyunsaturated fatty acids (omega-3) given for 12 weeks were associated with a significantly decreased risk for conversion to psychosis 12 months later (NEJM JW Psychiatry Apr 2010 and Arch Gen Psychiatry 2010; 67:146). The same research group has now conducted a follow-up study.
At a mean follow-up of 6.7 years, 88% of participants received comprehensive assessments via interviews or hospital records. Conversion to psychosis occurred in 10% of omega-3 recipients versus 40% of controls, and analyses assuming that drop-outs developed psychosis produced similar findings. Participants who received active treatment also showed significantly better psychosocial and psychopathology outcomes, and significantly fewer received antipsychotics (29% vs. 54% of controls).
Amminger GP et al. Longer-term outcome in the prevention of psychotic disorders by the Vienna omega-3 study. Nat Commun 2015 Aug 11; 6:7934. (http://dx.doi.org/10.1038/ncomms8934)
Comment
These robust findings of a markedly lower conversion rate to psychosis in the omega-3 group strongly support instituting omega-3 supplementation in individuals at high risk for psychosis. The results add to similar reports for the benefits of omega-3 in multiple other psychiatric disorders (e.g., NEJM JW Psychiatry Nov 2014 and J Child Psychol Psychiatry 2015; 56:509)
Do these accumulating data support prescribing omega-3 supplements to all psychiatric patients? That approach would be consistent with dietary changes over past centuries that eventuated in progression from diets with an approximately 50:50 ratio of omega-3 to omega-6 to current diets with 15:1 or 16:1 omega-6 to omega-3 ratios — that is, present-day diets are less healthy than those eaten by our distant ancestors (Biomed Pharmacother 2006; 60:502).