Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 1;27(3):pyae014.
doi: 10.1093/ijnp/pyae014.

Network Meta-Analysis Indicates Superior Effects of Omega-3 Polyunsaturated Fatty Acids in Preventing the Transition to Psychosis in Individuals at Clinical High-Risk

Chengfeng Chen  1   2 , Yongyan Deng  3   4 , Yuling Li  1   2 , Meiting Zhang  1   2 , Tong Yu  1   2 , Kun Xie  1   2 , Wuyou Bao  5 , Peiying Li  5 , Ling Sun  5 , Tianhong Zhang  6 , Yikang Zhu  6 , Bin Zhang  5
Affiliations

Network Meta-Analysis Indicates Superior Effects of Omega-3 Polyunsaturated Fatty Acids in Preventing the Transition to Psychosis in Individuals at Clinical High-Risk

Chengfeng Chen et al. Int J Neuropsychopharmacol. .

Abstract

Background: The efficacy of pharmacological and nutritional interventions in individuals at clinical high risk for psychosis (CHR-P) remains elusive. This study aims to investigate the efficacy of pharmacological and nutritional interventions in CHR-P and whether these interventions can enhance the efficacy of psychological treatments.

Methods: We systematically reviewed data from 5 databases until July 24, 2021: PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure, and WanFang Data. The primary outcome was the transition to psychosis. Network meta-analyses were conducted at 3 time points (6, 12, and ≥24 months) considering both pharmacological/nutritional interventions alone and its combination with psychotherapy.

Results: Out of 11 417 identified references, 21 studies were included, comprising 1983 participants. CHR-P participants receiving omega-3 polyunsaturated fatty acids treatment were associated with a lower probability of transition compared with placebo/control at 6 months (odds ratio [OR] = 0.07, 95% confidence interval [CI] = .01 to .054), 12 months (OR = 0.14, 95% CI = .03 to .66), and ≥24 months (OR = 0.16, 95% CI = .05 to .54). Moreover, risperidone plus psychotherapy was associated with a lower likelihood of transition at 6 months compared with placebo/control plus psychotherapy, but this result was not sustained over longer durations.

Conclusion: Omega-3 polyunsaturated fatty acids helped in preventing transitions to psychosis compared with controls.

Prospero registration number: CRD42021256209.

Keywords: Clinical high risk of psychosis; network meta-analysis; omega-3 polyunsaturated fatty acids.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
PRISMA flow chart of the study selection process.
Figure 2.
Figure 2.
Network plots of direct comparisons in the network meta-analysis for transition outcome at 6, 12, and ≥24 months in 2 levels: pharmacological/nutritional interventions group (on the left) and pharmacological/nutritional interventions plus psychotherapy group (on the right). The width of the lines is proportional to the number of trials comparing each pair of treatments. AD, antidepressants; AP, antipsychotics; ARI, aripiprazole; BEN, benzodiazepine; Dser, D-serine; MS, mood stabilizers; NBI, needs-based interventions; OLA, olanzapine; Omega-3, omega-3 fatty acids; Pharm/Nutr interventions, pharmacological/nutritional interventions; Plcb/Ctrl, placebo/control; PT, psychotherapy; RIS, risperidone; ZIP, ziprasidone.
Figure 3.
Figure 3.
Forest plot of comparison in the risk ratio of conversion to psychosis in the network meta-analysis for transition outcome at 6, 12, and ≥24 months in 2 levels: pharmacological/nutritional interventions group (on the left) and pharmacological/nutritional interventions plus psychotherapy group (on the right). *Bold letters indicate statistical significance. AD, antidepressants; AP, antipsychotics; ARI, aripiprazole; BEN, benzodiazepine; CI, confidence interval; Dser, D-serine; MS, mood stabilizers; NBI, needs-based interventions; OLA, olanzapine; Omega-3, omega-3 fatty acids; OR, odds ratio; Pharm/Nutr interventions, pharmacological/nutritional interventions; Plcb/Ctrl, placebo/control; PT, psychotherapy; RIS, risperidone; ZIP, ziprasidone.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Addington J, Addington D, Abidi S, Raedler T, Remington G (2017) Canadian treatment guidelines for individuals at clinical high risk of psychosis. Can J Psychiatry 62:656–661. - PMC - PubMed
    1. Amminger GP, Schäfer MR, Papageorgiou K, Klier CM, Cotton SM, Harrigan SM, Mackinnon A, McGorry PD, Berger GE (2010) Long-chain ω-3 fatty acids for indicated prevention of psychotic disorders: a randomized placebo-controlled trial. Arch Gen Psychiatry 67:146–154. - PubMed
    1. Amminger GP, Schäfer MR, Schlögelhofer M, Klier CM, McGorry PD (2015) Longer-term outcome in the prevention of psychotic disorders by the Vienna omega-3 study. Nat Commun 6:7934. - PMC - PubMed
    1. Bakbergenuly I, Hoaglin DC, Kulinskaya E (2019) Pitfalls of using the risk ratio in meta-analysis. Res Synth Methods 10:398–419. - PMC - PubMed
    1. Bang M, Park JY, Kim KR, Lee SY, Song YY, Kang JI, Lee E, An SK (2019) Psychotic conversion of individuals at ultra‐high risk for psychosis: the potential roles of schizotypy and basic symptoms. Early Interv Psychia 13:546–554. - PubMed

Publication types

MeSH terms