Effects of omega-3 polyunsaturated fatty acid supplementation on cognitive functioning in youth at ultra-high risk for psychosis: secondary analysis of the NEURAPRO randomised controlled trial
Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
Connie Markulev
Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
Miriam R. Schäfer
Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
Maximus Berger
Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia; and Department of Psychiatry and Psychotherapy, University of Bern, Switzerland
Nilufar Mossaheb
Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
Monika Schlögelhofer
BioPsyC Biopsychosocial Corporation, Vienna, Austria
Stefan Smesny
Department of Psychiatry and Psychotherapy, Jena University Hospital, Germany
Ian B. Hickie
Brain and Mind Centre, The University of Sydney, Australia
Gregor E. Berger
Child and Adolescent Psychiatric Service, Canton of Zurich, Switzerland
Eric Y. H. Chen
Department of Psychiatry, University of Hong Kong, Hong Kong
Lieuwe de Haan
Department of Psychiatry, Academic Medical Center, The Netherlands
Dorien H. Nieman
Department of Psychiatry, Academic Medical Center, The Netherlands
Merete Nordentoft
Mental Health Centre Copenhagen, Department of Clinical Medicine, Copenhagen University Hospital, Denmark
Anita Riecher-Rössler
Faculty of Medicine, University of Basel, Switzerland
Swapna Verma
Early Psychosis Intervention, Institute of Mental Health, Singapore
Rebekah Street
Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
Andrew Thompson
Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
Hok Pan Yuen
Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
Robert Hester
Melbourne School of Psychological Sciences, The University of Melbourne, Australia
Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Australia; and School of Health Sciences, University of Manchester, UK
Patrick D. McGorry
Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia; and Melbourne School of Psychological Sciences, The University of Melbourne, Australia
G. Paul Amminger
Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
Background Cognitive impairments are well-established features of psychotic disorders and are present when individuals are at ultra-high risk for psychosis. However, few interventions target cognitive functioning in this population. Aims To investigate whether omega-3 polyunsaturated fatty acid (n−3 PUFA) supplementation improves cognitive functioning among individuals at ultra-high risk for psychosis. Method Data (N = 225) from an international, multi-site, randomised controlled trial (NEURAPRO) were analysed. Participants were given omega-3 supplementation (eicosapentaenoic acid and docosahexaenoic acid) or placebo over 6 months. Cognitive functioning was assessed with the Brief Assessment of Cognition in Schizophrenia (BACS). Mixed two-way analyses of variance were computed to compare the change in cognitive performance between omega-3 supplementation and placebo over 6 months. An additional biomarker analysis explored whether change in erythrocyte n−3 PUFA levels predicted change in cognitive performance. Results The placebo group showed a modest greater improvement over time than the omega-3 supplementation group for motor speed (ηp2 = 0.09) and BACS composite score (ηp2 = 0.21). After repeating the analyses without individuals who transitioned, motor speed was no longer significant (ηp2 = 0.02), but the composite score remained significant (ηp2 = 0.02). Change in erythrocyte n-3 PUFA levels did not predict change in cognitive performance over 6 months. Conclusions We found no evidence to support the use of omega-3 supplementation to improve cognitive functioning in ultra-high risk individuals. The biomarker analysis suggests that this finding is unlikely to be attributed to poor adherence or consumption of non-trial n−3 PUFAs.
