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

Nicholas Cheng; Alison McLaverty; Barnaby Nelson; Connie Markulev; Miriam R. Schäfer; Maximus Berger; Nilufar Mossaheb; Monika Schlögelhofer; Stefan Smesny; Ian B. Hickie; Gregor E. Berger; Eric Y. H. Chen; Lieuwe de Haan; Dorien H. Nieman; Merete Nordentoft; Anita Riecher-Rössler; Swapna Verma; Rebekah Street; Andrew Thompson; Hok Pan Yuen; Robert Hester; Alison Ruth Yung; Patrick D. McGorry; Kelly Allott; G. Paul Amminger

doi:10.1192/bjo.2022.572

BJPsych Open (Sep 2022)

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

Nicholas Cheng,
Alison McLaverty,
Barnaby Nelson,
Connie Markulev,
Miriam R. Schäfer,
Maximus Berger,
Nilufar Mossaheb,
Monika Schlögelhofer,
Stefan Smesny,
Ian B. Hickie,
Gregor E. Berger,
Eric Y. H. Chen,
Lieuwe de Haan,
Dorien H. Nieman,
Merete Nordentoft,
Anita Riecher-Rössler,
Swapna Verma,
Rebekah Street,
Andrew Thompson,
Hok Pan Yuen,
Robert Hester,
Alison Ruth Yung,
Patrick D. McGorry,
Kelly Allott,
G. Paul Amminger

Affiliations

Nicholas Cheng: ORCiD; Orygen, Centre for Youth Mental Health, The University of Melbourne, Australia
Alison McLaverty: Melbourne School of Psychological Sciences, The University of Melbourne, Australia
Barnaby Nelson: ORCiD; 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
Alison Ruth Yung: ORCiD; 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
Kelly Allott: ORCiD; 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

DOI: https://doi.org/10.1192/bjo.2022.572
Journal volume & issue: Vol. 8

Abstract

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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.

Published in BJPsych Open

ISSN: 2056-4724 (Online)
Publisher: Cambridge University Press
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system: Psychiatry
Website: https://www.cambridge.org/core/journals/bjpsych-open

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