Comparative Efficacy of Omega-3 Fatty Acid with Other Interventions for Depression in Children and Adolescents: A Systematic Review and Network Meta-Analysis.

IF 1.5 4区 医学 Q2 PEDIATRICS Journal of child and adolescent psychopharmacology Pub Date : 2024-09-01 Epub Date: 2024-07-03 DOI:10.1089/cap.2024.0017
Chifong Lam, Lin Han, Roger S McIntyre, Kayla M Teopiz, Bing Cao
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Abstract

Background: The administration of omega-3 polyunsaturated fatty acid supplements is recommended as an adjuvant therapy for adults diagnosed with major depressive disorder. The evaluation of replicated data in combination treatment with omega-3 has been extensively conducted in adults over the past decade. However, the generalizability of these findings to pediatric groups is still uncertain. The objectives of this evaluation were twofold: (1) to evaluate the effectiveness of omega-3 and associated combination therapies in reducing the severity of depressive symptoms, and (2) to include remission rates (i.e., reduction of more than 50% in depression symptoms) as a measure of therapeutic efficacy. Methods: We conducted a literature search on PubMed/EMBASE from inception to October 2023. Data analyses were conducted using Stata (version 17.0). Results: We identified a total of 3168 articles. After eligibility screening of identified studies, nine studies (n = 561 participants) were included in our analysis herein. Pairwise comparisons revealed no significant improvement in depression symptoms for any intervention versus placebo. However, a clustered ranking plot identified omega-3 plus inositol as the most effective treatment for pediatric depression (77.3% efficacy). Omega-3 paired with psychoeducational psychotherapy significantly lowered the remission rate compared to placebo (standardized mean difference = 0.44, 95% confidence interval: 0.00-0.87, p = 0.048), resulting in a 91.5% remission rate, making it the most effective treatment in the study. Conclusions: Taken together, this network meta-analysis presents compelling evidence supporting the antidepressant effects of omega-3 in pediatric groups with depression. Future research should aim to investigate omega-3 as monotherapy for young individuals with depression, as well as investigate the efficacy of omega-3 in comparison to psychosocial interventions for affected individuals.

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欧米茄-3 脂肪酸与其他干预措施对儿童和青少年抑郁症的疗效比较:系统回顾与网络荟萃分析》。
背景:欧米伽-3 多不饱和脂肪酸补充剂被推荐作为重度抑郁障碍成人患者的辅助疗法。过去十年中,在成人中广泛开展了对欧米伽-3联合治疗重复数据的评估。然而,这些研究结果对儿童群体的普适性仍不确定。此次评估有两个目的:(1)评估欧米伽-3和相关综合疗法在减轻抑郁症状严重程度方面的有效性;(2)将缓解率(即抑郁症状减轻 50%以上)作为衡量疗效的标准。研究方法我们在 PubMed/EMBASE 上进行了从开始到 2023 年 10 月的文献检索。使用 Stata(17.0 版)进行数据分析。结果我们共发现了 3168 篇文章。在对已确定的研究进行资格筛选后,有 9 项研究(n = 561 名参与者)纳入了我们的分析。配对比较显示,任何干预措施与安慰剂相比,抑郁症状均无明显改善。不过,聚类排序图显示,欧米伽-3 加肌醇是治疗小儿抑郁症最有效的方法(有效率为 77.3%)。与安慰剂相比,欧米伽-3与心理教育心理疗法配对可显著降低缓解率(标准化平均差=0.44,95%置信区间:0.00-0.87,p=0.048),从而使缓解率达到91.5%,成为该研究中最有效的治疗方法。结论综上所述,这项网络荟萃分析提供了令人信服的证据,支持欧米伽-3对儿童抑郁症患者的抗抑郁作用。未来的研究应着眼于调查欧米伽-3作为单一疗法对年轻抑郁症患者的治疗效果,以及调查欧米伽-3与心理干预相比对受影响人群的疗效。
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来源期刊
CiteScore
3.60
自引率
5.30%
发文量
61
审稿时长
>12 weeks
期刊介绍: Journal of Child and Adolescent Psychopharmacology (JCAP) is the premier peer-reviewed journal covering the clinical aspects of treating this patient population with psychotropic medications including side effects and interactions, standard doses, and research on new and existing medications. The Journal includes information on related areas of medical sciences such as advances in developmental pharmacokinetics, developmental neuroscience, metabolism, nutrition, molecular genetics, and more. Journal of Child and Adolescent Psychopharmacology coverage includes: New drugs and treatment strategies including the use of psycho-stimulants, selective serotonin reuptake inhibitors, mood stabilizers, and atypical antipsychotics New developments in the diagnosis and treatment of ADHD, anxiety disorders, schizophrenia, autism spectrum disorders, bipolar disorder, eating disorders, along with other disorders Reports of common and rare Treatment Emergent Adverse Events (TEAEs) including: hyperprolactinemia, galactorrhea, weight gain/loss, metabolic syndrome, dyslipidemia, switching phenomena, sudden death, and the potential increase of suicide. Outcomes research.
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