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This article is part of the Research Topic

Early Intervention in Psychotic Disorders

Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2019.00393

Relationship between polyunsaturated fatty acids and psychopathology in the NEURAPRO clinical trial.

 Maximus Berger1, 2*,  Barnaby Nelson1, 2, Connie Markulev1, 2, Hok-Pan Yuen1, 2, Miriam Schaefer1, 2,  Nilufar Mossaheb3, 4,  Monika Schloegelhofer3, Stefan Smesny5, Ian Hickie6,  Gregor E. Berger7, Eric Chen8,  Lieuwe De Haan9,  Dorien Nieman9, Merete Nordentoft10,  Anita Riecher-Roessler11,  Swapna Verma12,  Andrew Thompson1, 2, Alison R. Yung1, 2, Patrick D. McGorry1, 2 and  G. Paul Amminger1, 2
  • 1Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Australia
  • 2Centre for Youth Mental Health, University of Melbourne, Australia
  • 3Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
  • 4Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
  • 5University Hospiatal Jena, Germany
  • 6Brain and Mind Centre, University of Sydney, Australia
  • 7Department of Child and Adolescent Psychiatry, Faculty of Medicine, University of Zurich, Switzerland
  • 8Department of Psychiatry, University of Hong Kong, China
  • 9Academic Medical Center (AMC), Netherlands
  • 10Bispebjerg Hospital, Denmark
  • 11Department of Psychiatry, University Hospital of Basel, Switzerland
  • 12Institute of Mental Health, Singapore

Background
Deficiencies in membrane polyunsaturated fatty acids (PUFA) such as omega-3 (n-3) fatty acids are thought to contribute to the pathophysiological processes underlying psychotic disorders. Emerging evidence suggests that the levels of PUFA are related to clinical symptoms but significant heterogeneity exists between studies. Here, we investigated associations of membrane PUFA with clinical symptoms and functioning in a large sample of individuals at ultra-high risk (UHR) for psychosis.
Methods
A total of 285 participants of the NEURAPRO clinical trial were investigated for erythrocyte PUFA levels, including the n-3 index, n-6/n-3 PUFA ratio, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Severity of general psychopathology (BPRS), psychotic symptoms (BPRS psychosis subscale), negative symptoms (SANS), manic symptoms (YMRS), depressive symptoms (MADRS) and functioning (SOFAS, GF-R, GF-S) were assessed concurrently. Partial correlation taking into account the effects of gender, age and smoking were used to examine the relationship between PUFAs and symptoms severity.
Results
The n-3 index negatively correlated with the severity of general psychopathology, psychotic symptoms, depressive symptoms and manic symptoms. The n-6/n-3 PUFA ratio positively correlated with severity of psychotic and depressive symptoms. The n-3 PUFA DHA negatively correlated with the severity of general psychopathology, positive, manic and depressive symptoms. EPA negatively correlated with manic symptoms. Nervonic acid, an n-9 monounsaturated fatty acid, positively correlated with general psychopathology, positive and negative symptoms, depressive symptoms and manic symptoms. The long-chain saturated fatty acid tetracosanoic acid positively correlated with general psychopathology, positive, manic and depressive symptoms.
Conclusions
Partially consistent with a previous study, psychotic symptoms, depressive symptoms and symptoms of mania were associated with several classes of FAs in the present study. These findings support the relevance of membrane fatty acids for the onset of psychotic symptoms and indicate that FAs should be further evaluated as biomarkers in the UHR for psychosis group.

Keywords: Ultra-high risk (UHR), Omega-3 FA, Psychotic disorder, Psychopatholgy, outcomes

Received: 14 Jan 2019; Accepted: 17 May 2019.

Edited by:

Claes Wahlestedt, Leonard M. Miller School of Medicine, United States

Reviewed by:

Armando D’Agostino, University of Milan, Italy
Kristin S. Cadenhead, University of California, San Diego, United States  

Copyright: © 2019 Berger, Nelson, Markulev, Yuen, Schaefer, Mossaheb, Schloegelhofer, Smesny, Hickie, Berger, Chen, De Haan, Nieman, Nordentoft, Riecher-Roessler, Verma, Thompson, Yung, McGorry and Amminger. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Maximus Berger, Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, 3052, Victoria, Australia, maximus.berger@orygen.org.au