Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials.
Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials.
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DOI：
10.1371/journal.pone.0096905
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Caraci F
中科院分区：
文献类型：
--
作者：
Grosso G;Pajak A;Marventano S;Castellano S;Galvano F;Bucolo C;Drago F;Caraci F
尽管在抑郁症患者中补充omega-3多不饱和脂肪酸（PUFA）被认为可以改善抑郁症状，但之前的研究结果并不是唯一的。考虑到研究中患者的临床差异，对omega-3 PUFA治疗抑郁症的随机对照试验（RCTs）进行最新的荟萃分析。检索MEDLINE、EMBASE、PsycInfo和Cochrane数据库中截至2013年8月发表的使用omega-3 PUFA治疗抑郁症状患者的随机对照试验。抑郁严重程度临床测量的标准化平均差异是主要结局。使用的欧米伽-3类型（特别是二十碳五烯酸[EPA]和二十二碳六烯酸[DHA]）和欧米伽-3作为单一或辅助治疗也进行了研究。荟萃回归分析评估了研究规模、基线抑郁严重程度、试验持续时间、omega-3剂量和患者年龄的影响。分别对dsm定义的重度抑郁症（MDD）患者和有抑郁症状但未诊断为MDD的患者进行的11项和8项试验的荟萃分析显示，与安慰剂相比，omega-3 PUFA治疗的临床获益显著（随机效应模型的标准化差异分别为0.56 SD [95% CI: 0.20, 0.92]和0.22 SD [95% CI: 0.01, 0.43]；合并分析为0.38 SD [95% CI: 0.18, 0.59]）。在制剂中主要使用EPA，而不是DHA，影响了最终的临床疗效。使用omega-3 PUFA作为辅助治疗比单一治疗有显著的临床疗效。疗效与研究规模、基线抑郁严重程度、试验持续时间、患者年龄和研究质量没有关系。Omega-3 PUFA在双相情感障碍患者的随机对照试验中显示有效，而在探索其对年轻人群、围产期抑郁症、除抑郁症以外的原发疾病和健康受试者的抑郁症状的疗效方面，没有发现证据。使用omega-3 PUFA对诊断为重度抑郁症的患者和未诊断为重度抑郁症的抑郁症患者有效。
Despite omega-3 polyunsaturated fatty acids (PUFA) supplementation in depressed patients have been suggested to improve depressive symptomatology, previous findings are not univocal. To conduct an updated meta-analysis of randomized controlled trials (RCTs) of omega-3 PUFA treatment of depressive disorders, taking into account the clinical differences among patients included in the studies. A search on MEDLINE, EMBASE, PsycInfo, and the Cochrane Database of RCTs using omega-3 PUFA on patients with depressive symptoms published up to August 2013 was performed. Standardized mean difference in clinical measure of depression severity was primary outcome. Type of omega-3 used (particularly eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) and omega-3 as mono- or adjuvant therapy was also examined. Meta-regression analyses assessed the effects of study size, baseline depression severity, trial duration, dose of omega-3, and age of patients. Meta-analysis of 11 and 8 trials conducted respectively on patients with a DSM-defined diagnosis of major depressive disorder (MDD) and patients with depressive symptomatology but no diagnosis of MDD demonstrated significant clinical benefit of omega-3 PUFA treatment compared to placebo (standardized difference in random-effects model 0.56 SD [95% CI: 0.20, 0.92] and 0.22 SD [95% CI: 0.01, 0.43], respectively; pooled analysis was 0.38 SD [95% CI: 0.18, 0.59]). Use of mainly EPA within the preparation, rather than DHA, influenced final clinical efficacy. Significant clinical efficacy had the use of omega-3 PUFA as adjuvant rather than mono-therapy. No relation between efficacy and study size, baseline depression severity, trial duration, age of patients, and study quality was found. Omega-3 PUFA resulted effective in RCTs on patients with bipolar disorder, whereas no evidence was found for those exploring their efficacy on depressive symptoms in young populations, perinatal depression, primary disease other than depression and healthy subjects. The use of omega-3 PUFA is effective in patients with diagnosis of MDD and on depressive patients without diagnosis of MDD.
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影响因子：
11
作者：
Bloch, M. H.;Hannestad, J.
通讯作者：
Hannestad, J.
影响因子：
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作者：
Amminger, G. Paul;Schafer, Miriam R.;Berger, Gregor E.
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影响因子：
4.8
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影响因子：
7.1
作者：
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通讯作者：
Calder, Philip C.
影响因子：
6.6
作者：
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通讯作者：
de Jonge, P.