Docosahexaenoic Acid for Selective Prevention of Posttraumatic Stress Disorder Among Severely Injured Patients: A Randomized, Placebo-Controlled Trial
Docosahexaenoic Acid for Selective Prevention of Posttraumatic Stress Disorder Among Severely Injured Patients: A Randomized, Placebo-Controlled Trial
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DOI：
10.4088/jcp.14m09260
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发表时间：
2015-08-01
影响因子：
5.3
通讯作者：
Hamazaki, Tomohito
中科院分区：
文献类型：
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作者：
Matsuoka, Yutaka;Nishi, Daisuke;Hamazaki, Tomohito
目的：二十二碳六烯酸（DHA）可能有助于预防或减轻创伤后应激障碍（PTSD）症状。我们检验了DHA预防严重意外伤害后PTSD （DSM-IV）的有效性和安全性。方法：2008年12月至2013年8月，我们对日本东京国家灾难医疗中心重症监护室连续收治的110例事故受伤患者进行随机、双盲、安慰剂对照试验。所有患者接受20分钟关于意外伤害的心理反应的教育，并随机分配接受1470 mg/d DHA加147 mg/d二十碳五烯酸（EPA, n = 53）或安慰剂（n = 57） 12周。主要观察指标为3个月随访时临床应用PTSD量表（CAPS）的总分。次要结局包括PTSD诊断（完全或部分PTSD）。通过红细胞脂肪酸组成来评估干预措施的依从性。结果：3个月时，两组CAPS总分无差异（DHA组10.78 vs安慰剂组9.22;n = 100; P = 0.572）。我们发现11.1%的DHA组和5.5%的安慰剂组患上了PTSD。与安慰剂组相比，DHA组红细胞DHA和EPA水平显著升高（P < 0.01）。结论：在严重意外伤害后3个月，补充二十二碳六烯酸对PTSD症状的二级预防并不优于安慰剂。不同比例的DHA和EPA以及更高剂量的omega-3脂肪酸作为PTSD二级预防的效果仍有待确定。(C) 2015年全国医师研究生出版社版权所有
Objective: Docosahexaenoic acid (DHA) might help prevent or attenuate posttraumatic stress disorder (PTSD) symptoms. We examined the efficacy and safety of DHA for preventing PTSD (DSM-IV) after severe accidental injury.Method: From December 2008 to August 2013, we conducted a randomized, double-blind, placebo-controlled trial of 110 accident-injured patients consecutively admitted to an intensive care unit of the National Disaster Medical Center in Tokyo, Japan. All patients were taught about their psychological reactions to accidental injury for 20 minutes and were randomly assigned to receive 1,470 mg/d of DHA plus 147 mg/d of eicosapentaenoic acid (EPA; n = 53) or placebo (n = 57) for 12 weeks. The primary outcome was total score on the Clinician-Administered PTSD Scale (CAPS) at 3-month follow-up. Secondary outcomes included PTSD diagnosis (full-blown or partial PTSD). Adherence to the interventions was assessed by erythrocyte fatty acid composition.Results: At 3 months, the CAPS total score revealed no differences between the 2 groups (10.78 in the DHA group vs 9.22 in the placebo group; n = 100; P = .572). We found that 11.1% of the DHA group and 5.5% of the placebo group developed PTSD. The erythrocyte level of DHA and EPA in the DHA group was significantly elevated compared to the placebo group (P < .01).Conclusions: Docosahexaenoic acid supplementation was not superior to placebo for the secondary prevention of PTSD symptoms at 3 months after severe accidental injury. The efficacy of a different ratio of DHA and EPA and higher doses of omega-3 fatty acids as secondary prevention of PTSD remains to be determined. (C) Copyright 2015 Physicians Postgraduate Press, Inc.