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 YuenRobert Hester, Alison Ruth Yung, Patrick D. Mcgorry, Kelly Allott, G. Paul Amminger

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Abstract

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.
Original languageEnglish
Article numbere165
JournalBJPsych Open
Volume8
Issue number5
DOIs
Publication statusPublished - 8 Sept 2022

Keywords

  • Cognition
  • clinical high risk
  • early intervention
  • psychotic disorders
  • randomised controlled trial

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