Long‐Chain Omega‐3 Polyunsaturated Fatty Acids in the Blood of Children and Adolescents with Juvenile Bipolar Disorder

Abstract

Reduced long-chain omega-3 polyunsaturated fatty acids (LCn-3PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been reported in adult patients suffering from depression and bipolar disorder (BD). LCn-3PUFA status has not previously been examined in children and adolescents with BD compared with healthy controls. Fifteen children and adolescents (9-18 years, M ± SD = 14.4 ± 3.48) diagnosed with juvenile bipolar disorder (JBD) and fifteen healthy age and sex-matched controls were assessed for dietary intake and fasting red blood cell (RBC) membrane concentrations of LCn-3PUFA. Fatty acid concentrations were compared between participants diagnosed with JBD and controls after controlling for dietary intake. RBC membrane concentrations of EPA and DHA were not significantly lower in participants diagnosed with JBD compared with healthy controls (M ± sem EPA = 3.37 ± 0.26 vs. 3.69 ± 0.27 lg/mL, P = 0.458; M ± sem DHA = 22.08 ± 2.23 vs. 24.61 ± 2.38 lg/mL, P = 0.528) after controlling for intake. Red blood cell DHA was negatively (r = -0.55; P = 0.044) related to clinician ratings of depression. Although lower RBC concentrations of LCn-3PUFA were explained by lower intakes in the current study, previous evidence has linked reduced LCn-3PUFA to the aetiology of BD. As RBC DHA was also negatively related to symptoms of depression, a randomised placebo-controlled study examining supplementation with LCn-3PUFA as an adjunct to standard pharmacotherapy appears warranted in this patient population.

Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease

“…204,205 A small study compared youth with versus without BD and found large between-group differences in red blood cell membrane concentrations of omega-3 levels; however, these were not significant after controlling for dietary intake. 206 However, greater docosahexaenoic acid levels were associated with significantly lower depressive symptoms in the BD group. The Ryukyus Child Health Study (n=3067 boys and 3450 girls, 12-15 years old) examined fish intake and omega-3 levels in relation to depressive symptoms.…”

Reduced mania and depression in juvenile bipolar disorder associated with long-chain ω-3 polyunsaturated fatty acid supplementation

“…Several participants received other medication in addition to a primary mood-stabilizer, with the most common being risperidone, dexamphetamine and selective serotonin re-uptake inhibitors. Details of inclusion and exclusion criteria have been described previously (Clayton et al, 2008). Participants had not taken LCn-3PUFA supplements within the previous 12 weeks and were not receiving any medications that affected lipid metabolism or blood coagulation.…”

“…Fasting blood samples were collected at each assessment and red blood cells (RBCs) were separated from plasma for analysis of fatty acids using gas chromatography. Details of the assessment of mood, behaviour and RBC fatty acids have been described previously (Clayton et al, 2008).…”

“…Changes in measures were analysed by repeated measures analysis using the MIXED Model procedure in the SAS program (Clayton et al, 2008). Percentage changes in psychological measures were correlated with baseline measures and changes in RBC LCn-3PUFA by Pearson correlation.…”

The Use of Omega-3 Fatty Acids in Mental Illness

“…[66][67][68] Clayton et al found no differences in omega-3 fatty acid concentrations in pediatric bipolar disorder when controlling for the intake of omega-3 fatty acids. 69 Rather, the authors suggest that the high cost of fresh fish and low socioeconomic status often associated with bipolar disorder may account for the lower concentrations of omega-3 fatty.…”