Omega-3 Fatty Acid Supplementation in Adolescents with Borderline Personality Disorder and Ultra-High Risk Criteria for Psychosis: A Post Hoc Subgroup Analysis of a Double—Blind, Randomized Controlled Trial

Abstract

Objective: To investigate whether long-chain omega-3 (n-3) polyunsaturated fatty acids (PUFAs) improve functioning and psychiatric symptoms in young people with borderline personality disorder (BPD) who also meet ultra-high risk criteria for psychosis. Methods:We conducted a post hoc subgroup analysis of a double-blind, randomized controlled trial. Fifteen adolescents with BPD (mean age 16.2 years, [SD 2.1]) were randomized to either 1.2 g/day n-3 PUFAs or placebo. The intervention period was 12 weeks. Study measures included the Positive and Negative Syndrome Scale, the Montgomery-Åsberg Depression Rating Scale, and the Global Assessment of Functioning. Side effects were documented with the Udvalg for Kliniske Undersøgelser. Fatty acids in erythrocytes were analyzed using capillary gas chromatography.Results: At baseline, erythrocyte n-3 PUFA levels correlated positively with psychosocial functioning and negatively with psychopathology. By the end of the intervention, n-3 PUFAs significantly improved functioning and reduced psychiatric symptoms, compared with placebo. Side effects did not differ between the treatment groups.Conclusions: Long-chain n-3 PUFAs should be further explored as a viable treatment strategy with minimal associated risk in young people with BPD.(Clinical Trial Registration Number: NCT00396643) W W W

ESCAP Expert Article: Borderline personality disorder in adolescence: An expert research review with implications for clinical practice

“…In a small double-blind, placebo-controlled RCT, Amminger et al [140] investigated whether omega-3 polyunsaturated fatty acids (PUFAs), given as capsules of a fish oil supplement, improved psychosocial functioning and psychopathology in 15 adolescents with BPD who also met ultra-high risk criteria for psychosis. After a 12-week intervention, omega-3 PUFAs significantly improved functioning and reduced psychiatric symptoms compared with placebo.…”

Borderline Personality Disorder in Adolescence

“…One preliminary study exists for the use of omega-3 fatty acids in adolescents with BPD and ultra high risk for psychosis. 134 Overall, there is no current evidence for any specific pharmacotherapy as a first-line treatment of adolescent BPD, and the risks of polypharmacy and iatrogenic harm are high in these young people. 9 Comorbid disorders should be treated according to their respective clinical guidelines for adolescents, and this might sometimes involve pharmacotherapy.…”

Pharmacotherapy of personality disorders: what we know and what we have to search for

“…Amminger et al [101] performed a 12 week double-blind RCT comparing long-chain omega-3 polyunsaturated fatty acids and placebo in BPD patients with high risk of psychosis. The treatment group showed a significantly greater improvement in global functioning compared over placebo group.…”