Omega-3 fatty acids and supportive psychotherapy for perinatal depression: A randomized placebo-controlled study

Freeman, Marlene P.; Davis, Melinda F.; Sinha, Prawal; Wisner, Katherine L.; Hibbeln, Joseph R.; Gelenberg, Alan J.

doi:10.1016/j.jad.2007.12.228

Cited by 171 publications

(150 citation statements)

References 43 publications

(34 reference statements)

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“…105 It has been reported that fish consumption and omega-3 status after childbirth are not associated with PND, 106 but there is still interest in exploring the role of omega-3 fatty acids in PND, alone or combined with supportive psychotherapy. 107 …”

Section: Pharmacological Interventions or Supplementsmentioning

confidence: 99%

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

Morrell

Sutcliffe

Booth

et al. 2016

Health Technol Assess

105

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A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression C Jane Morrell, 1 * Paul Sutcliffe, 2 Andrew Booth, 3 John Stevens, 3 This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was funded by the HTA programme as project number 11/95/03. The contractual start date was in November 2012. The draft report began editorial review in August 2014 and was accepted for publication in June 2015. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HTA programme or the Department ...

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Section: Pharmacological Interventions or Supplementsmentioning

confidence: 99%

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

Morrell

Sutcliffe

Booth

et al. 2016

Health Technol Assess

105

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“…Of the former, six were randomized controlled trials (Doornbos et al, 2009;Freeman et al, 2008;Llorent et al, 2003;Makrides et al, 2010;Mozurkewich et al, 2013;Rees, Austin, & Parker, 2008) and two pilot trials (Freeman et al, 2006;Marangell et al, 2004). The nine observational studies included: one ecological study (Hibbeln, 2002), a cross-sectional study (De Vriese, Christophe, & Maes, 2003), a case-control study (Browne, Scott, & Silvers, 2006), and six cohort studies (da Rocha & Kac, 2012;Markhus et al, 2013;Miyake et al, 2006;Otto, De Groot, & Hornstra, 2003;Parker et al, 2014;Strøm, Mortensen, Halldorsson, Thorsdottir, & Olsen, 2009).…”

Section: Overall Results In Context With Expectations Arising From Thmentioning

confidence: 99%

Role of Omega-3 Unsaturated Fatty Acids in the Postpartum Depression: Systematic Review and Narrative Synthesis

Mougharbel¹,

Deonandan²

2016

GJHS

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Background: Postpartum depression (PPD) is a complex mental health disorder that affects women during their childbearing years. It is a serious medical condition that occurs in approximately 15% of women after birth and has an adverse effect on both the mother and the infant. Hypotheses exist relating dietary deficiencies in a pregnant or postnatal woman's diet may cause postnatal depression. It is unclear whether Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are effective for treating or preventing PPD. Objectives:To assess the best available evidence to date regarding the effect of n-3 PUFAs on the etiology, prevention and treatment of postnatal depression. Methods:A systematic review and narrative synthesis was conducted in order to address the gaps in knowledge. For the systematic review, a broad search of electronic databases of published quantitative literature was conducted. The narrative synthesis consists of four elements: 1) developing a theory; 2) developing a preliminary synthesis; 3) exploring relationships in the data; 4) assessing the robustness of the synthesis. Published experimental and observational studies were accepted involving women who were pregnant or who had given birth in the previous six weeks. N-3 PUFAs was the intervention of interest and PPD was the outcome.Results: Out of 181 potential articles, a total of 17 studies met the inclusion criteria. The overwhelming majority of the studies found that n-3 PUFAs had no inverse association with PPD evaluations. Significant heterogeneity was observed among included studies. Conclusions:Overall, This systematic review and narrative synthesis failed to find a significant positive association between n-3 PUFAs intake and PPD.

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“…For three studies, depression was not the primary outcome measure (35,36,41) . All included studies used marine-derived n-3 PUFA interventions; some used fish oil (35,36,44) , some DHA (41,43) , and some a combination of DHA and EPA (42,45) . Therefore, the remainder of the present paper focuses on these fatty acids.…”

Section: Resultsmentioning

confidence: 99%

The efficacy of n-3 fatty acids DHA and EPA (fish oil) for perinatal depression

2010

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Depressive symptoms are common during pregnancy and the post-partum period. Although essential n-3 PUFA may have beneficial effects on depression, it remains unclear whether they are also effective for perinatal depression. The purpose of the present study was to assess the efficacy of n-3 supplementation for perinatal depression, by performing a meta-analysis on currently available data. After a thorough literature search, we included seven randomised controlled trials in the meta-analysis, all with EPA and/or DHA supplementation. Most studies were judged to be of low-to-moderate quality, mainly due to small sample sizes and failure to adhere to Consolidated Standards of Reporting Trials guidelines. Some studies were not primarily designed to address perinatal depression. A total of 309 women on n-3 fatty acid supplementation were compared with 303 women on placebo treatment. n-3 Supplementation was not found to be significantly more effective than placebo at post-treatment with a pooled effect size (Hedges's g) of 20·03 (95 % CI 2 0·18, 0·13; P¼ 0·76) using a fixed-effects model. Heterogeneity was low-to-moderate (I 2 ¼ 30 %). In a subgroup analysis of three small studies of pregnant women with major depression, there was some indication of effectiveness (effect size 0·17; 95 % CI 2 0·21, 0·55). In conclusion, the question of whether EPA and DHA administration is effective in the prevention or treatment of perinatal depression cannot be answered yet. Future research should focus on women who are clinically depressed (or at risk). The quality of research in this area needs to improve.

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Omega-3 fatty acids and supportive psychotherapy for perinatal depression: A randomized placebo-controlled study

Cited by 171 publications

References 43 publications

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression

Role of Omega-3 Unsaturated Fatty Acids in the Postpartum Depression: Systematic Review and Narrative Synthesis

The efficacy of n-3 fatty acids DHA and EPA (fish oil) for perinatal depression

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