Psychiatry - Theses
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ItemAdjunctive Natural Low Dose Docosahexanoic Acid (DHA) Omega-3 in Residual Symptoms in Depressed Patients( 2021)The stated goal of psychiatric treatment is the remission of all presenting symptoms and a return of the patient to full pre-morbid functional status. Increasingly, the presence of residual symptoms of disorder have been linked to an early relapse of the underlying psychiatric syndrome. While pharmacological treatments of moderate to severe psychiatric disorders are the main therapeutic approach, remission is achieved in around 30% of patients with the first treatment. Adjunctive treatment regimens based on medications, so-called ‘nutraceuticals’ or psychotherapy, have been investigated for their ability to alleviate these persistent residual symptoms. Among adjunctive treatments omega-3 polyunsaturated fatty acids (PUFAs) have been investigated for their effects on symptoms of depression and anxiety. While many questions remain, one PUFA, docosahexaenoic acid (DHA), has shown promise as an adjunct to the treatment for the presenting complaints in Major Depressive Disorder but has not been investigated for residual symptoms. This exploratory study utilised a double-blind, placebo-controlled, cross-over methodology to investigate the efficacy of DHA in patients with residual symptoms of depression and anxiety meeting DSM-V criteria for a Major Depressive Disorder. Depression and anxiety symptoms were assessed at the end of 12-weeks of either placebo or DHA (and then the crossed-over situation) with clinician and patient rated scales and compared using a repeated measures analysis of variance. Neither the last observation carried forward nor the observed cases sets of data showed any statistically significant changes in depression or anxiety symptoms during treatment with placebo or DHA. Changes in patient rated scales, assessed using the same statistical methodology, were concordant with the findings from the clinician rated scales. It is concluded that DHA, in the doses used in this study, does not offer significant clinical benefits to patients with persistent residual mood symptoms. Several factors specific to the patient population studied are discussed which may explain the apparent lack of clinical effect. Further studies are suggested which could overcome some of the barriers to efficacy encountered in this trial.