title: Effects of n-3 long-chain polyunsaturated fatty acids on depressed mood: systematic review of published trials.
abstract: BACKGROUND
  Greater dietary intakes of n-3 long-chain polyunsaturated fatty acids (n-3 PUFAs) may be beneficial for depressed mood.
  
  
  OBJECTIVE
  This study aimed to systematically review all published randomized controlled trials investigating the effects of n-3 PUFAs on depressed mood.
  
  
  METHODS
  Eight medical and health databases were searched over all years of records until June 2006 for trials that exposed participants to n-3 PUFAs or fish, measured depressed mood, were conducted on human participants, and included a comparison group.
  
  
  RESULTS
  Eighteen randomized controlled trials were identified; 12 were included in a meta-analysis. The pooled standardized difference in mean outcome (fixed-effects model) was 0.13 SDs (95% CI: 0.01, 0.25) in those receiving n-3 PUFAs compared with placebo, with strong evidence of heterogeneity (I2 = 79%, P < 0.001). The presence of funnel plot asymmetry suggested that publication bias was the likely source of heterogeneity. Sensitivity analyses that excluded one large trial increased the effect size estimates but did not reduce heterogeneity. Meta-regression provided some evidence that the effect was stronger in trials involving populations with major depression-the difference in the effect size estimates was 0.73 (95% CI: 0.05, 1.41; P = 0.04), but there was still considerable heterogeneity when trials that involved populations with major depression were pooled separately (I2 = 72%, P < 0.001).
  
  
  CONCLUSIONS
  Trial evidence that examines the effects of n-3 PUFAs on depressed mood is limited and is difficult to summarize and evaluate because of considerable heterogeneity. The evidence available provides little support for the use of n-3 PUFAs to improve depressed mood. Larger trials with adequate power to detect clinically important benefits are required.
authors.affiliation: Department of Experimental Psychology, University of Bristol, Bristol, United Kingdom. k.appleton@qub.ac.uk
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Appleton
authors.forename: Robert C
authors.initials: RC
authors.lastname: Hayward
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Peters
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Rogers
authors.forename: David
authors.initials: D
authors.lastname: Kessler
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Ness
mesh_terms: D000328:Adult; D002648:Child; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology; D004032:Diet; D004305:Dose-Response Relationship, Drug; D019317:Evidence-Based Medicine; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000188:drug therapy* / Q000453:epidemiology; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic
chemical_list: D015525:Fatty Acids, Omega-3