title: A randomized, controlled, crossover trial of fish oil treatment for impulsive aggression in children and adolescents with disruptive behavior disorders.
abstract: OBJECTIVE
  Epidemiological research links aggression to low serum concentrations of omega-3 fatty acids, such as those found in fish oil. However, no studies have specifically examined whether fish oil supplementation can reduce the frequency and severity of impulsive aggression in children with disruptive behavior disorders.
  
  
  METHODS
  Children presenting with impulsive aggression and meeting research criteria for diagnosis of disruptive behavior disorders were randomized to receive either: 1) Fish oil capsules (4 g daily) for 6 weeks followed by placebo (identical-looking capsules) for 6 weeks; or 2) placebo for 6 weeks, followed by fish oil for 6 weeks, in a double-blind, crossover design. Primary outcomes were the Children's Aggression Scale and the Modified Overt Aggression Scale. Secondary outcomes included emotional and behavioral functioning (Strengths and Difficulties Questionnaire [SDQ]), hyperactivity symptoms (Attention-Deficit/Hyperactivity Disorder [ADHD] Rating Scale), family functioning (Family Assessment Device), and cognitive functioning (Stop Signal Task, Trail-Making Task, and Eriksen Flanker Task). Serum concentrations of omega-3 and omega-6 fatty acids were measured at baseline, and at 6 and 12 weeks.
  
  
  RESULTS
  Twenty-one children participated (81% male; mean age 10.3±2.2 years; range 7-14). Fish oil treatment increased serum concentrations of eicosapentanoic acid (F=14.76, p<0.05) and total omega-3s (F=20.56, p<0.05), but did not influence primary ratings of aggression. In fact, a trend suggested that fish oil worsened a secondary measure of aggression (SDQ Conduct Subscale, F=4.34, p=0.06). Fish oil treatment was associated with an improvement in one rating of hyperactivity (SDQ Hyperactivity Subscale, F=2.22, p<0.05), but did not influence any other outcome measures.
  
  
  CONCLUSIONS
  These findings suggest that fish oil treatment does not improve aggression in children with disruptive behavior disorders.
authors.affiliation: 1 Kids in Mind Research, Mater Research , Mater Health Services, South Brisbane, QLD, Australia .
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Dean
authors.forename: William
authors.initials: W
authors.lastname: Bor
authors.forename: Kareen
authors.initials: K
authors.lastname: Adam
authors.forename: Francis G
authors.initials: FG
authors.lastname: Bowling
authors.forename: Mark A
authors.initials: MA
authors.lastname: Bellgrove
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000187:drug effects*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000097:blood / Q000150:complications / Q000178:diet therapy*; D002648:Child; D003071:Cognition / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000097:blood; D043371:Fatty Acids, Omega-6 / Q000097:blood; D005260:Female; D005395:Fish Oils / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D007175:Impulsive Behavior / Q000187:drug effects*; D008297:Male; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005395:Fish Oils