title: Fish consumption and resilience to depression in Japanese company workers: a cross-sectional study.
abstract: BACKGROUND
  Depression is a common disorder that is influenced by psychosocial factors in the workplace. Increasing resilience, the ability to cope with stress in the face of adversity, is considered an important strategy to prevent depression. It has been suggested that consumption of fish, which is a major source of long chain n-3 polyunsaturated fatty acids (LC n-3 PUFA), may prevent depression. However, associations between depression, resilience, and fish consumption have not been documented. The aim of the study is to investigate the association between fish consumption and resilience to depression.
  
  
  METHODS
  Participants were 527 Japanese employees at three worksites of a large company. The Center for Epidemiologic Studies Depression (CES-D) Scale was administered to assess depressive symptoms, and the 14-item Resilience Scale (RS-14) was administered to assess resilience. A self-report questionnaire extracted from the Food Frequency Questionnaire was used to measure fish consumption frequency. Regression analyses were conducted to assess a mediation model based on a statistical analysis framework defined by Baron and Kenny. The indirect association of resilience was calculated with the bootstrapping method. Each analysis was adjusted by age, sex, marital status, work position, and educational background.
  
  
  RESULTS
  The association between fish consumption frequency and total CES-D score was significant (B=-0.94; p=0.011). The association between fish consumption frequency and total RS-14 score was significant (B=1.4; p=0.010), as was association total RS-14 score and the total CES-D score (B=-0.34; p<0.001). When controlling for total RS-14 score, there was no longer a significant association between fish consumption frequency and total CES-D score. The bootstrapping results revealed that significant indirect association though fish consumption frequency and total CES-D score (bias corrected and accelerated confidence interval=-0.83 to -0.13; 95% confidence interval) through total RS-14 score.
  
  
  CONCLUSIONS
  Fish consumption might be associated with resilience to depression. Further studies are needed, particularly double blind randomized placebo controlled intervention trials on the potential preventative effect of LC n-3 PUFA on resilience to depression.
authors.affiliation: Department of Neuropsychiatry, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan. e-yoshi@nms.ac.jp.|Department of Neuropsychiatry, Nippon Medical School, Tokyo, Japan. e-yoshi@nms.ac.jp.
authors.forename: Eisho
authors.initials: E
authors.lastname: Yoshikawa
authors.affiliation: Department of Psychiatry, National Disaster Medical Center, Tokyo, Japan. d-nishi@umin.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nishi
authors.affiliation: Department of Psychiatry, National Disaster Medical Center, Tokyo, Japan. matsuoka-psy@umin.ac.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Matsuoka
mesh_terms: D000328:Adult; D000818:Animals; D003430:Cross-Sectional Studies; D003863:Depression / Q000517:prevention & control*; D004032:Diet; D005260:Female; D005399:Fishes; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D055500:Resilience, Psychological; D011795:Surveys and Questionnaires; D055815:Young Adult