title: ω-3 Fatty acids for major depressive disorder in adults: an abridged Cochrane review.
abstract: OBJECTIVE
  To assess the effects of n-3 polyunsaturated fatty acids (n-3PUFAs; also known as ω-3 fatty acids) compared with comparator for major depressive disorder (MDD) in adults.
  
  
  METHODS
  Systematic review and meta-analyses.
  
  
  METHODS
  The Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Registers (CCDANCTR) and International Trial Registries searched to May 2015. CINAHL searched to September 2013.
  
  
  
  METHODS
  a randomised controlled trial (RCT); that provided n-3PUFAs as an intervention; used a comparator; measured depressive symptomology as an outcome; and was conducted in adults with MDD.
  
  
  RESULTS
  Primary outcomes were depressive symptomology and adverse events.
  
  
  RESULTS
  20 trials encompassing 26 relevant studies were found. For n-3PUFAs versus placebo, n-3PUFA supplementation resulted in a small-to-modest benefit for depressive symptomology: SMD=-0.32 (95% CI -0.52 to -0.12; 25 studies, 1373 participants, very low-quality evidence), but this effect is unlikely to be clinically meaningful, is very imprecise and, based on funnel plot inspection, sensitivity analyses and comparison with large well-conducted trials, is likely to be biased. Considerable evidence of heterogeneity between studies was also found, and was not explained by subgroup or sensitivity analyses. Numbers of individuals experiencing adverse events were similar in intervention and placebo groups (OR=1.24, 95% CI 0.95 to 1.62; 19 studies, 1207 participants; very low-quality evidence). For n-3PUFAs versus antidepressants, no differences were found between treatments in depressive symptomology (MD=-0.70 (95% CI -5.88 to 4.48); 1 study, 40 participants, very low-quality evidence).
  
  
  CONCLUSIONS
  At present, we do not have sufficient evidence to determine the effects of n-3PUFAs as a treatment for MDD. Further research in the form of adequately powered RCTs is needed.
authors.affiliation: Department of Psychology, Faculty of Science and Technology, Bournemouth University, Poole, UK.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Appleton
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Hannah M
authors.initials: HM
authors.lastname: Sallis
authors.affiliation: National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition, Diet and Lifestyle at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Perry
authors.affiliation: National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition, Diet and Lifestyle at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Ness
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Churchill
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D015525:Fatty Acids, Omega-3
keywords: EPIDEMIOLOGY; NUTRITION & DIETETICS; THERAPEUTICS