Network meta-analysis indicates superior effects of omega-3 polyunsaturated fatty acids in preventing the transition to psychosis in individuals at clinical high-risk.

BACKGROUND: The efficacy of pharmacological and nutritional interventions in individuals at clinical high risk for psychosis (CHR-P) remains elusive. This study aims to investigate the efficacy of pharmacological and nutritional interventions in CHR-P and whether these interventions can enhance the efficacy of psychological treatments.

METHODS: We systematically reviewed data from five databases until July 24, 2021: PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure, and WanFang Data. The primary outcome was the transition to psychosis. Network meta-analyses were conducted at three time points (6, 12, and ≥24 months) considering both pharmacological/nutritional interventions alone and its combination with psychotherapy.

RESULTS: Out of 11,417 identified references, 21 studies were included, comprising 1,983 participants. CHR-P participants receiving omega-3 polyunsaturated fatty acids treatment were associated with a lower probability of transition compared to placebo/control at 6 months (OR 0.07, 95% CI 0.01 to 0.054), 12 months (OR 0.14, 95% CI 0.03 to 0.66), and ≥24 months (OR 0.16, 95% CI 0.05 to 0.54). Moreover, risperidone plus psychotherapy, was associated with a lower likelihood of transition at 6 months in comparison to placebo/control plus psychotherapy, but this result was not sustained over longer durations.

CONCLUSION: Omega-3 polyunsaturated fatty acids helped in preventing transitions to psychosis compared to controls.