A Meta-Analytic Review of Polyunsaturated Fatty Acid Compositions in Patients with Depression

  • Pao-Yen Lin
    Department of Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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  • Shih-Yi Huang
    School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
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  • Kuan-Pin Su
    Address correspondence to Kuan-Pin Su, M.D., Ph.D., Department of Psychiatry, China Medical University Hospital, No. 2 Yuh-Der Road, Taichung 404, Taiwan
    School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan

    Department of Psychiatry and Mind-Body Research Center (MBI-Lab), Institute of Neural and Cognitive Sciences, China Medical University, Hospital, Taichung, Taiwan
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      On the basis of evidence from studies showing the antidepressant effects of omega-3 polyunsaturated fatty acids and the inverse relation between fish consumption and the prevalence of depression, the phospholipid hypothesis seems promising in ascertaining the etiology and treatment of depression. Although several studies have shown lower levels of omega-3 (n-3) polyunsaturated fatty acids in depressive patients, the results of individual polyunsaturated fatty acids, including docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and the omega-6 (n-6) polyunsaturated fatty acid arachidonic acid (AA), were inconsistent.


      We conducted the meta-analyses of 14 studies comparing the levels of polyunsaturated fatty acids between depressive patients and control subjects. The effect size of each study was synthesized by using a random effects model.


      Compared with control subjects, the levels of EPA, DHA, and total n-3 polyunsaturated fatty acids were significantly lower in depressive patients. There was no significant change in AA or total n-6 polyunsaturated fatty acids.


      The results showed lower levels of EPA, DHA, and total n-3 polyunsaturated fatty acids in patients with depression, thus implying that n-3 polyunsaturated fatty acids play a role in the pathogenesis of depression. Our findings provide further support to the phospholipid hypothesis of depression and a rationale for using n-3 polyunsaturated fatty acids as an alternative treatment for depression. With these results, future studies examining specific roles of DHA and EPA in different clusters of depressive symptoms are warranted.

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        Biological PsychiatryVol. 68Issue 2
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          For centuries, poets and folklore have asserted a relation between the heart (vascular system) and depression. The common metaphor of a “broken heart” is a symbol of the recognition of the link, and in fact “broken heart syndrome,” also called stress-induced cardiomyopathy, is a recognized entity characterized by a sudden temporary weakening of the myocardium. Vascular disease—in particular, ischemic heart disease—and depression are two of the most prevalent and devastating health problems (1). Thus, it is not unexpected that these two conditions often coexist.
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