Associations of n-3 polyunsaturated fatty acid status and intake with paediatric major depressive disorder in Swiss adolescents: A case-control study

Ester Osuna; Isabelle Herter-Aeberli; Silvia Probst; Sophie Emery; Mona Albermann; Noemi Baumgartner; Michael Strumberger; Cristian Ricci; Klaus Schmeck; Susanne Walitza; Martin Hersberger; Michael B Zimmermann; Isabelle Häberling; Gregor Berger; Jeannine Baumgartner; Omega-3 study team

doi:10.1016/j.jad.2023.07.046

Associations of n-3 polyunsaturated fatty acid status and intake with paediatric major depressive disorder in Swiss adolescents: A case-control study

J Affect Disord. 2023 Oct 15:339:355-365. doi: 10.1016/j.jad.2023.07.046. Epub 2023 Jul 10.

Authors

Affiliations

¹ Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Switzerland.
² Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Switzerland.
³ Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Switzerland; Psychiatry St. Gallen, Wil, SG, Switzerland.
⁴ Research Department of Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, University of Basel, Switzerland.
⁵ Africa Unit for Transdisciplinary Health Research (AUTHER), North-West University, Potchefstroom, South Africa.
⁶ Division of Clinical Chemistry and Biochemistry, University Children's Hospital Zurich, University of Zurich, Switzerland.
⁷ Laboratory of Human Nutrition, Institute of Food, Nutrition and Health, ETH Zürich, Switzerland; Department of Nutritional Sciences, King's College London, London, United Kingdom. Electronic address: jeannine.baumgartner@kcl.ac.uk.

PMID: 37437731
DOI: 10.1016/j.jad.2023.07.046

Abstract

Background: Observational studies suggest a link between n-3 polyunsaturated fatty acid (PUFA) intake, n-3 PUFA status, and depression in adults, but studies in adolescents are scarce. This study aimed to determine associations of n-3 PUFA status and intake with paediatric major depressive disorder (pMDD) in Swiss adolescents.

Methods: We conducted a matched case-control study in 95 adolescents diagnosed with pMDD and 95 healthy controls aged 13 to <18 years. We analysed red blood cell (RBC) fatty acid (FA) composition (% of total FA). n-3 PUFA intake was assessed using a focused food frequency questionnaire and depression severity was assessed by the Children's Depression Rating Scale-Revised (CDRS-R).

Results: Mean RBC eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were lower in cases than controls (EPA: 0.41 ± 0.11 vs 0.46 ± 0.12, p < 0.001; DHA: 4.07 ± 1.04 vs 4.73 ± 1.04, p < 0.001). Subsequently, the mean RBC n-3 index was lower (4.51 ± 1.10 vs 5.20 ± 1.11, p < 0.001) and the n-6/n-3 PUFA ratio higher (5.51 ± 1.25 vs 4.96 ± 1.08, p < 0.001) in cases than controls. Adolescents with a higher n-3 index had lower odds for depression (OR = 0.49 [95% CI: 0.32-0.71]). In contrast, the n-6/n-3 PUFA ratio was associated with higher odds for depression (OR = 1.58 [95% CI: 1.14-2.25]). Intake of alpha-linolenic acid, EPA and DHA did not differ between cases and controls.

Conclusion: Our results suggest that a higher RBC n-3 PUFA status during adolescence is associated with a lower risk for pMDD, whereas a higher n-6/n-3 PUFA ratio is associated with a higher risk for pMDD. Differences in n-3 PUFA intake did not explain the observed differences in n-3 PUFA status.

Keywords: Adolescents; Case-control study; Paediatric major depression; n-3 polyunsaturated fatty acids.