Omega-3 Supplementation Associated with Improved Parent-Rated Executive Function in Youth with Mood Disorders: Secondary Analyses of the Omega 3 and Therapy (OATS) Trials

Anthony T. Vesco et al.

Published in The Journal of Child Psychology and Psychiatry in 2018

Conducted at Ohio State University College of Medicine


Background—Improvements in executive functioning (EF) may lead to improved quality of life and lessened functional impairment for children with mood disorders. The aim was to assess the impact of omega-3 supplementation (Ω3) and psychoeducational psychotherapy (PEP), each alone and in combination, on EF in youth with mood disorders. We completed secondary analyses of two randomized controlled trials (RCTs) of Ω3 and PEP for children with depression and bipolar disorder.

Methods—Ninety-five youth with depression or bipolar disorder-not otherwise specified/cyclothymic disorder were randomized in 12-week RCTs. Two capsules (Ω3 or placebo) were given twice daily (1.87g Ω3 total daily, mostly eicosapentaenoic acid). Families randomized to PEP participated in twice-weekly 50-minute sessions. Analyses assess impact of interventions on the Behavior Rating Inventory of Executive Functioning (BRIEF) parent-report Global Executive Composite (GEC) and two subscales, Behavior Regulation (BRI) and Metacognition (MI) Indices. Intent-to-treat repeated measures ANOVAs, using multiple imputation for missing data, included all 95 randomized participants. Trials were registered with, NCT01341925 & NCT01507753. 

Results—Participants receiving Ω3 (aggregating combined and monotherapy) improved significantly more than aggregated placebo on GEC (p=0.001, d=0.70), BRI (p=0.004, d=0.49), and MI (p=0.04, d=0.41). Ω3 alone (d=0.49) and combined with PEP (d=0.67) each surpassed placebo on GEC. Moderation by ADHD comorbidity was non-significant although those with ADHD showed nominally greater gains. PEP monotherapy had negligible effect. 

Conclusions—Decreased impairment in EF was associated with Ω3 supplementation in youth with mood disorders. Research examining causal associations of Ω3, EF, and mood symptoms is warranted.