RESUMO
OBJECTIVE: Epidemiological research links aggression to low serum concentrations of omega-3 fatty acids, such as those found in fish oil. However, no studies have specifically examined whether fish oil supplementation can reduce the frequency and severity of impulsive aggression in children with disruptive behavior disorders. METHODS: Children presenting with impulsive aggression and meeting research criteria for diagnosis of disruptive behavior disorders were randomized to receive either: 1) Fish oil capsules (4 g daily) for 6 weeks followed by placebo (identical-looking capsules) for 6 weeks; or 2) placebo for 6 weeks, followed by fish oil for 6 weeks, in a double-blind, crossover design. Primary outcomes were the Children's Aggression Scale and the Modified Overt Aggression Scale. Secondary outcomes included emotional and behavioral functioning (Strengths and Difficulties Questionnaire [SDQ]), hyperactivity symptoms (Attention-Deficit/Hyperactivity Disorder [ADHD] Rating Scale), family functioning (Family Assessment Device), and cognitive functioning (Stop Signal Task, Trail-Making Task, and Eriksen Flanker Task). Serum concentrations of omega-3 and omega-6 fatty acids were measured at baseline, and at 6 and 12 weeks. RESULTS: Twenty-one children participated (81% male; mean age 10.3±2.2 years; range 7-14). Fish oil treatment increased serum concentrations of eicosapentanoic acid (F=14.76, p<0.05) and total omega-3s (F=20.56, p<0.05), but did not influence primary ratings of aggression. In fact, a trend suggested that fish oil worsened a secondary measure of aggression (SDQ Conduct Subscale, F=4.34, p=0.06). Fish oil treatment was associated with an improvement in one rating of hyperactivity (SDQ Hyperactivity Subscale, F=2.22, p<0.05), but did not influence any other outcome measures. CONCLUSIONS: These findings suggest that fish oil treatment does not improve aggression in children with disruptive behavior disorders.
Assuntos
Agressão/efeitos dos fármacos , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/dietoterapia , Óleos de Peixe/farmacologia , Óleos de Peixe/uso terapêutico , Comportamento Impulsivo/efeitos dos fármacos , Adolescente , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/sangue , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/complicações , Criança , Cognição/efeitos dos fármacos , Estudos Cross-Over , Método Duplo-Cego , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-6/sangue , Feminino , Óleos de Peixe/efeitos adversos , Humanos , Masculino , Resultado do TratamentoRESUMO
BACKGROUND: Early pregnancy loss has been linked to enduring psychological morbidity. AIMS: This study aimed to investigate the utility of the Kessler 10 (K10) questionnaire as a brief screening instrument to identify women at risk for the development of psychiatric diagnoses three months post-miscarriage. METHOD: Participants were 117 consecutive women presenting at a public hospital emergency department and receiving a diagnosis of miscarriage. MAIN OUTCOME MEASURES: K10 screen for psychological distress and the Structured Clinical Interview for DSM Disorders to determine psychiatric diagnoses. RESULTS: A majority of women (81.2%) experienced elevated levels of distress initially, 24.8% in the very high range. They were not at increased risk of psychiatric diagnoses at three months compared with the general population; however, they were significantly more likely to report subsyndromal symptoms at this time compared with the general population. The baseline K10 score was the only significant predictor of distress at follow-up (r = 0.45, P < 0.001). The receiver operating characteristic curve shows that a cut-off of 14 on the K10 has suitable sensitivity (97%) and specificity (82%) for predicting ongoing psychological distress in women who miscarry. CONCLUSIONS: The K10 is effective in identifying women at risk for ensuring psychological symptoms following miscarriage.