Adolescents with or at ultra‐high risk for bipolar disorder exhibit erythrocyte docosahexaenoic acid and eicosapentaenoic acid deficits: a candidate prodromal risk biomarker. Issue 3 (20th October 2015)

• Record Type: Journal Article
• Authors: McNamara, Robert K.; Jandacek, Ronald; Tso, Patrick; Blom, Thomas J.; Welge, Jeffrey A.; Strawn, Jeffrey R.; Adler, Caleb M.; Strakowski, Stephen M.; DelBello, Melissa P.
• Is Part Of: Early intervention in psychiatry. Volume 10:Issue 3(2016:Jun.)
• Page Start: 203
• Page End: 211
• Publication Date: 2015-10-20
• Subjects: arachidonic acid (AA) -- eicosapentaenoic acid (EPA) -- mania -- omega‐3 index -- ultra‐high risk; Mental health -- Periodicals; Psychiatry -- Periodicals; Psychiatry -- Research -- Periodicals; Mental illness -- Prevention -- Research -- Periodicals; Mental illness -- Treatment -- Research -- Periodicals; 616.89
• DOI: 10.1111/eip.12282
• Languages: English
• ISSNs: 1751-7885

Abstract

Abstract: Aim: Mood disorders are associated with low levels of the long‐chain omega‐3 (LC n ‐3) fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). This study investigated LC n ‐3 fatty acid biostatus in youth with or at varying risk for developing mania to assess its utility as a prodromal risk biomarker. Method: Erythrocyte fatty acid composition was determined in healthy adolescents ( n = 28, HC), asymptomatic adolescents with a biological parent with bipolar I disorder ( n = 30; 'high risk', HR), adolescents with a biological parent with bipolar I disorder and major depressive disorder, or depressive disorder not otherwise specified ( n = 36; 'ultra‐high risk', UHR), and first‐episode adolescent bipolar manic patients ( n = 35, BP). Results: Group differences were observed for DHA ( P ≤ 0.0001) and EPA ( P = 0.03). Compared with HC, erythrocyte EPA + DHA ('omega‐3 index') was significantly lower in BP (−24%, P ≤ 0.0001) and UHR (−19%, P = 0.0006) groups, and there was a trend in the HR group (−11%, P = 0.06). Compared with HC (61%), a greater percentage of HR (77%, P = 0.02), UHR (80%, P = 0.005) and BP (97%, P = 0.001) subjects exhibited EPA + DHA levels of ≤4.0%. Among all subjects ( n = 130), EPA + DHA was inversely correlated with manic ( r = −0.29, P = 0.0008) and depressive ( r = −0.28, P = 0.003) symptom severity. The AA/EPA + DHA ratio was significantly greater in BP (+22%, P = 0.0002) and UHR (+16%, P = 0.001) groups. Conclusions: Low EPA + DHA levels coincide with the initial onset of mania, and increasing risk for developing bipolar disorder is associated with graded erythrocyte EPA + DHA deficits. Low erythrocyte EPA + DHA biostatus may represent a promising prodromal risk biomarker warranting additional evaluation in future prospective studies.