Effects of multivitamin, mineral and n-3 polyunsaturated fatty acid supplementation on aggression among long-stay psychiatric in-patients: randomised clinical trial. Issue 2 (3rd March 2022)

• Record Type: Journal Article
• Authors: de Bles, Nienke J.; Rius-Ottenheim, Nathaly; Geleijnse, Johanna M.; van de Rest, Ondine; Bogers, Jan P.A.M.; Schat, Anke; Nijman, Henk L.I.; van den Berg, David; Joos, Lucas; van Strater, Annelies; de Ridder, Tine; Stolker, Joost J.; van den Hout, Wilbert B.; van Hemert, Albert M.; Giltay, Erik J.
• Is Part Of: BJPsych open. Volume 8:Issue 2(2022)
• Publication Date: 2022-03-03
• Subjects: Aggression -- supplements -- nutrition -- psychiatric in-patients -- n-3 polyunsaturated fatty acids; Psychiatry -- Periodicals; Mental health -- Periodicals; 616.89005
• DOI: 10.1192/bjo.2022.8
• Languages: English
• ISSNs: 2056-4724

Abstract

Abstract : Background: Aggression and violent incidents are a major concern in psychiatric in-patient care. Nutritional supplementation has been found to reduce aggressive incidents and rule violations in forensic populations and children with behavioural problems. Aims: To assess whether multivitamin, mineral and n-3 polyunsaturated fatty acid supplementation would reduce the number of aggressive incidents among long-stay psychiatric in-patients. Method: The trial was a pragmatic, multicentre, randomised, double-blind placebo-controlled study. Data were collected from 25 July 2016 to 29 October 2019, at eight local sites for mental healthcare in The Netherlands and Belgium. Participants were randomised (1:1) to receive 6-month treatment with either three supplements containing multivitamins, minerals and n-3 polyunsaturated fatty acid, or placebo. The primary outcome was the number of aggressive incidents, determined by the Staff Observation Aggression Scale – Revised (SOAS-R). Secondary outcomes were patient quality of life, affective symptoms and adverse events. Results: In total, 176 participants were randomised (supplements, n = 87; placebo, n = 89). Participants were on average 49.3 years old (s.d. 14.5) and 64.2% were male. Most patients had a psychotic disorder (60.8%). The primary outcome of SOAS-R incidents was similar in supplement (1.03 incidents per month, 95% CI 0.74–1.37) and placebo groups (0.90 incidents per month, 95% CI 0.65–1.19), with a rate ratio of 1.08 (95% CI 0.67–1.74, P = 0.75). Differential effects were not found in sensitivity analyses on the SOAS-R or on secondary outcomes. Conclusions: Six months of nutritional supplementation did not reduce aggressive incidents among long-stay psychiatric in-patients.