今回は「小児、思春期の躁うつ病症状に対するオメガ３の有効性について」です。

J Child Adolesc Psychopharmacol. 2015 Sep;25(7):526-34. doi: 10.1089/cap.2013.0141. Epub 2015 Aug 19.

Omega-3 Supplementation for Psychotic Mania and Comorbid Anxiety in Children.
Vesco AT, et al


Abstract
OBJECTIVES:
Therapeutic benefits of omega-3 fatty acids (Ω3) for mood disorders, psychosis, and anxiety have been reported in the literature. The purpose of the present article is to provide a literature review of Ω3 supplementation for affective disorders and to illustrate the benefits of Ω3 with a case presentation of a young girl with a history of bipolar disorder-type 1 with psychotic features and generalized anxiety disorder.

METHODS:
Reviewed literature includes treatment studies of the impact of Ω3 on child mood disorders supplemented by review of meta-analyses within the adult mood disorders literature. The subject of this case report participated in 11 in-depth diagnostic and functional assessments over 5 years as part of an unrelated study. Three years were presupplementation and 2 years were with supplementation with no other medication changes, thus making a naturalistic multiple-baseline single-subject experiment.

RESULTS:
Augmentation over a 2 year period was notable for clinically significant and sustained improvement in depressive, manic, and psychotic symptoms.

CONCLUSION:
Ω3 supplementation may be a safe, adjunct intervention for treating bipolar disorder in children and adolescents, even in the presence of psychotic and anxious features. The 2 year follow-up in this case offers hope of an accumulating and enduring benefit. Further research into mechanisms of Ω3 action and of combination treatment with other well-known interventions for mood disorders would be beneficial.


やはりオメガ３は躁うつ病の症状に対してある一定の有効性は認めているようですが、単独投与ではもちろん症状をコントールできないため、薬物療法や精神療法に併用してオメガ３など栄養療法を行うことが望ましいと思われます。

しかしどちらにしてもオメガ３だけでなく、DHA、EPA、ビタミン類など、特定の栄養素を使用することで精神症状が改善する可能性を示唆する論文は増えてきています。

外来でも最近はただなんらかの診断に対して薬物療法や心理療法をやるだけでなく、運動療法、栄養療法、作業療法など、さまざまな治療選択肢を組み合わせ、多職種チームで治療に取り組みことで、これまで以上の成果をみています。

どの疾患に対しても体や脳を構成する細胞の材料となる栄養は非常に重要だと思いますので、実践しながら、臨床経験を蓄積していきたいと思います。

記事作成：加藤晃司（医療法人永朋会）
　　　　　専門：児童精神科（日本精神神経学会専門医、日本児童青年期精神医学会認定医、子どものこころ専門医）