Metabolic abnormalities and low dietary Omega 3 are associated with symptom severity and worse functioning prior to the onset of psychosis: Findings from the North American Prodrome Longitudinal Studies Consortium

• Type of Material: Article
• Authors: Kristin S. Cadenhead, University of California San Diego; Amedeo Minichino, University of Oxford; Skylar Kelsven, University of California San Diego; Jean Addington, University of Calgary; Carrie Bearden, University of California Los Angeles; Tyrone D. Cannon, Yale University; Barbara A. Cornblatt, Zucker Hillside Hospital; Dan Mathalon, University of California San Francisco; Thomas H. McGlashan, Yale University; Diana O. Perkins, University of North Carolina Chapel Hill; Larry J. Seidman, Harvard; Ming Tsuang, University of California San Diego; Elaine Walker, Emory University; Scott W. Woods, Yale University; Jeff Yao, VA Medical Center
• Language: English
• Date: 2019-02-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 Elsevier B.V.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.schres.2018.09.022
• Title of Journal or Parent Work: Schizophrenia Research
• Volume: 204
• Start Page: 96
• End Page: 103
• Grant/Funding Information: This study was supported by the National Institute of Mental Health (R01 U01 MH082022 to Dr Cadenhead, grant U01MH081984 to Dr Addington; grants U01 MH081928; P50 MH080272; Commonwealth of Massachusetts SCDMH82101008006 to Dr Seidman; grant U01MH081902 to Dr Cannon; P50 MH066286 (Prodromal Core) to Dr Bearden; grant U01MH082004 to Dr Perkins; grant U01MH081988 to Dr Walker; grant U01MH082022 to Dr Woods; and UO1 MH081857–05 grant to Dr Cornblatt.
• Keywords: Double-Blind Method; Prehypertension; Prediabetic State; Oxidative stress; Omega 3; Child; Adult; Dyslipidemias; Prodromal Symptoms; Young Adult; Risk; Clinical high risk; Metabolic Syndrome; Overweight; Male; Female; Severity of Illness Index; Diabetes Mellitus; Humans; Metabolic; Fatty acid; Fatty Acids, Omega-3; Adolescent; Hypertension
• Research Categories: Health Sciences, Nutrition; Psychology, Clinical

Abstract

Objective: Patients with schizophrenia have a high prevalence of metabolic disorders and cardiovascular mortality. It is possible that a vulnerability to metabolic abnormalities is associated with risk for psychosis, symptoms and functionality. In this study, we evaluate demographic information, cardiometabolic indices, symptoms and functioning in an antipsychotic free cohort at Clinical High Risk (CHR) for psychosis from the NAPLS Omega 3 fatty acid clinical trial. Method: Subjects received physical exams and metabolic monitoring prior to randomization into the Omega 3 versus Placebo trial. Anthropometrical measures, vital signs, glucose, and lipids were assessed along with symptoms, functioning, dietary Omega 3 fatty acids, erythrocyte polyunsaturated fatty acid content and a measure of lipid peroxidation (TBARS, Thiobarbituric acid-reactive substances). Results: The sample included 113 CHR subjects (42.1% female; 17.5% Latino) ages 12–29. The mean BMI was 24.3 with a trend toward higher BMI and a higher incidence of metabolic syndrome in Latino subjects; 36% of the sample was obese/overweight; 37.6% met criteria for prehypertension/hypertension; 4.2% met criteria for prediabetes/diabetes; 9.6% showed evidence of insulin resistance and 44.7% had dyslipidemia. The TBARS was elevated at 9.8 μM ± 6.1 (normal 1.86–3.94 μM). Metabolic parameters and a diet low in Omega 3 rich foods were significantly associated with prodromal symptoms and poor functioning. Conclusions: CHR subjects show a high percentage of metabolic abnormalities prior to exposure to antipsychotic medication. These findings reinforce that early detection of metabolic disturbances and food insecurity is crucial since these factors are modifiable with the potential for significant gains in terms of quality of life, physical and mental health.