The effect of omega-3 polyunsaturated fatty acid supplementation on emotional dysregulation, oppositional behaviour and conduct problems in ADHD: A systematic review and meta-analysis

J Affect Disord. 2016 Jan 15;190:474-482. doi: 10.1016/j.jad.2015.09.053. Epub 2015 Oct 29.


Background: A number of randomised controlled trials report a beneficial effect of omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation on emotional lability (EL) and related domains (e.g. oppositional behaviour, conduct problems). Given that n-3 PUFA supplementation shows a significant effect on reducing symptoms of attention-deficit/hyperactivity disorder (ADHD) and that EL and related behaviours commonly co-occurs with ADHD, it is important that there is a more conclusive picture as to the effect of n-3 PUFA on these co-occurring clinical domains.

Methods: Databases (Ovid Medline, Embase, Psychinfo) were searched for trials assessing the effects of n-3 PUFA on EL, oppositional behaviour, aggression and conduct problems. We included trials in children who had ADHD or a related neurodevelopmental disorder.

Results: Of the 1775 identified studies, 10 were included in the meta-analysis. In the primary analyses n-3 PUFA supplementation did not show improvements in measures of EL, oppositional behaviour, conduct problems or aggression. However subgroup analyses of higher quality studies and those meeting strict inclusion criteria found a significant reduction in EL and oppositional behaviour.

Limitations: A number of treatment effects may have failed to reach statistical significance due to small sample sizes and within and between study heterogeneity in terms of design and study participants.

Conclusions: These results exclude the possibility of moderate to large effects. They provide suggestive evidence of small effects of n-3 PUFA on reducing EL and oppositional behaviour in subgroups of children with ADHD.

Keywords: Attention deficit hyperactivity disorder; Emotional lability; Meta-analysis; Omega-3; Oppositional behaviour; Randomised controlled trial.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Affective Symptoms / diet therapy*
  • Aggression / drug effects
  • Attention Deficit Disorder with Hyperactivity / diet therapy*
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Dietary Supplements
  • Emotions*
  • Fatty Acids, Omega-3 / therapeutic use*
  • Humans
  • Problem Behavior*
  • Randomized Controlled Trials as Topic


  • Fatty Acids, Omega-3