Longitudinal trajectories of plasma polyunsaturated fatty acids and associations with psychosis-spectrum outcomes in early adulthood

David Mongan; Benjamin I Perry; Colm Healy; Subash Raj Susai; Stan Zammit; Mary Cannon; David R Cotter

doi:10.1016/j.biopsych.2024.04.004

Longitudinal trajectories of plasma polyunsaturated fatty acids and associations with psychosis-spectrum outcomes in early adulthood

Biol Psychiatry. 2024 Apr 15:S0006-3223(24)01229-0. doi: 10.1016/j.biopsych.2024.04.004. Online ahead of print.

Authors

David Mongan¹, Benjamin I Perry², Colm Healy³, Subash Raj Susai³, Stan Zammit⁴, Mary Cannon⁵, David R Cotter⁵

Affiliations

¹ Centre for Public Health, Queen's University Belfast, Northern Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland. Electronic address: davidmongan@rcsi.ie.
² Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom.
³ Department of Psychiatry, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland.
⁴ Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom.
⁵ Department of Psychiatry, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland; Future Neuro SFI Research Centre, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland.

PMID: 38631425
DOI: 10.1016/j.biopsych.2024.04.004

Abstract

Background: Evidence supports associations between polyunsaturated fatty acids (PUFAs) such as docosahexaenoic acid (DHA) and psychosis. However, PUFA trajectories in the general population have not been characterised and associations with psychosis-spectrum outcomes in early adulthood are unknown. background METHODS: Plasma omega-6:omega-3 ratio and DHA %total fatty acids were measured by nuclear magnetic spectroscopy at 7,15,17 and 24years in the Avon Longitudinal Study of Parents and Children. Curvilinear growth mixture modelling evaluated BMI-adjusted trajectories of both measures. Outcomes were assessed at 24years. Psychotic experiences (PEs), At-Risk-Mental-State status, psychotic disorder and number of PEs were assessed using the Psychosis-Like Symptoms interview PLIKSi (n=3635, 2247 [61.8%]female). Negative symptoms score was measured using the Community Assessment of Psychic Experiences (n=3484, 2161 [62.0%]female). Associations were adjusted for sex, ethnicity, parental social class, cumulative smoking and alcohol use.

Results: Relative to stable average, the persistently high omega-6:omega-3 ratio trajectory was associated with increased odds of PEs and psychotic disorder, but attenuated on adjustment for covariates (PEs adjusted odds ratio[aOR] 1.63, 95% confidence interval[CI] 0.92-2.89; psychotic disorder aOR 1.69, 95%CI 0.71-4.07). This was also the case for persistently low DHA (PEs aOR 1.42, 95%CI 0.84-2.37; psychotic disorder aOR 1.14, 95%CI 0.49-2.67). Following adjustment, persistently high omega-6:omega-3 ratio was associated with increased number of PEs (β0.41, 95%CI 0.05-0.78) and negative symptoms score (β0.43, 95%CI 0.14-0.72), as was persistently low DHA (number of PEs:β 0.45, 95%CI 0.14-0.76; negative symptoms:β 0.35, 95%CI 0.12-0.58).

Conclusions: Optimisation of PUFA status during development warrants further investigation in relation to psychotic symptoms in early adulthood.

Keywords: ALSPAC; negative symptoms; omega-3; plasma; polyunsaturated fatty acid; psychosis.