建议将Omega-3多不饱和脂肪酸(n-3PUFA)作为重度抑郁症(MDD)的综合治疗方法。2019年,国际营养精神病学研究协会(ISNPR)制定了第一个n-3PUFA治疗MDD的实践指南。为了加强这些指南并增强其临床适用性,我们综合了以前通过Delphi方法获得的证据和临床经验.
通过内部会议制定了涉及MDD治疗五个主要领域的19项声明。邀请了14名国际专家参加基于网络的Delphi流程,该流程对声明进行了验证。使用了李克特量表,共识水平设定为7.0/10.0,模棱两可的水平设定为5.1-6.9。得分<5.0的项目被分配到第二轮德尔菲调查中,并带有相反的问题。
所有小组成员都完成了调查。十六项声明达成共识,和声明“n-3PUFA是成人MDD的潜在辅助治疗方法之一”达成了最高共识。“N-3PUFA是成人MDD的潜在单一疗法之一”,得分最低。关于“特殊人群”,\"许多项目,尽管有次优的支持性证据,但达成了高度共识。
小组成员对n-3PUFA有专门的兴趣;重点放在临床问题而不是生物学机制上。
德尔菲过程有助于弥合科学证据和临床实践之间的差距,支持PUFA的某些用途,并确定当前证据中值得未来研究的不足。
Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are recommended as an integrative treatment for major depressive disorder (MDD). In 2019, the International Society for Nutritional Psychiatry Research (ISNPR) developed the first practice
guidelines for n-3 PUFA treatment of MDD. To strengthen these
guidelines and enhance their clinical applicability, we synthesized the evidence and clinical experiences previously obtained through the Delphi methodology.
Nineteen statements covering five major domains in MDD treatment were formulated through internal meetings. Fourteen international experts were invited to participate in the web-based Delphi process that validated the statements. Likert scales were used, and
consensus level was set at 7.0/10.0, with the equivocal level set at 5.1-6.9. The items with scores < 5.0 were allocated into a second round Delphi survey with inverse questions.
All panelists completed the survey. Sixteen statements reached
consensus, and the statement \"n-3 PUFAs are one of the potential adjunctive treatments for adult MDD\" reached the highest agreement. \"N-3 PUFAs are one of the potential monotherapies for adult MDD\" instead scored lowest. Regarding \"special populations,\" many items, reached high
consensus despite sub-optimal supportive evidence.
The panelists had a specialized interest in n-3 PUFAs; focus was placed on clinical issues rather than on biological mechanisms.
The Delphi process helps bridge the gap between scientific evidence and clinical practice, supports certain uses of PUFA and identifies insufficiency in current evidence that merit future research.