Long-chain polyunsaturated fatty acids in childhood developmental and psychiatric disorders

Both omega-3 and omega-6 long-chain polyunsaturated fatty acids (LC-PUFA) are crucial to brain development and function, but omega-3 in particular are often lacking from modern diets in developed countries.

Increasing evidence, reviewed here, indicates that LC-PUFA deficiencies or imbalances are associated with childhood developmental and psychiatric disorders including ADHD, dyslexia, dyspraxia and autistic spectrum disorders. These conditions show a high clinical overlap and run in the same families, as well as showing associations with various adult psychiatric disorders in which fatty acid abnormalities are already implicated, such as depression, other mood disorders and schizophrenia.

Preliminary evidence from controlled trials also suggests that dietary supplementation with LC-PUFA might help in the management of these kinds of childhood behavioural and learning difficulties. Treatment with omega 3 fatty acids appears most promising, but the few small studies published to date have involved different populations, study designs, treatments and outcome measures. Large-scale studies are now needed to confirm the benefits reported.

Further research is also required to assess the durability of such treatment effects, to determine optimal treatment compositions and dosages, and to develop reliable ways of identifying those individuals most likely to benefit from this kind of treatment.

Childhood developmental and psychiatric disorders clearly reflect multifactorial influences, but the study of LC-PUFA and their metabolism could offer important new approaches to their early identification and management. Heterogeneity and comorbidity are such, however, that a focus on specific traits or symptoms may prove more fruitful than an exclusive reliance on current diagnostic categories.