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Published in: BMC Psychiatry 1/2011

Open Access 01-12-2011 | Study protocol

Attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among disaster medical assistance team members after the Great East Japan Earthquake: The APOP randomized controlled trial

Authors: Yutaka Matsuoka, Daisuke Nishi, Naoki Nakaya, Toshimasa Sone, Kei Hamazaki, Tomohito Hamazaki, Yuichi Koido

Published in: BMC Psychiatry | Issue 1/2011

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Abstract

Background

On March 11, 2011, a magnitude 9.0 earthquake, the most powerful ever recorded in Japan, and a massive tsunami struck off the coast of the Sanriku region. A Disaster Medical Assistance Team, a mobile medical team with specialized training that is deployed during the acute phase of a disaster, was dispatched to areas with large-scale destruction and multiple injured and sick casualties. Previous studies have reported critical incident stress (i.e. posttraumatic stress disorder symptoms and depressive symptoms) among rescue workers as well as the need for screening and prevention for posttraumatic stress disorder. So far we have shown in an open trial that posttraumatic stress disorder symptoms in critically injured patients can be reduced by taking omega-3 fatty acids intended to stimulate hippocampal neurogenesis.

Method/Design

This study is designed to determine the effectiveness of attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among Disaster Medical Assistance Team members after the Great East Japan Earthquake, and is named the APOP randomized controlled trial which is currently ongoing. First, we will provide psycho-education on posttraumatic distress, which is common in responders to the Disaster Medical Assistance Team members deployed to the disaster area. Second, observational research will be conducted to evaluate critical incident stress following the completion of medical activities. Third, team members who provide consent to participate in the intervention research will be randomly divided into a group given an omega-3 fatty acid supplement and a group not given the supplements. Outcome will be evaluated at 12 weeks after the supplements are shipped to the team members.

Discussion

Measures that address critical incident stress in disaster responders are important, but there is no substantial evidence that links such measures with prevention of posttraumatic stress disorder. Thus, any confirmation through this study that the intake of omega-3 fatty acid supplements serves as a simple preventative measure for critical incident stress will be of great significance.

Trial registration

UMIN Clinical Trials Registry, UMIN000005367
Appendix
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Literature
1.
go back to reference Bryant RA, Guthrie RM: Maladaptive self-appraisals before trauma exposure predict posttraumatic stress disorder. J Consult Clin Psychol. 2007, 75: 812-815.CrossRefPubMed Bryant RA, Guthrie RM: Maladaptive self-appraisals before trauma exposure predict posttraumatic stress disorder. J Consult Clin Psychol. 2007, 75: 812-815.CrossRefPubMed
2.
go back to reference Epstein RS, Fullerton CS, Ursano RJ: Posttraumatic Stress Disorder Following an Air Disaster: A Prospective Study. Am J Psychiatry. 1998, 155: 934-938.CrossRefPubMed Epstein RS, Fullerton CS, Ursano RJ: Posttraumatic Stress Disorder Following an Air Disaster: A Prospective Study. Am J Psychiatry. 1998, 155: 934-938.CrossRefPubMed
3.
go back to reference Fullerton CS, Ursano RJ, Wang L: Acute Stress Disorder, Posttraumatic Stress Disorder, and Depression in Disaster or Rescue Workers. Am J Psychiatry. 2004, 161: 1370-1376. 10.1176/appi.ajp.161.8.1370.CrossRefPubMed Fullerton CS, Ursano RJ, Wang L: Acute Stress Disorder, Posttraumatic Stress Disorder, and Depression in Disaster or Rescue Workers. Am J Psychiatry. 2004, 161: 1370-1376. 10.1176/appi.ajp.161.8.1370.CrossRefPubMed
4.
go back to reference Ressler KJ, Mayberg HS: Targeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinic. Nat Neurosci. 2007, 10: 1116-1124. 10.1038/nn1944.CrossRefPubMedPubMedCentral Ressler KJ, Mayberg HS: Targeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinic. Nat Neurosci. 2007, 10: 1116-1124. 10.1038/nn1944.CrossRefPubMedPubMedCentral
5.
go back to reference Kitamura T, Saitoh Y, Takashima N, Murayama A, Niibori Y, Ageta H, Sekiguchi M, Sugiyama H, Inokuchi K: Adult neurogenesis modulates the hippocampus-dependent period of associative fear memory. Cell. 2009, 139: 814-827. 10.1016/j.cell.2009.10.020.CrossRefPubMed Kitamura T, Saitoh Y, Takashima N, Murayama A, Niibori Y, Ageta H, Sekiguchi M, Sugiyama H, Inokuchi K: Adult neurogenesis modulates the hippocampus-dependent period of associative fear memory. Cell. 2009, 139: 814-827. 10.1016/j.cell.2009.10.020.CrossRefPubMed
6.
go back to reference Matsuoka Y: Clearance of fear memory from the hippocampus through neurogenesis by omega-3 fatty acids: a novel preventive strategy for posttraumatic stress disorder?. Biopsychosoc Med. 2011, 5: 3-10.1186/1751-0759-5-3.CrossRefPubMedPubMedCentral Matsuoka Y: Clearance of fear memory from the hippocampus through neurogenesis by omega-3 fatty acids: a novel preventive strategy for posttraumatic stress disorder?. Biopsychosoc Med. 2011, 5: 3-10.1186/1751-0759-5-3.CrossRefPubMedPubMedCentral
7.
go back to reference Beltz BS, Tlusty MF, Benton JL, Sandeman DC: Omega-3 fatty acids upregulate adult neurogenesis. Neurosci Lett. 2007, 415: 154-158. 10.1016/j.neulet.2007.01.010.CrossRefPubMedPubMedCentral Beltz BS, Tlusty MF, Benton JL, Sandeman DC: Omega-3 fatty acids upregulate adult neurogenesis. Neurosci Lett. 2007, 415: 154-158. 10.1016/j.neulet.2007.01.010.CrossRefPubMedPubMedCentral
8.
go back to reference Kawakita E, Hashimoto M, Shido O: Docosahexaenoic acid promotes neurogenesis in vitro and in vivo. Neuroscience. 2006, 139: 991-997. 10.1016/j.neuroscience.2006.01.021.CrossRefPubMed Kawakita E, Hashimoto M, Shido O: Docosahexaenoic acid promotes neurogenesis in vitro and in vivo. Neuroscience. 2006, 139: 991-997. 10.1016/j.neuroscience.2006.01.021.CrossRefPubMed
9.
go back to reference Matsuoka Y, Nishi D, Yonemoto N, Hamazaki K, Hashimoto K, Hamazaki T: Omega-3 fatty acids for secondary prevention of posttraumatic stress disorder after accidental injury: An open-label pilot study. J Clin Psychopharmacol. 2010, 217-219. 30 Matsuoka Y, Nishi D, Yonemoto N, Hamazaki K, Hashimoto K, Hamazaki T: Omega-3 fatty acids for secondary prevention of posttraumatic stress disorder after accidental injury: An open-label pilot study. J Clin Psychopharmacol. 2010, 217-219. 30
10.
go back to reference Matsuoka Y, Nishi D, Nakajima S, Yonemoto N, Hashimoto K, Noguchi H, Homma M, Otomo Y, Kim Y: The Tachikawa cohort of motor vehicle accident study investigating psychological distress: design, methods and cohort profiles. Soc Psychiatry Psychiatr Epidemiol. 2009, 44: 341-10.1007/s00127-009-0496-4.CrossRef Matsuoka Y, Nishi D, Nakajima S, Yonemoto N, Hashimoto K, Noguchi H, Homma M, Otomo Y, Kim Y: The Tachikawa cohort of motor vehicle accident study investigating psychological distress: design, methods and cohort profiles. Soc Psychiatry Psychiatr Epidemiol. 2009, 44: 341-10.1007/s00127-009-0496-4.CrossRef
11.
go back to reference Hamazaki T, Sawazaki S, Itomura M, Asaoka E, Nagao Y, Nishimura N, Yazawa K, Kuwamori T, Kobayashi M: The effect of docosahexaenoic acid on aggression in young adults. A placebo-controlled double-blind study. J Clin Invest. 1996, 97: 1129-1133. 10.1172/JCI118507.CrossRefPubMedPubMedCentral Hamazaki T, Sawazaki S, Itomura M, Asaoka E, Nagao Y, Nishimura N, Yazawa K, Kuwamori T, Kobayashi M: The effect of docosahexaenoic acid on aggression in young adults. A placebo-controlled double-blind study. J Clin Invest. 1996, 97: 1129-1133. 10.1172/JCI118507.CrossRefPubMedPubMedCentral
12.
go back to reference Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB: Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995, 52: 1048-1060.CrossRefPubMed Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB: Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995, 52: 1048-1060.CrossRefPubMed
13.
go back to reference Schlenger WE, Caddell JM, Ebert L, Jordan BK, Rourke KM, Wilson D, Thalji L, Dennis JM, Fairbank JA, Kulka RA: Psychological reactions to terrorist attacks: findings from the National Study of Americans' Reactions to September 11. Jama. 2002, 288: 581-588. 10.1001/jama.288.5.581.CrossRefPubMed Schlenger WE, Caddell JM, Ebert L, Jordan BK, Rourke KM, Wilson D, Thalji L, Dennis JM, Fairbank JA, Kulka RA: Psychological reactions to terrorist attacks: findings from the National Study of Americans' Reactions to September 11. Jama. 2002, 288: 581-588. 10.1001/jama.288.5.581.CrossRefPubMed
14.
go back to reference Brunet A, Weiss DS, Metzler TJ, Best SR, Neylan TC, Rogers C, Fagan J, Marmar CR: The Peritraumatic Distress Inventory: a proposed measure of PTSD criterion A2. Am J Psychiatry. 2001, 158: 1480-1485. 10.1176/appi.ajp.158.9.1480.CrossRefPubMed Brunet A, Weiss DS, Metzler TJ, Best SR, Neylan TC, Rogers C, Fagan J, Marmar CR: The Peritraumatic Distress Inventory: a proposed measure of PTSD criterion A2. Am J Psychiatry. 2001, 158: 1480-1485. 10.1176/appi.ajp.158.9.1480.CrossRefPubMed
15.
go back to reference Simeon D, Greenberg J, Knutelska M, Schmeidler J, Hollander E: Peritraumatic reactions associated with the World Trade Center disaster. Am J Psychiatry. 2003, 160: 1702-1705. 10.1176/appi.ajp.160.9.1702.CrossRefPubMed Simeon D, Greenberg J, Knutelska M, Schmeidler J, Hollander E: Peritraumatic reactions associated with the World Trade Center disaster. Am J Psychiatry. 2003, 160: 1702-1705. 10.1176/appi.ajp.160.9.1702.CrossRefPubMed
16.
go back to reference Nishi D, Matsuoka Y, Noguchi H, Sakuma K, Yonemoto N, Yanagita T, Homma M, Kanba S, Kim Y: Reliability and validity of the Japanese version of the Peritraumatic Distress Inventory. Gen Hosp Psychiatry. 2009, 31: 75-79. 10.1016/j.genhosppsych.2008.09.002.CrossRefPubMed Nishi D, Matsuoka Y, Noguchi H, Sakuma K, Yonemoto N, Yanagita T, Homma M, Kanba S, Kim Y: Reliability and validity of the Japanese version of the Peritraumatic Distress Inventory. Gen Hosp Psychiatry. 2009, 31: 75-79. 10.1016/j.genhosppsych.2008.09.002.CrossRefPubMed
17.
go back to reference Nishi D, Matsuoka Y, Yonemoto N, Noguchi H, Kim Y, Kanba S: Peritraumatic Distress Inventory as a predictor of post-traumatic stress disorder after a severe motor vehicle accident. Psychiatry and Clinical Neurosciences. 2010, 64: 149-156. 10.1111/j.1440-1819.2010.02065.x.CrossRefPubMed Nishi D, Matsuoka Y, Yonemoto N, Noguchi H, Kim Y, Kanba S: Peritraumatic Distress Inventory as a predictor of post-traumatic stress disorder after a severe motor vehicle accident. Psychiatry and Clinical Neurosciences. 2010, 64: 149-156. 10.1111/j.1440-1819.2010.02065.x.CrossRefPubMed
18.
go back to reference Weiss DS, Marmar CR: The Impact of Event Scale Revised. Assessing psychological trauma and PTSD. Edited by: Wilson JP, Keane TM. 1997, New York: The Guilford Press, 399-411. Weiss DS, Marmar CR: The Impact of Event Scale Revised. Assessing psychological trauma and PTSD. Edited by: Wilson JP, Keane TM. 1997, New York: The Guilford Press, 399-411.
19.
go back to reference Asukai N, Kato H, Kawamura N, Kim Y, Yamamoto K, Kishimoto J, Miyake Y, Nishizono-Maher A: Reliability and validity of the Japanese-language version of the impact of event scale-revised (IES-R-J): four studies of different traumatic events. J Nerv Ment Dis. 2002, 190: 175-182. 10.1097/00005053-200203000-00006.CrossRefPubMed Asukai N, Kato H, Kawamura N, Kim Y, Yamamoto K, Kishimoto J, Miyake Y, Nishizono-Maher A: Reliability and validity of the Japanese-language version of the impact of event scale-revised (IES-R-J): four studies of different traumatic events. J Nerv Ment Dis. 2002, 190: 175-182. 10.1097/00005053-200203000-00006.CrossRefPubMed
20.
go back to reference Radloff LS: The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977, 1: 385-401. 10.1177/014662167700100306.CrossRef Radloff LS: The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement. 1977, 1: 385-401. 10.1177/014662167700100306.CrossRef
21.
go back to reference Shima S, Shikano T, Kitamura T: A new self-report depression scale (in Japanese). Seishinigaku. 1985, 27: 717-723. Shima S, Shikano T, Kitamura T: A new self-report depression scale (in Japanese). Seishinigaku. 1985, 27: 717-723.
22.
go back to reference Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM: Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002, 32: 959-976. 10.1017/S0033291702006074.CrossRefPubMed Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, Walters EE, Zaslavsky AM: Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002, 32: 959-976. 10.1017/S0033291702006074.CrossRefPubMed
23.
go back to reference Furukawa TA, Kessler RC, Slade T, Andrews G: The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychol Med. 2003, 33: 357-362. 10.1017/S0033291702006700.CrossRefPubMed Furukawa TA, Kessler RC, Slade T, Andrews G: The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychol Med. 2003, 33: 357-362. 10.1017/S0033291702006700.CrossRefPubMed
24.
go back to reference Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand SL, Manderscheid RW, Walters EE, Zaslavsky AM: Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003, 60: 184-189. 10.1001/archpsyc.60.2.184.CrossRefPubMed Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand SL, Manderscheid RW, Walters EE, Zaslavsky AM: Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003, 60: 184-189. 10.1001/archpsyc.60.2.184.CrossRefPubMed
25.
go back to reference Wagnild GM, Young HM: Development and psychometric evaluation of the Resilience Scale. J Nurs Meas. 1993, 1: 165-178.PubMed Wagnild GM, Young HM: Development and psychometric evaluation of the Resilience Scale. J Nurs Meas. 1993, 1: 165-178.PubMed
26.
go back to reference Nishi D, Uehara R, Kondo M, Matsuoka Y: Reliability and validity of the Japanese version of the Resilience Scale and its short version. BMC Res Notes. 2010, 3: 310-10.1186/1756-0500-3-310.CrossRefPubMedPubMedCentral Nishi D, Uehara R, Kondo M, Matsuoka Y: Reliability and validity of the Japanese version of the Resilience Scale and its short version. BMC Res Notes. 2010, 3: 310-10.1186/1756-0500-3-310.CrossRefPubMedPubMedCentral
Metadata
Title
Attenuating posttraumatic distress with omega-3 polyunsaturated fatty acids among disaster medical assistance team members after the Great East Japan Earthquake: The APOP randomized controlled trial
Authors
Yutaka Matsuoka
Daisuke Nishi
Naoki Nakaya
Toshimasa Sone
Kei Hamazaki
Tomohito Hamazaki
Yuichi Koido
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2011
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-11-132

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