Fish oil pills may be able to save some young people with signs of mental illness from descending into full-blown psychosis, according to a preliminary but first-of-its-kind study.

The Austrian study of just 81 patients comes from leaders in the field of youth mental health and adds to evidence suggesting severe mental illness might be prevented with the right intervention.

'Schizophrenia is among the most mysterious and costliest diseases in terms of human suffering, so anything that gives some hope to avoid this is great.' — Dr. Paul Amminger

Though it sounds simple, fish oil fits a hypothesis on the cause of psychotic disorders including schizophrenia that points to a possible disorder in how the body handles fatty acids.

"If it works, it will be an absolutely tremendous development," said Dr. Jeffrey Lieberman, chairman of psychiatry at Columbia University Medical Center in New York, who wasn't involved in the study. More research is needed to see if the results are accurate, he said.

The researchers are beginning a larger international study with hopes of replicating their findings, which appear in February's Archives of General Psychiatry.

Schizophrenia is a severe mental illness that typically strikes adolescents and young adults. It is estimated that 2.4 million Americans and 300,000 Canadians have the disorder, which is treated with medication.

Since the 1990s, researchers have wondered if the disease could be stopped in its earliest stages, before it overpowers a person's grip on reality. Studies have tried anti-psychotics in some young people, but troubling side-effects pose ethical questions and results have been mixed.

For the new study, researchers identified 81 people, aged 13 to 25, with warning signs of schizophrenia.

The signs include:

• Sleeping dramatically more or less than usual.
• Growing suspicious of others.
• Believing someone is putting thoughts in their head.
• Thinking they have magical powers.

The young people in the study had sought professional help and most were referred by psychiatrists at the Medical University of Vienna.

Researchers randomly assigned 41 of the patients to take four fish oil pills a day for three months. The daily dose of 1,200 milligrams was about what many people take to get protective benefits of fish oil for the heart and costs less than 40 cents a day.

The rest of the patients received dummy pills. After one year of monitoring, two of the 41 patients in the fish oil group, or about five per cent, had become psychotic, or completely out of touch with reality. In the placebo group, 11 of 40 became psychotic, about 28 per cent.

Brain cell development

No one knows what causes schizophrenia, but one hypothesis says people with the disease don't process fatty acids correctly, leading to damaged brain cells.

It is becoming increasingly clear that fish oil is important to the development of brain cells, said Dr. Phil Brock, director of Child and Adolescent Psychiatry at the Women and Children's Hospital in Adelaide, Australia.

Omega-3 fatty acids in fish oil could help brain cells to repair and stabilize, the researchers speculate. Some prior studies on omega-3 supplements in people with full-blown schizophrenia have shown benefits.

It is also well established that people with schizophrenia have lower levels of omega-3 or polyunsaturated fatty acids, said lead author Dr. Paul Amminger, formerly of Vienna and now at the Orygen Youth Health Research Centre at the University of Melbourne in Australia.

"Schizophrenia is among the most mysterious and costliest diseases in terms of human suffering, so anything that gives some hope to avoid this is great," said Amminger.

Side-effects of antipsychotic drugs, including sexual dysfunction and weight gain, are troubling to young people, Amminger said.

Supplement questions

Fish oil, recommended for heart health, is more acceptable to patients who have warning symptoms.

Scientists in the field greeted the findings with cautious excitement. "The results are very impressive and very striking and really represent a step forward potentially for patients and their families," said Dr. Neil Richtand, a schizophrenia researcher at the University of Cincinnati College of Medicine.

But Brock said he thinks it is too early to say whether fish oil could be prescribed for a range of mental illness.

Dr. Janet Wozniak of Harvard Medical School said the findings, while preliminary, might reasonably cause psychiatrists to recommend fish oil to some patients because there are known benefits and little risk. She advised consumers to look for high-quality nutritional supplements.

Most fish oil capsules are free from contaminants and test well for quality, said William Obermeyer of ConsumerLab.com, which tests supplements for manufacturers and publishes ratings for subscribers.

The research was funded by the Stanley Medical Research Institute, a nonprofit in Chevy Chase, Md., that supports research on schizophrenia and bipolar disorder.

With files from the Australian Broadcasting Corp