Please select the eligibility criteria that correspond to the clinical trial below.
Title: CAROTID: CAD Randomized Omega-3 Trial In Depression
Brief Summary: Depressive disorders are common in patients with Coronary Artery Disease (CAD), occurring in up to 47% of patients. Left untreated, these symptoms not only have a strong negative impact on quality-of-life, but also increase risk of future cardiac events and death. Unfortunately, about 64% of CAD patients do not respond to current antidepressant treatments. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are two omega-3 (ω-3) fatty acids found in fatty fish that are important for brain function. Recent evidence showed that depressed CAD patients have lower levels of EPA and DHA than non-depressed CAD patients. This information, taken together with the known roles of ω-3 fatty acids in brain function, suggests that deficiencies may contribute to depression. However, it is unknown if increasing consumption of ω-3 fatty acids would alleviate depression and improve quality of life. While intake of adequate levels of ω-3 fatty acids is difficult to obtain through diet, concentrated supplements containing EPA and DHA that are safe, readily available, and inexpensive are now obtainable in Canada. CAROTID (CAD Randomized Omega-3 Trial In Depression) will randomize patients with CAD, with and without depressive symptoms, after 6 months of cardiac rehabilitation and usual care to receive either ω-3 fatty acid supplements or placebo daily during their final 6 months of cardiac rehabilitation. The investigators hypothesize that CAD patients randomized to receive ω-3 fatty acid supplements will show greater improvement in depressive symptoms and quality-of-life over time. The investigators will also evaluate possible improvements in other important determinants of quality of life: memory and other cognitive abilities.


Options:
A: Inclusion Criteria:

* Men and women
* Aged 65 years and over
* Informed consent signed

Exclusion Criteria:

* A score of \> 16 on the CES-D (Centre for Epidemiological Studies-Depression Scale
* A score of \< 21 points on MMSE (Mini-Mental State Examination)
* Current or recent (\<4 weeks) use of fish oil supplements or intake of more than 4 times fish as judged by a fish consumption questionnaire
* Current use of pharmacological antidepressants
* Current use of dementia (Alzheimer) medication
* Serious liver disease
* Use of more than 4 glasses of alcohol per day
* Unable to participate as judged by the responsible medical physician
* Allergy to fish(oil)
* Swallowing problems
* Participation in another clinical trial less than 2 months before the start of the trial or at the same time
B: Inclusion Criteria:

* the diagnostic criteria of DSM-IV for MDD
* 18 to 65 years old
* pre-study ratings of 18 or greater on the 21-item Hamilton Rating Scale for Depression (HAMD)
* physically healthy under comprehensive evaluations in medical history, physical examination, and laboratory parameters tests
* have not received any psychiatric treatment in 2 weeks
* competent to receive a full explanation of this study and give written informed consent.

Exclusion Criteria:

* a recent or past history of other DSM-IV AxisI diagnoses besides unipolar major depression, including psychotic disorders, organic mental disorders, impulse control disorders, substance use disorder or substance abuse (last 6 months prior to the study), and bipolar disorders
* AxisII diagnoses, including borderline and antisocial personality disorder
* a notable medical comorbidity
* acutely suicidal ideation and attempt were noted that close monitoring such as hospitalization is necessary
* regular consumption of omega-3 PUFAs supplements or a habit of eating ﬁsh equal or more than 4 times per week
C: Inclusion Criteria:

* Language (speaks and understands English)
* Between 45-80 years old
* Stable coronary artery disease (based on no hospitalization for cardiac events for at least 7 weeks prior)
* Angiographic documentation of presence and extent of coronary artery disease (number of vessels involved, extent of stenosis, etc.)
* Written, informed consent

Exclusion Criteria:

* Significant acute medical illness (sepsis, autoimmune condition, drug overdose, uncontrolled diabetes, severely disturbed liver, kidney or lung function, anemia, hypothyroidism)
* Clinically significant cognitive impairment (Mini-Mental State Examination \< 24)
* Other neurologic conditions (Parkinson's disease, Huntington's chorea, history of epilepsy, birth trauma, significant traumatic brain injury, clinical stroke, progressive supranuclear paralysis, brain tumour, subdural hematoma, multiple sclerosis)
* Canadian Cardiovascular Society Class 4 (indicating unstable angina)
* Ventricular tachycardia and/or implantable cardioverter defibrillator
* Killip class greater than II (indicates high risk of mortality in post-myocardial infarction group)
* Premorbid or concurrent psychiatric diagnoses of schizophreniform or bipolar depressive disorders, current ethanol or substance abuse or any premorbid psychiatric condition requiring hospitalization
* Current use of a concentrated omega-3 fatty acid supplement, or contraindication to soybean/corn oil
* Pregnant women
* Women who become pregnant during the course of the study will be excluded immediately.
* Women of childbearing potential must be using an approved method of birth control.
* Allergies or hypersensitivity to fish
* Pre-existing bleeding disorder
* History of electroconvulsive therapy.
* Suicidal ideation or a history of suicidal ideation/attempts (determined during SCID-I at screening/baseline visits)
* Severe depression, defined by Hamilton Depression Rating score \>23
* Current or history of psychotic episode or personality disorder.
D: Inclusion Criteria:

* willingness to participation,
* diabetic patients 30- 60 years old,
* body mass index in the range 25-40,
* avoidance of dietary supplements,
* vitamins and herbal products at least 3 months before and throughout the intervention

Exclusion Criteria:

* people who have used n-3 Fatty Acid Supplementation in last 3 months,
* having chronic renal disease ,
* GI disease,
* Hepatobiliary diseases,
* hematological disorders,
* hypo- or hyperthyroidism,
* type 1 diabetes,
* treatment with orlistat or sibutramine for weight loss,
* pregnancy and lactation,
* treatment with insulin or Thiazolidinediones.

Answer: C