Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Efficacy of Omega-3 Fatty Acids in Maintaining Optimal Mental Health in Elderly People: a Double-blind Placebo-controlled Trial
Brief Summary: The efficacy of EPA-DHA supplementation will be assessed in a randomized placebo-controlled trial with cognitive decline and early signs of depression as primary outcome measures.


Options:
A: Inclusion Criteria:

* Meets DSM-IV diagnostic criteria for major depressive disorder
* A Clinical Global Impression-Severity (CGI-S) score greater than 3
* A Baseline Hamilton-D-17 (HAM-D-17) (Hamilton, 1960,1967) score of ³ 15
* Willing to use effective forms of contraception

Exclusion Criteria:

* Pregnant
* Suicidal or homicidal
* Serious or unstable medical illness, including cardiovascular, liver, kidney, respiratory, endocrine, neuralgic, or blood disease
* History of seizure disorder
* History of organic mental disorders, substance abuse, schizophrenia, schizoaffective disorder, delusional disorder, bipolar disorder, or other psychotic disorders
* History of inflammatory or auto-immune disorder (e.g., rheumatoid arthritis, multiple sclerosis, or cancer
* History of multiple adverse drug reactions or an allergy to the study drugs
* Mood-congruent or mood-incongruent psychotic features
* Current use of other psychotropic drugs
* Clinical or laboratory evidence of hypothyroidism
* Failed to respond during the course of current major depressive episode to at least one adequate antidepressant trial, defined as 6 weeks or more of treatment with 40 mg/day of citalopram (or its antidepressant equivalent)
* Received electroconvulsive therapy (ECT) within 6 months of study entry
* Currently taking supplements enriched with omega-3 fatty acids (e.g., flax seed oil) or has taken at least 1 g/day of omega-3 fatty acids
* Consuming a diet that contains more than 3g/day of omega-3 fatty acids at study entry
* Taking anticoagulants or history of a bleeding disorder
* Patients who are currently in psychotherapy that was initiated within 90 days prior to the study screening visit.
* Current infection
* Use of systematic corticosteroid or steroid antagonists or other immunosuppressant agents (e.g., cyclosporine, interferon)
* Smokes more than 10 cigarettes per day
* Taking a vitamin E supplement greater than 400 IU
B: 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
C: Inclusion Criteria:

* Documented coronary heart disease
* Diagnosis of major depression based on structured interview

Exclusion Criteria:

* Moderate to severe cognitive impairment
* Meets DSM-5 criteria for depressive disorder due to a general medical condition or medication
* Major Axis I psychiatric disorder other than unipolar depression or an anxiety disorder, a high risk of suicide, or current substance abuse other than tobacco;
* Not expected to survive one year or physically unable to tolerate the study protocol
* Known sensitivity to sertraline or omega-3, or an allergy to fish oil or shellfish
* Taking an antidepressant or an omega-3 supplement at baseline
* Exempted by their cardiologist or primary care physician
* Refuses to provide informed consent
* Participating in a competing protocol or trial
D: Inclusion Criteria:

* 12 to 19 years old (inclusive) of both sexes and all ethnic/racial groups.
* DSM-IV-TR criteria for MDD
* MDD Duration of at least 8 weeks and a severity score of at least 40 on the CDRS-R.
* Age at first onset MDD of at least 12 years.
* No significant medical or neurological disorder
* For female subjects, negative pregnancy test at time of enrollment.
* Female subjects who are sexually active and not using a method of birth control will be excluded. Use of hormonal contraceptives (such as prescribed "birth control pills" or a prescribed birth control implant) is not exclusionary.
* Subjects must be able to swallow capsules.
* A minimum IQ of 80 will be required.

Exclusion Criteria:

* Current or Past DSM-IV-TR diagnoses of bipolar disorder, schizophrenia, psychosis, autism/pervasive developmental disorder (PDD), and Tourette's disorder (TD).
* Current diagnosis of eating disorder, panic disorder, obsessive-compulsive disorder (OCD), post traumatic stress disorder (PTSD), conduct disorder, and substance related disorders other than nicotine.
* Current suicidal ideation with intent or plan, or who may pose a danger to themselves.
* Current antidepressant treatment will be excluded. Past antidepressant treatment will not be exclusionary, so long as patients are off antidepressant medication for 60 days prior to study entry. No individual will be advised to terminate ongoing treatment.
* Certain short half-life medications, such as vitamins that contain unidentified ingredients, St. Johns Wort, S-adenosyl Methionine (SAM), clonidine, and some over-the-counter medications.
* A minimum of 90 days off of treatment with long half life medications, such as neuroleptics, prior to study entry is required. Stimulant medication treatment for ADHD will not be exclusionary.
* If adolescents have been in psychotherapy prior to their entry in the study, they will be allowed to continue with the treatment. However, psychotherapy cannot be initiated at the time of study entry.

Answer: B