Please select the eligibility criteria that correspond to the clinical trial below.
Title: Omega-3 for Depression and Other Cardiac Risk Factors-2
Brief Summary: The purpose of this 10 week randomized, placebo-controlled, double-blind clinical trial is to determine whether antidepressant augmentation with two grams of EPA omega-3 per day is superior to antidepressant therapy alone for major depression in patients with coronary heart disease (CHD).


Options:
A: 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
B: Inclusion Criteria:

* Eligible participants will be adult patients with chronic HCV, assessed by hepatologists and then referred for IFN-α therapy and have capacity and willingness to give written informed consent

Exclusion Criteria:

* Patients will be excluded if they have major depressive episode at assessment
* Any history of pre-existing psychotic disorders (e.g. schizophrenia or bipolar disorder)
* Alcohol or drug dependence within one year before entry into the study
* Seizure disorders and evidence of any unstable substantial coexisting medical conditions (e.g. cardiovascular, endocrine, haematological, renal, or neurological diseases)
C: Inclusion Criteria:

* Diagnosis of relapsing-remitting MS
* Diagnosis of depressive disorder
* Score between 11 and 30 on the Montgomery-Asberg Depression Rating Scale (MADRS)
* Score of 25 or greater on the Mini-Mental State Examination (MMSE)
* Currently taking antidepressant medication for at least 3 months prior to study entry

Exclusion Criteria:

* Currently taking fatty acid supplements
* Consume more than 6 oz of fish per week within 1 month prior to study entry
* Severe depression
* Suicidal thoughts
* Other psychological disorders
* Currently taking more than two types of antidepressants
* Any serious medical condition that would interfere with the study
* Worsening of MS symptoms or corticosteroid treatment within 1 month prior to study entry
* Current enrollment in another fish oil study
* Pregnancy
D: Inclusion Criteria:

* Adult male and female patients, age greater than or equal to 21 years
* Diagnosis of Major Depressive Disorder determined by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) criteria with a Hamilton Depression Rating Scale Score greater than or equal to 18\*
* New York Heart Association Class greater than or equal to II

  * For patients with with left ventricular ejection fraction greater than 40 %, abnormal brain natriuretic peptide and/or previous hospitalization due to heart failure is also required
  * For inpatients, the Hamilton Depression Rating Scale scores need to be remain at 18 or above for two weeks following the discharge

Exclusion Criteria:

* Significant cognitive impairment, indicated as a Mini-Mental State Examination (MMSE) total score of 23 or lower
* History of alcohol or other drug dependence within the past 90 days
* Severe physical disability (visual, sensory, or motor) that may interfere with psychiatric assessment
* History or presence of psychoses, bipolar disorder, and/or severe personality disorders
* Life-threatening comorbidity with the likelihood of 50% mortality in one year
* Active suicidal ideations
* Current use of antipsychotic medications or psychotropic medications except Selective Serotonin Reuptake Inhibitors (SSRIs) and /or benzodiazepine
* Female patients who have a positive pregnancy test or are lactating. If female patients are of childbearing potential, they must use an effective and accepted means of contraception, such as oral contraceptives or a double-barrier method (condom and diaphragm) to protect against pregnancy
* Documented history of hypersensitivity or intolerance to omega 3 products; or use of omega 3 supplement for greater than or equal to 3 months at an equivalent or greater dose of the proposed study
* Treatment with electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) within 90 days\*
* Uncorrected hypothyroidism or hyperthyroidism
* Treatment with any investigational agent within 1 month before randomization
* Acute coronary syndrome, i.e., Myocardial Infarction (MI) or unstable angina, revascularization procedure within the preceding month, or planned cardiac surgery within 3 months postrandomization

  * The exclusion of patients who received ECT or TMS within 90 days is adopted from other depression-intervention trials and meant to eliminate confounders. It is believed that the effects of ECT on mood and cognition may last for a couple of months, and duration of TMS effects is poorly known and may be similar to the ECT intervention.

Answer: A