• Incidence of diagnosis of PTSD (including partial PTSD) [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Total score of Montgomery Asberg Depression Rating Scale (MADRAS) [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Incidence of depression evaluated by Mini-International Neuropsychiatric Interview (MINI) [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Autonomic response measured before, during and after script driven imagery and acoustic stimulation [ Time Frame: Three month ] [ Designated as safety issue: Yes ]
• Score of Impact of Event Scale revised (IES-R) [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Score of Hospital Anxiety and Depression scale (HADS) [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Score of health related Quality of Life scale, SF-36 [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]
• Score of Conner-Davidson Resilience Scale (CD-RISC) [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Brain-derived neurotrophic factor (BDNF) in serum [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Number of days of leave taken from the time of injury [ Time Frame: Three month ] [ Designated as safety issue: No ]
• Buss-Perry Aggression Questionnaire (BAQ) [ Time Frame: Three month, one month, baseline ] [ Designated as safety issue: No ]
• Total score of Clinician-Administrated PTSD Scale (CAPS) [ Time Frame: One month ] [ Designated as safety issue: Yes ]
• DHEA: dehydroepiandrosterone [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]
• NPY: neuropeptide Y [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]
• IL-1 beta: interleukin 1 beta [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]
• IL-6: interleukin 6 [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]
• TNF alpha: tumor necrosis factor alpha [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]
• D-serine [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]
• L-serine [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]
• DL-serine [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]
• Activin [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]

• Incidence of diagnosis of PTSD (including partial PTSD) [ Time Frame: Three month ] [ Designated as safety issue: Yes ]
• Total score of Montgomery Asberg Depression Rating Scale (MADRAS) [ Time Frame: Three month ] [ Designated as safety issue: Yes ]
• Incidence of depression evaluated by Mini-International Neuropsychiatric Interview (MINI) [ Time Frame: Three month ] [ Designated as safety issue: Yes ]
• Autonomic response measured before, during and after script driven imagery and acoustic stimulation [ Time Frame: Three month ] [ Designated as safety issue: Yes ]
• Score of Impact of Event Scale revised (IES-R) [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Score of Hospital Anxiety and Depression scale (HADS) [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Score of health related Quality of Life scale, SF-36 [ Time Frame: Three month, one month ] [ Designated as safety issue: No ]
• Score of Conner-Davidson Resilience Scale (CD-RISC) [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Brain-derived neurotrophic factor (BDNF) in serum [ Time Frame: Three month, one month ] [ Designated as safety issue: Yes ]
• Number of days of leave taken from the time of injury [ Time Frame: Three month ] [ Designated as safety issue: No ]

The purpose of this study is to evaluate efficacy and safety of Polyunsaturated Fatty Acid for the prevention of Posttraumatic Stress Disorder (PTSD) in patients with accidental injuries.

Accidental injuries, mostly motor vehicle accident, in civilian population are frequent events.For instance, nearly one-third of injured patients appear to develop trauma-related psychiatric illness and the major diagnoses are post-traumatic stress disorder (PTSD) and depressive disorder.Omega-3 Polyunsaturated Fatty Acid (Omega-3 PUFA) has some evidence of efficacy of treatment in patients with anxiety and mood disorders, but no evidence of preventing anxiety and mood disorders that occur subsequent to accidental injuries.We evaluate efficacy and safety of Omega-3 PUFA for the secondary prevention of Posttraumatic Stress Disorder (PTSD) and related psychiatric illness in patients with accidental injury

• Trauma
• Posttraumatic Stress Disorder

• Dietary Supplement: Omega-3 Polyunsaturated Fatty Acid
• Dietary Supplement: Placebo

• Experimental: Dietary Supplement: Omega-3 Polyunsaturated Fatty Acid
• Placebo Comparator: Placebo

Inclusion Criteria:

1. 18 plus years
2. A native Japanese speaking ability
3. Possibility to contact patients with injury in 240 hours, and dosing in oral use
4. Physical and metal status to possible understands scope and contents in the trial and gets informed consent

Exclusion Criteria:

1. Clearly irretrievable acute brain parenchyma damage and subdural or subarachnoidal bleeding detected by computed tomography and/or magnetic resonance imaging
2. Cognitive impairment: Mini Mental State Examination < 24
3. Heavy drinker or 100IU/L ≦ γGTP in administration
4. Heavy smoker (over 40 cigarettes per day)
5. History and current suspicion in diagnosis of psychosis and bipolar I disorder
6. Suspicion in diagnosis of alcoholic, substance-related disorder and eating disorder
7. Existence of marked serious symptoms such as suicidal ideation, self-harm behavior, dissociation, status of need rapidly psychiatric treatment
8. Use of anti-epilepsy drug, lithium, ethyl icosapentate and anti-coagulant drug (for example, aspirin, warfarin, etc) within 3 month at regular intervals
9. Use of polyunsaturated fatty acid supplement within 3 month at regular intervals
10. Habit of eating fish over 4 times per week

• University of Toyama
• Chiba University