Romijn Amy R, Rucklidge Julia J, Kuijer Roeline G, Frampton Chris
1 Department of Psychology, University of Canterbury, Christchurch, New Zealand.
2 School of Psychology, Early Years and Therapeutic Studies, University of South Wales, Pontypridd, UK.
Aust N Z J Psychiatry. 2017 Aug;51(8):810-821. doi: 10.1177/0004867416686694. Epub 2017 Jan 10.
This trial investigated whether probiotics improved mood, stress and anxiety in a sample selected for low mood. We also tested whether the presence or severity of irritable bowel syndrome symptoms, and levels of proinflammatory cytokines, brain-derived neurotrophic factor and other blood markers, would predict or impact treatment response.
Seventy-nine participants (10 dropouts) not currently taking psychotropic medications with at least moderate scores on self-report mood measures were randomly allocated to receive either a probiotic preparation (containing Lactobacillus helveticus and Bifidobacterium longum) or a matched placebo, in a double-blind trial for 8 weeks. Data were analysed as intent-to-treat.
No significant difference was found between the probiotic and placebo groups on any psychological outcome measure (Cohen's d range = 0.07-0.16) or any blood-based biomarker. At end-point, 9 (23%) of those in the probiotic group showed a ⩾60% change on the Montgomery-Åsberg Depression Rating Scale (responders), compared to 10 (26%) of those in the placebo group ([Formula: see text], p = ns). Baseline vitamin D level was found to moderate treatment effect on several outcome measures. Dry mouth and sleep disruption were reported more frequently in the placebo group.
This study found no evidence that the probiotic formulation is effective in treating low mood, or in moderating the levels of inflammatory and other biomarkers. The lack of observed effect on mood symptoms may be due to the severity, chronicity or treatment resistance of the sample; recruiting an antidepressant-naive sample experiencing mild, acute symptoms of low mood, may well yield a different result. Future studies taking a preventative approach or using probiotics as an adjuvant treatment may also be more effective. Vitamin D levels should be monitored in future studies in the area. The results of this trial are preliminary; future studies in the area should not be discouraged.
本试验调查了益生菌是否能改善情绪低落人群的情绪、压力和焦虑状况。我们还测试了肠易激综合征症状的存在或严重程度、促炎细胞因子水平、脑源性神经营养因子及其他血液标志物水平是否能预测或影响治疗反应。
在一项为期8周的双盲试验中,79名目前未服用精神药物且自我报告情绪测量得分至少为中等的参与者(10名退出者)被随机分配接受益生菌制剂(含瑞士乳杆菌和长双歧杆菌)或匹配的安慰剂。数据按意向性分析。
在任何心理结果测量指标(科恩d值范围为0.07 - 0.16)或任何血液生物标志物方面,益生菌组和安慰剂组之间均未发现显著差异。在试验终点时,益生菌组中有9名(23%)参与者在蒙哥马利-阿斯伯格抑郁评定量表上显示出≥60%的变化(反应者),而安慰剂组中有10名(26%)参与者如此([公式:见原文],p =无显著性差异)。发现基线维生素D水平可调节对几种结果测量指标的治疗效果。安慰剂组口干和睡眠障碍的报告更为频繁。
本研究未发现证据表明该益生菌制剂对治疗情绪低落或调节炎症及其他生物标志物水平有效。对情绪症状未观察到效果可能是由于样本的严重程度、慢性病程或治疗抵抗性;招募未服用过抗抑郁药、有轻度急性情绪低落症状的样本可能会产生不同结果。未来采用预防方法或使用益生菌作为辅助治疗的研究可能也会更有效。该领域未来研究应监测维生素D水平。本试验结果是初步的;不应阻碍该领域的未来研究。