Department of Psychiatry, Keio University School of Medicine, Tokyo, Japan.
Department of Psychiatry, Keio University School of Medicine, Tokyo, Japan.
J Affect Disord. 2018 Aug 1;235:506-512. doi: 10.1016/j.jad.2018.04.038. Epub 2018 Apr 12.
The intestinal microbiota is considered as a potential common underpinning pathophysiology of Functional Gastrointestinal Disorders (FGIDs) and psychiatric disorders such as depression and anxiety. Fecal Microbiota Transplantation (FMT) has been reported to have therapeutic effects on diseases related to dysbiosis, but few studies have evaluated its effect on psychiatric symptoms.
We followed 17 patients with either Irritable Bowel Syndrome (IBS), Functional Diarrhea (FDr) or Functional Constipation (FC) who underwent FMT for the treatment of gastrointestinal symptoms and observation of psychiatric symptoms. Changes in Hamilton Rating Scale for Depression (HAM-D) and subscale of sleep-related items, Hamilton Rating Scale for Anxiety (HAM-A) and Quick Inventory for Depressive Symptoms (QIDS) between baseline and 4 weeks after FMT, and relationship with the intestinal microbiota were measured.
At baseline, 12 out of 17 patients were rated with HAM-D ≥ 8. Significant improvement in HAM-D total and sleep subscale score, HAM-A and QIDS were observed (p = 0.007, p = 0.007, p = 0.01, p = 0.007, respectively). Baseline Shannon index indicated that microbiota showed lower diversity in patients with HAM-D ≥ 8 compared to those of healthy donors and patients with HAM-D < 8. There was a significant correlation between baseline Shannon index and HAM-D score, and a correlation between Shannon index change and HAM-D improvement after FMT.
The small sample size with no control group.
Our results suggest that depression and anxiety symptoms may be improved by FMT regardless of gastrointestinal symptom change in patients with IBS, FDr and FC, and the increase of microbiota diversity may help to improve patient's mood.
肠道微生物群被认为是功能性胃肠病（FGIDs）和抑郁、焦虑等精神障碍的潜在共同潜在病理生理学基础。粪菌移植（FMT）已被报道对与肠道菌群失调相关的疾病具有治疗作用，但很少有研究评估其对精神症状的影响。
我们随访了 17 例接受 FMT 治疗胃肠症状并观察精神症状的 IBS、功能性腹泻（FDr）或功能性便秘（FC）患者。测量 FMT 前后 4 周汉密尔顿抑郁量表（HAM-D）和睡眠相关项目亚量表、汉密尔顿焦虑量表（HAM-A）和抑郁快速筛查量表（QIDS）的变化，并与肠道微生物群进行相关性分析。
基线时，17 例患者中有 12 例 HAM-D≥8。HAM-D 总分和睡眠亚量表评分、HAM-A 和 QIDS 均有显著改善（p=0.007、p=0.007、p=0.01、p=0.007）。基线 Shannon 指数表明，与健康供体和 HAM-D<8 的患者相比，HAM-D≥8 的患者肠道微生物群多样性较低。基线 Shannon 指数与 HAM-D 评分之间存在显著相关性，FMT 后 Shannon 指数变化与 HAM-D 改善之间存在相关性。
样本量小，无对照组。
无论 IBS、FDr 和 FC 患者的胃肠道症状是否发生变化，FMT 均可改善抑郁和焦虑症状，增加微生物多样性可能有助于改善患者的情绪。
