Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
MacAnxiety Research Centre, McMaster University, Hamilton, Ontario, Canada.
Depress Anxiety. 2019 Nov;36(11):1004-1025. doi: 10.1002/da.22936. Epub 2019 Jul 29.
Research in the past decade has shown that variations in the gut microbiome may influence behavior, and vice versa. As such, interest in the role of the gut microbiome in psychiatric conditions has drawn immense interest. This is evidenced by the recent surge in published studies examining microbial dysbiosis in clinical psychiatric populations, particularly autism spectrum disorder and depression. However, critical examination of these studies reveals methodological flaws in design and execution, suggesting that they may not be held to the same standards as other bodies of clinical research. Given the complex nature of the gut microbiome, this narrative review attempts to clarify concepts critical to effectively examine its potential role in psychopathology to appropriately inform mental health researchers. More specifically, the numerous variables known to affect the gut microbiome are discussed, including inflammation, diet, weight, and medications. A comprehensive review of the extant microbiome literature in clinical psychiatric populations is also provided, in addition to clinical implications and suggestions for future directions of research. Although there is a clear need for additional studies to elucidate the gut microbiome's role in psychiatric disorders, there is an even greater need for well-designed, appropriately controlled studies to truly impact the field.
过去十年的研究表明,肠道微生物组的变化可能会影响行为,反之亦然。因此,人们对肠道微生物组在精神疾病中的作用产生了浓厚的兴趣。这一点可以从最近大量发表的研究中得到证明,这些研究检查了临床精神科人群中的微生物失调,特别是自闭症谱系障碍和抑郁症。然而,对这些研究的批判性审查揭示了设计和执行方面的方法学缺陷,表明它们可能没有达到与其他临床研究相同的标准。鉴于肠道微生物组的复杂性,本叙述性评论试图澄清对有效检查其在精神病理学中潜在作用至关重要的概念,以便为精神健康研究人员提供信息。更具体地说,讨论了已知会影响肠道微生物组的许多变量,包括炎症、饮食、体重和药物。此外,还对临床精神科人群中现有的微生物组文献进行了全面回顾,并提出了临床意义和未来研究方向的建议。尽管需要进一步的研究来阐明肠道微生物组在精神疾病中的作用,但更需要精心设计、适当控制的研究来真正影响这一领域。