Tufts University School of Medicine, Boston, MA.
Department of Psychology, University of South Carolina, Columbia, SC.
J Acad Consult Liaison Psychiatry. 2022 May-Jun;63(3):268-279. doi: 10.1016/j.jaclp.2021.08.008. Epub 2021 Aug 27.
The microbiome's role in the etiology of depression has been a topic of many recent investigations. Findings suggest that dysbiosis, which describes a general disturbance in the gut microbiome, underlies negative gastrointestinal symptoms and is implicated in depression. We studied associations between gastrointestinal symptoms and depressive symptoms at a population level using cross-sectional data from the National Health and Nutrition Examination Survey (2005-2016, n = 36,287). We hypothesized that the odds of depressive symptoms would be significantly higher in those showing signs of gastrointestinal distress.
We analyzed 31,191 adults participating in the National Health and Nutrition Examination Survey from 2005-2016. Outcomes included presence of mucus or liquid in bowel leakage and stomach illness in the past month, diarrhea in the past year, and number of weekly bowel movements. The survey (and thus, our analyses) does not include microbiome samples, only self-reported gastrointestinal symptoms. Depressive symptoms were measured using the Patient Health Questionnaire. Moderate, moderately severe, and severe scores were coded as a positive outcome.
Compared to those without depressive symptoms, those with moderate-to-severe depressive symptoms had elevated odds of bowel mucus (odds ratio = 2.78; 95% confidence interval = 1.82-4.24), bowel liquid (odds ratio = 2.16; 95% confidence interval = 1.63-2.86), stomach illness (odds ratio = 1.82; 95% confidence interval = 1.31-2.53), diarrhea (sometimes vs. never odds ratio = 1.72; 95% confidence interval = 1.30-2.29), and constipation (sometimes vs. never odds ratio = 2.76; 95% confidence interval = 2.11-3.62). Overall, those with gastrointestinal symptoms were significantly more likely to have depressive symptoms.
While the intricacies of the brain-gut axis are being investigated at the molecular level, these population data provide further evidence for the association between depressive symptoms and signs of dysbiosis, which may inform health care providers' patient interactions.
微生物组在抑郁症发病机制中的作用一直是许多近期研究的主题。研究结果表明，微生态失调（描述肠道微生物组的一般紊乱）是负面胃肠道症状的基础，并与抑郁症有关。我们使用国家健康和营养检查调查（2005-2016 年，n=36287）的横断面数据，在人群水平上研究了胃肠道症状与抑郁症状之间的关联。我们假设，出现胃肠道不适迹象的人出现抑郁症状的几率会显著升高。
我们分析了 2005-2016 年参与国家健康和营养检查调查的 31191 名成年人的数据。结果包括过去一个月内粪便漏液中有粘液或液体以及胃部疾病、过去一年中腹泻以及每周排便次数。该调查（因此，我们的分析）不包括微生物组样本，仅包括自我报告的胃肠道症状。抑郁症状使用患者健康问卷进行测量。中度、中度严重和严重评分被编码为阳性结果。
与没有抑郁症状的人相比，有中度至重度抑郁症状的人出现粪便粘液（比值比=2.78；95%置信区间=1.82-4.24）、粪便液体（比值比=2.16；95%置信区间=1.63-2.86）、胃部疾病（比值比=1.82；95%置信区间=1.31-2.53）、腹泻（有时 vs. 从不比值比=1.72；95%置信区间=1.30-2.29）和便秘（有时 vs. 从不比值比=2.76；95%置信区间=2.11-3.62）的几率更高。总的来说，有胃肠道症状的人更有可能出现抑郁症状。
虽然大脑-肠道轴的复杂性正在分子水平上进行研究，但这些人群数据提供了更多证据表明抑郁症状与微生态失调之间的关联，这可能为医疗保健提供者的患者互动提供信息。
