Department of Psychiatry, Hospital Clínico Universitario de Valencia, Department of Psychiatry, Blasco Ibañez 17, floor 7B, 46010 Valencia, Spain.
Faculty of Psychology, University of Valencia, Valencia, Spain; INCLIVA - Health Research Institute, Valencia, Spain; TMAP - Evaluation Unit in Personal Autonomy, Dependency and Serious Mental Disorders, University of Valencia, Fundación INCLIVA, Av. Menéndez y Pelayo 4, 46010 Valencia, Spain.
Neurosci Biobehav Rev. 2024 Mar;158:105561. doi: 10.1016/j.neubiorev.2024.105561. Epub 2024 Jan 26.
The use of probiotics, prebiotics, synbiotics or fermented foods can modulate the gut-brain axis and constitute a potentially therapeutic intervention in psychiatric disorders. This systematic review aims to identify current evidence regarding these interventions in the treatment of patients with DSM/ICD psychiatric diagnoses. Forty-seven articles from 42 studies met the inclusion criteria. Risk of bias was assessed in all included studies. Major depression was the most studied disorder (n = 19 studies). Studies frequently focused on schizophrenia (n = 11) and bipolar disorder (n = 5) and there were limited studies in anorexia nervosa (n = 4), ADHD (n = 3), Tourette (n = 1), insomnia (n = 1), PTSD (n = 1) and generalized anxiety disorder (n = 1). Except in MDD, current evidence does not clarify the role of probiotics and prebiotics in the treatment of mental illness. Several studies point to an improvement in the immune and inflammatory profile (e.g. CRP, IL6), which may be a relevant mechanism of action of the therapeutic response identified in these studies. Future research should consider lifestyle and dietary habits of patients as possible confounders that may influence inter-individual treatment response.
益生菌、益生元、合生元或发酵食品的使用可以调节肠道-大脑轴，并构成精神障碍治疗的潜在干预措施。本系统评价旨在确定这些干预措施在治疗 DSM/ICD 精神科诊断患者中的当前证据。42 项研究中的 47 篇文章符合纳入标准。所有纳入的研究都评估了偏倚风险。研究最多的疾病是重度抑郁症（n=19 项研究）。研究经常集中在精神分裂症（n=11）和双相情感障碍（n=5），而神经性厌食症（n=4）、注意力缺陷多动障碍（n=3）、图雷特综合征（n=1）、失眠（n=1）、创伤后应激障碍（n=1）和广泛性焦虑障碍（n=1）的研究则有限。除了 MDD 之外，目前的证据并不清楚益生菌和益生元在治疗精神疾病中的作用。一些研究指出免疫和炎症谱的改善（例如 CRP、IL6），这可能是这些研究中确定的治疗反应的一个相关作用机制。未来的研究应考虑患者的生活方式和饮食习惯，因为这些可能是影响个体间治疗反应的混杂因素。
