Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Faculty of Social Work, University of Calgary, Calgary, AB, Canada.
Can J Psychiatry. 2024 Jul;69(7):503-512. doi: 10.1177/07067437241234954. Epub 2024 Feb 28.
Medications are critical for treating major depressive disorder (MDD) and bipolar disorder (BD). Unfortunately, 30% to 40% of individuals do not respond well to current pharmacotherapy. Given the compelling growing body of research on the gut-brain axis, this study aims to assess patient perspectives regarding microbiome-based therapies (MBT) such as probiotics, prebiotics, dietary changes, or fecal microbiota transplantation (FMT) in the management of MDD and BD.
This single-centred observational study used quantitative and qualitative assessments to examine patient perceptions of MBT. Participants diagnosed with MDD or BD completed an anonymous questionnaire obtaining demographics, prior medication history, and symptom burden. Self-assessment questionnaires specific to each diagnosis were also used: Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR), Altman Self-Rating Mania Scale (ASRM), and General Anxiety Disorder Questionnaire (GAD-7). A logistic regression model analysed the association of MBT acceptance with disorder type, QIDS-SR, and GAD-7 scores. A bootstrap method assessed the proportion of MBT acceptance. The qualitative assessment consisted of 30-minute interviews to elicit perceptions and attitudes towards MBT.
The qualitative assessment achieved information power with = 20. Results from the 63-item MBT questionnaire ( = 43) showed probiotics (37.2%) as the top choice, followed by FMT (32.6%), dietary change (25.6%), and prebiotics (4.6%). A majority of participants (72.1%) expressed willingness to try MBT for their mood disorder, however, logistic regression analysis did not identify statistically significant predictors for MBT acceptance among disorder type, QIDS-SR, and GAD-7.
There is an increased focus on the gut microbiota's role in mood disorders' etiology and treatment. Promising research and patient interest underscore the necessity for exploring and educating on patient perspectives and the factors influencing attitudes towards MBT.
药物对于治疗重度抑郁症(MDD)和双相情感障碍(BD)至关重要。不幸的是,30%至 40%的患者对当前的药物治疗反应不佳。鉴于肠道-大脑轴的研究不断增多,本研究旨在评估患者对基于微生物组的治疗(MBT)的看法,例如益生菌、益生元、饮食改变或粪便微生物群移植(FMT)在 MDD 和 BD 中的应用。
这项单中心观察性研究使用定量和定性评估来检查患者对 MBT 的看法。诊断为 MDD 或 BD 的参与者完成了一份匿名问卷,获取了人口统计学、既往用药史和症状负担等信息。还使用了针对每种诊断的特定自我评估问卷:抑郁症状快速自评量表(QIDS-SR)、Altman 自我评定躁狂量表(ASRM)和广泛性焦虑症问卷(GAD-7)。逻辑回归模型分析了 MBT 接受程度与疾病类型、QIDS-SR 和 GAD-7 评分之间的关联。采用自举法评估 MBT 接受程度的比例。定性评估包括 30 分钟的访谈,以了解患者对 MBT 的看法和态度。
定性评估达到了信息饱和水平( = 20)。63 项 MBT 问卷( = 43)的结果显示,益生菌(37.2%)是首选,其次是 FMT(32.6%)、饮食改变(25.6%)和益生元(4.6%)。大多数参与者(72.1%)表示愿意尝试 MBT 治疗他们的情绪障碍,但逻辑回归分析未发现 MBT 接受程度与疾病类型、QIDS-SR 和 GAD-7 之间有统计学意义的预测因素。
人们越来越关注肠道微生物群在情绪障碍发病机制和治疗中的作用。有前景的研究和患者的兴趣突显了探索和教育患者对 MBT 的看法以及影响其态度的因素的必要性。