Butler Mary I, Kittel-Schneider Sarah, Wagner-Skacel Jolana, Mörkl Sabrina, Clarke Gerard
Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland.
APC Microbiome Ireland, University College Cork, Cork, Ireland.
Curr Psychiatry Rep. 2025 May;27(5):347-361. doi: 10.1007/s11920-025-01604-w. Epub 2025 Apr 12.
We aim to update readers on the latest evidence regarding the role of the gut microbiome in generalized anxiety disorder (GAD), panic disorder (PD), agoraphobia, and social anxiety disorder (SAD). This review summarises the literature on microbiome composition and function in these conditions, provides insights about causality and mechanisms and evaluates current evidence for microbiome-based interventions in anxiety disorders.
Most studies exploring the microbiome in anxiety disorders are small, cross-sectional studies. Nevertheless, some consistent findings emerge. Bacterial taxa such as Eubacterium, Coprococcus and Faecalibacterium may be depleted in GAD. Studies in PD and SAD are scarce and, to our knowledge, there have been no studies conducted in agoraphobia. Probiotics may help reduce anxiety symptoms, although the majority of studies have been in non-clinical cohorts. Large, prospective studies are required to further elucidate the role of the microbiome-gut-brain axis in anxiety disorders. Microbiome-based interventions hold promise, but randomised controlled trials in clinical populations with relevant diagnoses are now warranted and urgently required.
我们旨在向读者介绍有关肠道微生物群在广泛性焦虑症（GAD）、惊恐障碍（PD）、广场恐惧症和社交焦虑症（SAD）中作用的最新证据。本综述总结了这些病症中微生物群组成和功能的相关文献，提供了关于因果关系和机制的见解，并评估了目前基于微生物群的焦虑症干预措施的证据。
大多数探索焦虑症中微生物群的研究都是小型横断面研究。然而，仍出现了一些一致的发现。在广泛性焦虑症中，诸如真杆菌属、粪球菌属和粪杆菌属等细菌类群可能会减少。关于惊恐障碍和社交焦虑症的研究很少，据我们所知，尚未有针对广场恐惧症的研究。益生菌可能有助于减轻焦虑症状，不过大多数研究是在非临床队列中进行的。需要进行大规模的前瞻性研究，以进一步阐明微生物群-肠道-脑轴在焦虑症中的作用。基于微生物群的干预措施具有前景，但现在有必要且迫切需要在有相关诊断的临床人群中开展随机对照试验。
