Moshfeghinia Reza, Nemati Hossein, Ebrahimi Asal, Shekouh Dorsa, Karami Saeed, Eraghi Mohammad Mirahmadi, Mohagheghzadeh Hoorad, Hunter Jennifer, Pasalar Mehdi
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Research Center for Psychiatry and Behavior Science, Shiraz University of Medical Sciences, Shiraz, Iran; Substance Abuse Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
J Psychiatr Res. 2025 Aug;188:104-116. doi: 10.1016/j.jpsychires.2025.05.053. Epub 2025 May 24.
Depression is a prevalent mental health disorder with significant societal impact and treatment challenges. Recent research on the gut-brain axis has led to interest in probiotics, synbiotics, and prebiotics as potential therapeutic options for depression. This systematic review aims to evaluate their effects and provide evidence-based insights for future research and clinical practice.
Six digital databases (Scopus, PubMed, Web of Science, Cochrane, PsycINFO, and CINAHL complete) were examined for English-language records. Inclusion criteria involved studies assessing the impact of probiotics, prebiotics, and synbiotic on depression and anxiety in individuals with depression. The Cochrane Collaboration's instrument was employed to evaluate the risk of bias. For meta-analysis, random-effects model was favored, and statistical analysis was conducted using Stata software version 17.
From initial 4407 studies 19 studies included in meta-analysis. A meta-analysis of 19 studies involving 1405 participants (882 cases and 523 controls) revealed a significant decrease in depression scores among patients receiving probiotics, prebiotics, or synbiotics compared to the control group (SMD: -1.76 [-2.42, -1.10]), despite high heterogeneity between studies (I: 96.29 %). Similarly, analysis of seven studies with 481 participants (237 cases and 244 controls) showed a significant decrease in anxiety scores for those receiving these supplements (SMD: -1.60 [-2.83, -0.36]), with high heterogeneity between studies (I: 96.90 %).
In conclusion, our meta-analysis indicates that probiotics, prebiotics, or synbiotics significantly reduce depression and anxiety symptoms in patients with depression. Future research should address heterogeneity in diagnosis and intervention types to better understand their efficacy.
抑郁症是一种普遍存在的心理健康障碍，具有重大的社会影响和治疗挑战。最近关于肠道-脑轴的研究引发了人们对益生菌、合生元和益生元作为抑郁症潜在治疗选择的兴趣。本系统评价旨在评估它们的效果，并为未来的研究和临床实践提供基于证据的见解。
检索了六个数字数据库（Scopus、PubMed、Web of Science、Cochrane、PsycINFO和CINAHL complete）中的英文记录。纳入标准包括评估益生菌、益生元和合生元对抑郁症患者抑郁和焦虑影响的研究。采用Cochrane协作组织的工具评估偏倚风险。对于荟萃分析，倾向于采用随机效应模型，并使用Stata软件17版进行统计分析。
从最初的4407项研究中，有19项研究纳入荟萃分析。对19项涉及1405名参与者（882例病例和523名对照）的研究进行的荟萃分析显示，与对照组相比，接受益生菌、益生元或合生元的患者抑郁评分显著降低（标准化均数差：-1.76 [-2.42, -1.10]），尽管研究之间存在高度异质性（I²：96.29%）。同样，对七项涉及481名参与者（237例病例和244名对照）的研究分析表明，接受这些补充剂的患者焦虑评分显著降低（标准化均数差：-1.60 [-2.83, -0.36]），研究之间存在高度异质性（I²：96.90%）。
总之，我们的荟萃分析表明，益生菌、益生元或合生元可显著减轻抑郁症患者的抑郁和焦虑症状。未来的研究应解决诊断和干预类型的异质性问题，以更好地了解它们的疗效。
