Role of the gut microbiome in three major psychiatric disorders

Major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia-spectrum disorders (SSD) are heterogeneous psychiatric disorders, which place significant burden on patient's well-being and global health. Disruptions in the gut-microbiome may play a role in these psychiatric disorders. This review presents current data on composition of the human gastrointestinal microbiota, and its interaction mechanisms in the gut-brain axis in MDD, BD and SSD. Diversity metrics and microbial relative abundance differed across studies. More studies reported inconsistent findings (n = 7) or no differences (n = 8) than studies who reported lower alpha-diversity in these psychiatric disorders (n = 5). The most consistent findings across studies were higher relative abundances of the genera Streptococcus, Lactobacillus, and Eggerthella and lower relative abundance of the butyrate producing Faecalibacterium in patients with psychiatric disorders. All three increased genera were associated with higher symptom severity. Confounders, such as medication use and life style have not been accounted for. So far, the results of probiotics trials have been inconsistent. Most traditional and widely used probiotics (consisting of Bifidobacterium spp. and Lactobacillus spp.) are safe, however, they do not correct potential microbiota disbalances in these disorders. Findings on prebiotics and faecal microbiota transplantation (FMT) are too limited to draw definitive conclusions. Disease-specific pro/prebiotic treatment or even FMT could be auspicious interventions for prevention and therapy for psychiatric disorders and should be investigated in future trials.

Automated summary

Major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia-spectrum disorders (SSD) are heterogeneous psychiatric disorders that have a significant impact on the well-being and global health of patients. Disruptions in the gut microbiome may contribute to the development of these disorders. Current research suggests that patients with psychiatric disorders tend to have higher levels of Streptococcus, Lactobacillus, and Eggerthella bacteria, and lower levels of Faecalibacterium, a bacteria that produces butyrate. However, further studies are needed to account for confounding factors such as medication use and lifestyle choices, and the effectiveness of probiotics and fecal microbiota transplantation (FMT) in treating these disorders remains inconclusive.