Effects of Prebiotics and Probiotics on Symptoms of Depression and Anxiety in Clinically Diagnosed Samples: Systematic Review and Meta-analysis of Randomized Controlled Trials.

IF 5.9 2区 医学 Q1 NUTRITION & DIETETICS
Afrida Asad, Megan Kirk, Sufen Zhu, Xue Dong, Min Gao
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引用次数: 0

Abstract

Context: The use of prebiotics and probiotics as a treatment for psychiatric conditions has gained interest due to their potential to modulate the gut-brain axis. This review aims to assess the effectiveness of these interventions in reducing symptoms of depression and anxiety in psychiatric populations.

Objective: The aim was to comprehensively review and appraise the effectiveness of prebiotic, probiotic, and synbiotic interventions in reducing clinical depression and anxiety symptoms.

Data sources: Systematic searches were conducted across Embase, Medline, PsycINFO, CINAHL, Cochrane Library, and Science Citation Index from database inception to May 22, 2023.

Data extraction: Randomized controlled trials investigating prebiotic, probiotic, or synbiotic interventions for treating clinical depression or anxiety symptoms in clinical samples were included. Data were extracted on study characteristics, intervention details, and outcome measures. The Cochrane Collaboration Tool was used to assess the risk of bias.

Data analysis: The standardized mean difference (SMD) was calculated using Hedge's g as the metric of effect size. A random-effects model was applied to estimate pooled effect sizes with 95% CIs. Subgroup analyses were performed based on study characteristics, methodological factors, and intervention types. Sensitivity analyses excluded studies with a high risk of bias.

Results: Twenty-three RCTs involving 1401 patients met the inclusion criteria, with 20 trials providing sufficient data for meta-analysis. Of these, 18 trials investigated probiotics for depression, 9 trials assessed probiotics for anxiety, and 3 trials examined prebiotics for depression. Probiotics demonstrated a significant reduction in depression symptoms (SMD: -0.96; 95% CI: -1.31, -0.61) and a moderate reduction in anxiety symptoms (SMD: -0.59; 95% CI: -0.98, -0.19). Prebiotics did not show a significant effect on depression (SMD: -0.28; 95% CI: -0.61, 0.04). High heterogeneity was observed across studies, and subgroup analyses indicated that study duration and probiotic formulations contributed to the variation in effect sizes.

Conclusion: Probiotics showed substantial reductions in depression symptoms and moderate reductions in anxiety symptoms. Prebiotics showed a nonsignificant trend toward reducing depression. An adjunctive mental health treatment approach that diagnoses, monitors, and treats the gut microbiome alongside traditional pharmacological treatment holds promise for clinical practice.

Systematic review registration: PROSPERO registration no. CRD42023424136.

益生元和益生菌对临床诊断样本中抑郁和焦虑症状的影响:随机对照试验的系统评价和荟萃分析
背景:使用益生元和益生菌作为精神疾病的治疗已经引起了人们的兴趣,因为它们具有调节肠-脑轴的潜力。本综述旨在评估这些干预措施在减轻精神病患者抑郁和焦虑症状方面的有效性。目的:旨在全面回顾和评价益生元、益生菌和综合干预在减轻临床抑郁和焦虑症状方面的有效性。数据来源:系统检索Embase、Medline、PsycINFO、CINAHL、Cochrane Library和Science Citation Index,检索时间为数据库建立至2023年5月22日。数据提取:随机对照试验调查益生元,益生菌,或合成干预治疗临床抑郁或焦虑症状的临床样本。提取研究特征、干预细节和结果测量的数据。使用Cochrane协作工具评估偏倚风险。数据分析:采用Hedge’s g作为效应大小度量,计算标准化平均差(SMD)。随机效应模型用于估计95% ci的合并效应大小。根据研究特征、方法学因素和干预类型进行亚组分析。敏感性分析排除了高偏倚风险的研究。结果:23项rct共1401例患者符合纳入标准,其中20项试验提供了足够的数据进行meta分析。其中,18项试验研究了益生菌治疗抑郁症,9项试验评估了益生菌治疗焦虑,3项试验研究了益生菌治疗抑郁症。益生菌显着减少抑郁症状(SMD: -0.96;95% CI: -1.31, -0.61)和焦虑症状的中度减轻(SMD: -0.59;95% ci: -0.98, -0.19)。益生元对抑郁症无显著影响(SMD: -0.28;95% ci: -0.61, 0.04)。研究中观察到高度异质性,亚组分析表明,研究持续时间和益生菌配方对效应大小的变化有影响。结论:益生菌可显著减轻抑郁症状,中度减轻焦虑症状。益生元在减少抑郁方面没有明显的趋势。一种辅助精神健康治疗方法,诊断、监测和治疗肠道微生物组与传统的药物治疗有希望的临床实践。系统评审注册:普洛斯彼罗注册号。CRD42023424136。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Nutrition reviews
Nutrition reviews 医学-营养学
CiteScore
12.20
自引率
1.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: Nutrition Reviews is a highly cited, monthly, international, peer-reviewed journal that specializes in the publication of authoritative and critical literature reviews on current and emerging topics in nutrition science, food science, clinical nutrition, and nutrition policy. Readers of Nutrition Reviews include nutrition scientists, biomedical researchers, clinical and dietetic practitioners, and advanced students of nutrition.
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