Iqbal A, Bokhari SFH, Rehman MU, Faizan Sattar SM, Bakht D, Dost W, Basit A. Gut-brain connection in schizophrenia: A narrative review. World J Psychiatry 2025; 15(5): 103751 [DOI: 10.5498/wjp.v15.i5.103751]
Corresponding Author of This Article
Wahidullah Dost, Department of Curative Medicine, Kabul University of Medical Sciences, Karte-e-sakhi, Kabul 10001, Afghanistan. wahidullahdost96@gmail.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. May 19, 2025; 15(5): 103751 Published online May 19, 2025. doi: 10.5498/wjp.v15.i5.103751
Gut-brain connection in schizophrenia: A narrative review
Asma Iqbal, Syed Faqeer Hussain Bokhari, Muneeb Ur Rehman, Syed Muhammad Faizan Sattar, Danyal Bakht, Wahidullah Dost, Abdul Basit
Asma Iqbal, Syed Faqeer Hussain Bokhari, Muneeb Ur Rehman, Syed Muhammad Faizan Sattar, Danyal Bakht, Abdul Basit, Department of Medicine and Surgery, King Edward Medical University, Lahore 54000, Punjab, Pakistan
Wahidullah Dost, Department of Curative Medicine, Kabul University of Medical Sciences, Kabul 10001, Afghanistan
Co-first authors: Asma Iqbal and Syed Faqeer Hussain Bokhari.
Author contributions: Iqbal A and Bokhari SFH contributed equally as co-first authors; Iqbal A contributed to conceptualization, study design, and manuscript drafting; Bokhari SFH played a key role in data collection, literature review, and statistical analysis; Rehman MU was responsible for screening studies, extracting relevant data, and assisting in manuscript preparation; Faizan Sattar SM contributed to data interpretation and manuscript revisions; Bakht D assisted in the literature search and synthesis; Dost W supervised the entire study, provided final manuscript approval, and ensured adherence to systematic review guidelines; Basit A provided critical review and revisions; and all authors have reviewed and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wahidullah Dost, Department of Curative Medicine, Kabul University of Medical Sciences, Karte-e-sakhi, Kabul 10001, Afghanistan. wahidullahdost96@gmail.com
Received: November 29, 2024 Revised: February 23, 2025 Accepted: March 31, 2025 Published online: May 19, 2025 Processing time: 152 Days and 17.2 Hours
Abstract
Schizophrenia is a complex neuropsychiatric disorder characterized by cognitive, emotional, and behavioral impairments. The microbiota-gut-brain axis is crucial in its pathophysiology, mediating communication between the gut and brain through neural, immune, endocrine, and metabolic pathways. Dysbiosis, or an imbalance in gut microbiota, is linked to neuroinflammation, systemic inflammation, and neurotransmitter disruptions, all of which contribute to the symptoms of schizophrenia. Gut microbiota-derived metabolites, such as short-chain fatty acids, influence brain function, including immune responses and neurotransmitter synthesis. These findings suggest that microbial imbalances exacerbate schizophrenia, providing a novel perspective on the disorder’s underlying mechanisms. Emerging microbiota-targeted therapies—such as probiotics, prebiotics, dietary interventions, and fecal microbiota transplantation—show promise as adjunctive treatments, aiming to restore microbial balance and improve clinical outcomes. While further research is needed, targeting the microbiota-gut-brain axis offers an innovative approach to schizophrenia management, with the potential to enhance patient outcomes and quality of life.
Core Tip: Emerging research highlights the critical role of the gut-brain axis in schizophrenia. Dysbiosis, or imbalances in gut microbiota, may contribute to neuroinflammation, neurotransmitter dysregulation, and blood-brain barrier disruption, all of which are central to the pathophysiology of the disorder. Targeting gut health through probiotics, prebiotics, dietary changes, and fecal microbiota transplantation holds promise as adjunctive therapies to traditional antipsychotics, offering new, integrative strategies for improving cognitive, emotional, and behavioral outcomes in schizophrenia. Further research is needed to validate and refine these approaches.
