Dai LY, Chen RR, Chen HR, Yin JH, Huang ZX, Yin BW, Liu XY. Potential clinical benefits of probiotics, prebiotics, synbiotics, and postbiotics for depression via the microbiota-gut-brain axis. World J Psychiatry 2025; 15(5): 98436 [DOI: 10.5498/wjp.v15.i5.98436]
Corresponding Author of This Article
Xing-Yan Liu, BMed, Professor, Department of General Psychiatry, Wenzhou Seventh People's Hospital, No. 158 Xueshiqian Road, Panqiao Street, Ouhai District, Wenzhou 325000, Zhejiang Province, China. 13645771028@163.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Meta-Analysis
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/
Ling-Yi Dai, Ru-Ru Chen, Hao-Ran Chen, Jia-Hui Yin, Zhen-Xing Huang, Bo-Wen Yin, Xing-Yan Liu, Department of General Psychiatry, Wenzhou Seventh People's Hospital, Wenzhou 325000, Zhejiang Province, China
Co-first authors: Ling-Yi Dai and Ru-Ru Chen.
Author contributions: Dai LY and Chen RR contribute equally to this study as co-first authors; Dai LY and Chen RR acquisition of data, analysis and interpretation of data, drafting the article, final approval; Chen HR acquisition of data, analysis and interpretation of data, drafting the article, final approval; Yin JH interpretation of data, revising the article, final approval; Yin BW interpretation of data, revising the article, final approval; Liu XY conception and design of the study, critical revision, final approval.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Xing-Yan Liu, BMed, Professor, Department of General Psychiatry, Wenzhou Seventh People's Hospital, No. 158 Xueshiqian Road, Panqiao Street, Ouhai District, Wenzhou 325000, Zhejiang Province, China. 13645771028@163.com
Received: August 20, 2024 Revised: February 6, 2025 Accepted: April 7, 2025 Published online: May 19, 2025 Processing time: 253 Days and 0.4 Hours
Abstract
BACKGROUND
Depression is a common mental-health disorder worldwide. Several studies have demonstrated the effects of gut microbiota-targeting interventions, such as probiotics, prebiotics, synbiotics, and postbiotics (PPSP), on depression.
AIM
To assess the potential benefits of PPSP on patients diagnosed with depressive disorder.
METHODS
A literature search of the PubMed, Web of Science, and Elsevier Science Direct databases for relevant studies published from database inception to March 2024 was performed. Studies that used a randomized controlled trial design and evaluated differences in depression between PPSP and placebo were included. Depressive symptoms were assessed using a validated scale. Analysis was performed using Review Manager version 5.4 (The Cochrane Collaboration, 2020).
RESULTS
Fourteen studies comprising 906 patients with depressive symptoms were included. PPSP improved depression compared with placebo [SMD: -0.39 (95%CI: -0.60 to -0.17); P < 0.001]. PPSP resulted in significant reductions in Hamilton Depression Rating Scale [MD: -1.72 (95%CI: -2.57 to -0.88); P < 0.001] and Beck Depression Inventory [MD: -2.69 (95%CI: -4.67 to -0.71); P < 0.001] scores. Sub-analysis confirmed the antidepressant effects of probiotics on depressive symptoms [SMD: -0.32 (95%CI: -0.48 to -0.16); P < 0.001], with prebiotics exerting no apparent effect [SMD: -0.08 (95%CI: -0.39 to -0.23); P = 0.62], and synbiotics exerting statistically significant benefits [SMD: -1.09 (95%CI: -1.45 to -0.73); P < 0.001].
CONCLUSION
PPSP effectively alleviates depressive symptoms, and subgroup analysis supports the benefits of probiotics and synbiotics. Nevertheless, evidence supporting the use of PPSP for the treatment of depression remains insufficient.
Core Tip: The present study evaluated the effect of probiotics, prebiotics, synbiotics, and postbiotics (PPSP)-based treatment on depressive symptoms by analyzing data from 14 studies comprising 906 participants. Results indicated that PPSP could significantly improve symptoms in patients with depression compared with placebo, while subgroup analysis confirmed the apparent effects of probiotics and synbiotics in improving depressive symptoms. Larger randomized controlled trials, nevertheless, are required to further explore the benefits of PPSP in treating depression.
