Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Ruixue Huang, Ke Wang, Jianan Hu, Ruixue Huang, Ke Wang, Jianan Hu

Abstract

It has been reported that gut probiotics play a major role in the bidirectional communication between the gut and the brain. Probiotics may be essential to people with depression, which remains a global health challenge, as depression is a metabolic brain disorder. However, the efficacy of probiotics for depression is controversial. This study aimed to systematically review the existing evidence on the effect of probiotics-based interventions on depression. Randomized, controlled trials, identified through screening multiple databases and grey literature, were included in the meta-analysis. The meta-analysis was performed using Review Manager 5.3 software using a fixed-effects model. The meta-analysis showed that probiotics significantly decreased the depression scale score (MD (depressive disorder) = -0.30, 95% CI (-0.51--0.09), p = 0.005) in the subjects. Probiotics had an effect on both the healthy population (MD = -0.25, 95% CI (-0.47--0.03), p = 0.03) and patients with major depressive disorder (MDD) (MD = -0.73, 95% CI (-1.37--0.09), p = 0.03). Probiotics had an effect on the population aged under 60 (MD = -0.43, 95% CI (-0.72--0.13), p = 0.005), while it had no effect on people aged over 65 (MD = -0.18, 95% CI (-0.47-0.11), p = 0.22). This is the first systematic review and meta-analysis with the goal of determining the effect of probiotics on depression. We found that probiotics were associated with a significant reduction in depression, underscoring the need for additional research on this potential preventive strategy for depression.

Keywords: depression; meta-analysis; probiotics; randomized controlled trial.

Figures

Figure 1
Figure 1
An adapted PRISMA flow diagram.
Figure 2
Figure 2
(A) risk of bias for each RCT included: low risk of bias (+), high risk of bias (-), unclear risk of bias (?); and (B) bar chart comparing the percent risk of bias for each RCT included. The figure shows that the risk of bias was quite low.
Figure 3
Figure 3
(A) estimates for probiotics associated with depression in the meta-analysis; (B) forest plots for different ages; and (C) forest plots for depression status.
Figure 4
Figure 4
Funnel plot analysis. There was low heterogeneity among the studies, and no evidence of publication bias.

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