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Probiotics And Mental Health Pdf

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This review aims to present a comprehensive state-of-the-art analysis of the bidirectional crosstalk between gut microbiota and the central nervous system CNS.

Probiotics to prevent mental disorders

Thank you for visiting nature. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript. Poor maternal mental health has been associated with a myriad of pregnancy and child health complications.

Probiotics may represent a novel approach to intervene in poor mental health and obesity. We conducted this pre-specified secondary analysis of the Healthy Mums and Babies HUMBA randomised controlled trial to investigate whether probiotics would improve maternal mental health outcomes up to 36 weeks of pregnancy. Anxiety and physical well-being scores worsened over time irrespective of group allocation, and mental well-being scores did not differ between the two groups at 36 weeks.

Probiotics did not improve mental health outcomes in this multi-ethnic cohort of pregnant women with obesity. The perinatal period is a time of significant transition, wherein physical, psychological, and social changes occur, and new challenges are encountered 1 , 2 , 3 , 4. Thus, it is unsurprising that maternal mental health issues, such as depression and anxiety, are commonly experienced by women during this time.

The experience of poor maternal mental health has been associated with a myriad of adverse pregnancy and birth outcomes such as preterm birth 3 , 5 , 6 , 7 and low infant birthweight 3 , 6 , in addition to longer-term negative impacts regarding child development 8 , 9 , 10 , 11 , offspring mental health 8 , 12 , 13 , early mother-child interaction 14 , 15 , 16 , 17 , and ongoing mental health issues for the mother 17 , Despite significant consequences, maternal mental health symptomology continues to be under-recognised and under-treated 2 , Pregnancy with obesity represents an additional significant and prevalent health condition that can increase the risk of pregnancy complications and contribute to negative maternal and child outcomes that persist beyond the perinatal period 20 , 21 , Evidence suggests that obesity during pregnancy may be a factor contributing to an increased risk of adverse maternal mental health outcomes, as women who enter pregnancy with obesity have been found to be more likely to experience perinatal depression and anxiety symptoms relative to women who enter pregnancy at a normal or healthy weight 23 , 24 , A potentially novel approach to targeting both obesity and poor mental health is through the modification of the gut microbiota and thus the gut-brain axis, via consumption of probiotics.

Dysregulation of the gut-brain axis and alterations in the gut microbiota i. It has been hypothesised that probiotics may be able to restore microbial dysbiosis, improve gastrointestinal integrity, and subsequently reduce inflammation and normalise neuroendocrine activity and neurotransmission, thereby targeting both obesity and mental health disorders via a shared mechanistic pathway 26 , 29 , 30 , Probiotics are considered safe during pregnancy, and are a simple, easy, and cost-effective intervention, that have previously demonstrated positive metabolic outcomes in randomised controlled trials with pregnant women 32 , Research regarding mental health outcomes of pregnant women who consume probiotics is almost entirely absent from the literature, despite the growing body of studies exploring probiotics and mental health among non-pregnant populations, and studies exploring probiotics and other outcomes e.

One study which has explored mental health outcomes in pregnant women with a history of asthma, eczema, or hayfever, demonstrated that those allocated to receive the probiotic Lactobacillus rhamnosus HN during pregnancy, had significantly lower anxiety and depression scores in the postnatal period compared to those who received a placebo There remains a clear need to further investigate this relationship between probiotics and maternal mental health, and additionally to investigate this relationship in the context of pregnant women with obesity.

No randomised controlled trials have investigated the influence of probiotics on mental health outcomes among pregnant women with obesity. To address this research gap and contribute to the growing body of literature on probiotics and mental health, the current study was conducted to investigate the influence of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 on depression, anxiety, and functional health and well-being, among a multi-ethnic sample of pregnant women with obesity residing in the Counties Manukau Health CMH region in South Auckland, New Zealand.

The CMH region is characterised by high levels of pregnancy with obesity and socioeconomic deprivation, and has a high percentage of vulnerable ethnic minority residents 35 , thus making it a pertinent population for mental health research and intervention. We hypothesised that women allocated to the probiotic capsule intervention would have improvements in depression, anxiety, and functional health and well-being scores from baseline to 36 weeks of pregnancy, in comparison to those in the placebo group.

We also hypothesised that women allocated to the probiotic intervention would demonstrate lower depression and anxiety scores and higher functional health and well-being scores in comparison to the those in the placebo group at 36 weeks of pregnancy.

The HUMBA trial was a single-centre two-by-two factorial randomised controlled demonstration trial parallel groups , designed to investigate the influence of probiotic versus placebo capsules double-blind , and dietary intervention versus routine dietary advice no blinding on several outcome measures among a sample of pregnant women with obesity and their offspring in the CMH region.

While the primary outcomes of interest of the HUMBA trial were excessive gestational weight gain and infant birth weight, this secondary analysis pertains to antenatal mental health outcomes of the study cohort and focusses on the effects of the probiotic intervention. All participants provided written informed consent and the research was conducted in accordance with the Helsinki Declaration.

Additionally, participants were excluded if they declined to participate or were unable to provide informed written consent. Two hundred and thirty met the eligibility criteria, consented to participate, and were randomised to receive either probiotic or placebo capsules. Of the women recruited, primary outcome data pertaining to the current study depression scores at 36 weeks of pregnancy were obtained for women, thus forming the analytic sample. See Fig. Participants were stratified by BMI category Participants randomised to the probiotic intervention received probiotic capsules containing Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 Chr.

The probiotic formulation was based on that used in an earlier study which demonstrated reductions in gestational diabetes among pregnant women randomised to receive both dietary counselling and probiotic supplementation HUMBA participants randomised to placebo capsules received identical looking capsules instead containing microcrystalline cellulose and dextrose anhydrate Chr.

Participants were administered a canister of capsules monthly by a community health worker or a research midwife, and instructed to take one capsule per day. The HUMBA research team visited participants at pre-specified intervals over the course of pregnancy to collect outcome data and administer the capsules. The first i. Eligibility was confirmed, informed consent obtained, and randomisation was conducted.

Comprehensive health, sociodemographic, and lifestyle information was obtained, and questionnaires assessing maternal mental health outcomes depression 40 , anxiety 41 , and functional health and well-being 42 were administered to participants. The intervention commenced at this visit. Another assessment visit took place when the participants were 36 weeks pregnant. Questionnaires assessing maternal mental health outcomes were re-administered, and adherence to the intervention i.

Additional assessment visits were conducted as part of the wider HUMBA trial, and these are outlined in earlier publications 36 , Depression was assessed using the EPDS 40 , a item self-report scale widely used to screen for perinatal depression by assessing how depressed one has felt over the past 7 days.

Although originally developed to screen for postnatal depression, the EPDS is now commonly used to identify depressive symptoms that occur throughout the entire perinatal period. Scale items e. Scores can also be interpreted continuously, with higher total scores indicating higher levels of depression. The scale items e. Summed scores from all items thus range from 6— The summed score is then divided by six and multiplied by twenty in order to generate a new total score within the range of 20—80, which is comparable with the original STAI value range.

Different cut-off scores for the STAI from 39—50 have been used to indicate probable clinically significant anxiety levels in non-pregnant and pregnant samples, with ultimately higher scores indicating greater anxiety 34 , 46 , The SFv2 assesses both physical and mental aspects of functional health and well-being and encompasses eight specific domains physical functioning, role limitation due to physical functioning, bodily pain, general health perceptions, vitality, social functioning, role limitation due to emotional functioning, and mental health.

It is recommended that the eight domains of the SFv2 be aggregated to form two higher-order summary subscales, the Physical Component Summary PCS and the Mental Component Summary MCS , which measure physical and mental functional health and well-being respectively. Higher scores indicate better functional health and well-being. The current study utilised means, standard deviations, and scoring coefficients derived from the New Zealand population to derive the PCS and MCS scores The SFv2 has been found to be valid, reliable, and sensitive to change among diverse samples, including among people with physical health conditions, those undergoing an intervention, and among women during the perinatal period Participants were asked if they had taken their HUMBA capsule each day, and if not, how many capsules they had missed.

An overall binary measure of adherence was created based on the information provided by participants across these time points. Data were screened for errors, and the statistical assumptions for each test were checked. Normality was assessed for continuous outcome variables, with a judgement made based on a combination of visual assessment of histograms, skewness and kurtosis values, and Kolmogrov-Smirnov tests.

For outcome variables found not to be normally distributed depression, anxiety, and MCS scores , log, square root, and reciprocal transformations were trialled. However, these transformations failed to improve the distributions, and thus the variables were left untransformed. While independent samples t-tests and ANOVAs are considered relatively robust to violations of the normality assumption, additional non-parametric tests Mann-Whitney U and Wilcoxon signed-rank tests were conducted where required to strengthen confidence in findings.

The results of the non-parametric tests were consistent with those produced by the ANOVA analyses and are reported as supplementary information. Education levels were mixed. No difference in current antidepressant use was observed.

While the analytic sample and those excluded from analyses i. In terms of the follow-up data, independent samples t-tests revealed that mental health outcomes did not significantly differ between the probiotic and placebo groups at 36 weeks of pregnancy.

These mental health outcomes in relation to the effects of the intervention are discussed further in the primary analyses section below. As noted, comparable results produced using non-parametric tests are viewable as supplementary information. The significance of main effects and interaction effects did not differ from those of the original analyses including all participants.

The purpose of this study was to investigate the influence of probiotic capsules on mental health outcomes among a multi-ethnic and high-deprivation sample of pregnant women with obesity in New Zealand.

Through this pre-specified secondary analysis of the HUMBA trial we found that the probiotic capsules containing Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 did not improve depression, anxiety, or functional health and well-being scores from baseline to 36 weeks of pregnancy, or demonstrate a between-group difference at 36 weeks.

These findings were in contrast to our hypotheses. Depression scores remained stable across the two time points, whereas anxiety scores increased, and physical well-being PCS scores decreased, irrespective of group allocation. Mental well-being MCS scores did not differ between the two groups at 36 weeks of pregnancy.

Research regarding probiotics and mental health is at an emergent stage, with results from heterogeneous human randomised controlled trials remaining equivocal 54 , 55 , Our study findings are in contrast to the single previous study that investigated the effect of probiotics in pregnancy on mental health outcomes. Slykerman et al. However these results need to be interpreted with caution as they relied on retrospective self-reported mental health information i.

The results of this study may therefore not be generalisable to other populations, and these demographic differences may in part explain the conflicting results with our study. The results of Slykerman et al. In addition to the methodological limitation and demographic differences between our study and Slykerman et al. Research indicates that effects of probiotics are strain specific, and while most studies investigating probiotics and mental health outcomes have utilised strains from the Bifidobacterium or Lactobacillus genera of bacteria as in the case of our study and Slykerman et al.

This heterogeneity has so far prevented any consensus being formed regarding which strains are most efficacious and for whom 54 , 55 , 57 , It is possible that the probiotic strains employed in the current study Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 were not optimal in terms of improving mental health outcomes in the sample. This probiotic formulation was used as it had been safely and efficaciously used previously within a sample of pregnant women in a Finnish randomised controlled trial 32 , with results revealing positive metabolic outcomes.

More research investigating mental health outcomes in relation to the use of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 is required before the psychobiotic effects of this formulation can be substantiated or discounted. In addition to the lack of consensus regarding optimal probiotic strains, there is no consensus regarding the dosage of probiotics required to produce clinical effects 54 , 59 , 61 , The dosage employed in the current study was 6. Previous studies such as that by Whorwell et al.

Whorwell et al. Further investigation into the required dosage of probiotic formulations is thus necessary. For example, studies by Benton et al. Low levels of psychopathology present in samples at baseline has been suggested as a potential factor contributing to these results 54 , 64 ,

Psychobiotics: Biotherapeutics for Positive Mental Health

Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: Mohammadi and S. Jazayeri and K. Khosravi-Darani and Z.

For centuries, individuals have consumed probiotics as a means of improving quality of life and preventing disease. The gut microbiota refers to the collection of microorganisms residing within the gut. Psychiatric disorders show profound alterations of gut microbiota composition along with a lack of bacterial diversity. Specific subtypes of probiotics and prebiotics fibers that promote the growth of beneficial bacteria are referred to as psychobiotics , which impact the gut-brain axis and result in modifications of mood, anxiety, and cognitive function. It is essential for psychiatrists to improve their understanding of psychobiotic mechanisms and the evidence that supports their use in practice. In recent years, interventional studies have assessed the effects of psychobiotics for several symptom clusters, including depression and anxiety. However, some significant determinants, including duration of treatment, dosage of psychobiotics, and interactions with concomitant therapies, deserve more detailed investigation, and specific treatment guidelines for psychobiotics have not yet been established.

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study. Patients suffering from depression experience significant mood, anxiety, and cognitive symptoms. Currently, most antidepressants work by altering neurotransmitter activity in the brain to improve these symptoms. The aim of this review is to analyze the current body of research assessing the effects of probiotics, on symptoms of depression in humans. A systematic search of five databases was performed and study selection was completed using the preferred reporting items for systematic reviews and meta-analyses process.

Probiotics and the Microbiota-Gut-Brain Axis: Focus on Psychiatry

Metrics details. Current treatment of major depressive disorder MDD often does not achieve full remission of symptoms. Evidence has confirmed the modulation of the gut—brain—microbiota axis as a promising approach in MDD patients.

From probiotics to psychobiotics – the gut-brain axis in psychiatric disorders

The effects of probiotics on depressive symptoms in humans: a systematic review

Probiotics are living bacteria, which when ingested in adequate amounts, confer health benefits. Gut microbes are suggested to play a role in many psychiatric disorders and could be a potential therapeutic target. Between the gut and the brain, there is a bi-directional communication pathway called the microbiota-gut-brain axis. The purpose of this review is to examine data from recent interventional studies focusing on probiotics and the gut-brain axis for the treatment of depression, anxiety and schizophrenia.

Rapid scientific and technological advances have allowed for a more detailed understanding of the relevance of intestinal microbiota, and the entire body-wide microbiome, to human health and well-being. Rodent studies have provided suggestive evidence that probiotics e. However, despite the advances in the area of gastro-biological psychiatry, it becomes clear that there remains an urgent need to explore the value of beneficial microbes in controlled clinical investigations. With the history explored in this series, it is fair to ask if we are now on the cusp of major clinical breakthroughs, or are we merely in the quicksand of Autointoxication II? Though the first two parts of this series, we have attempted to provide a historical and contextual approach to the more direct lines of contemporary evidence as it relates to gut microbiota, its intentional manipulation, and mental health.

На что же уходит такая уйма времени. - спросил он, обращаясь в пустоту и чувствуя, как покрывается. Наверное, придется потревожить этой новостью Стратмора. Проверка на наличие вируса, - решительно сказал он себе, стараясь успокоиться.  - Я должен сделать проверку на наличие вируса.

The role of probiotics in maintaining healthy gut microbiota and detailed outcomes of clinical trials are here reported for easy understanding of the concept.

Effects of Probiotics on Cognitive Reactivity, Mood, and Sleep Quality

Если Дэвид и дальше задержится, придется послать ему на помощь кого-то из полевых агентов АНБ, а это было связано с риском, которого коммандер всеми силами хотел избежать. - Коммандер, - сказал Чатрукьян, - я уверен, что нам надо проверить… - Подождите минутку, - сказал Стратмор в трубку, извинившись перед собеседником. Он прикрыл микрофон телефона рукой и гневно посмотрел на своего молодого сотрудника.  - Мистер Чатрукьян, - буквально прорычал он, - дискуссия закончена.

 Разница, - бормотал он себе под нос.  - Разница между U235 и U238. Должно быть что-то самое простое.

Взгляд его черных глаз стал тяжелым и неподвижным. Возвращение домой оказалось долгим и слишком утомительным. Последний месяц был для Лиланда Фонтейна временем больших ожиданий: в агентстве происходило нечто такое, что могло изменить ход истории, и, как это ни странно директор Фонтейн узнал об этом лишь случайно.

Слева остался футбольный стадион, впереди не было ни одной машины. Тут он услышал знакомый металлический скрежет и, подняв глаза, увидел такси, спускавшееся вниз по пандусу в сотне метров впереди. Съехав на эту же улицу, оно начало набирать скорость, двигаясь прямо в лоб мотоциклу.

Притормозив, он задумался, в какую сторону повернуть, и в этот момент мотор его веспы кашлянул и заглох. Стрелка топливного индикатора указывала на ноль. И, как бы повинуясь неведомому сигналу, между стенами слева от него мелькнула тень. Нет сомнений, что человеческий мозг все же совершеннее самого быстродействующего компьютера в мире.

 Он работает на Монокле, - пояснил Смит.  - Посылает сообщение о том, что Танкадо ликвидирован.


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