Why does health start with the gut? The importance of microbiota and the use of probiotics in the context of maintaining mental health and supportive treatment of mental disorders. Part II Review article
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Published:
Jun 30, 2025
Keywords:
microbiota, probiotics, psychobiotics, depression
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Abstract
In recent decades, there has been growing interest in the influence of gut microbiota on human mental and physical health. Understanding the role of microbiota, including interactions between the digestive system and the central nervous system, is of particular importance in the context of lifestyle diseases, including the increasing prevalence of mental disorders. Research results indicate that the composition of gut microbiota may differ significantly between healthy individuals and those suffering from depressive or anxiety disorders. This fact provides the basis for research on the use of probiotics and psychobiotics as a potential support for standard pharmacotherapy. This article discusses the importance of microbiota, not only in terms of physical health, but also mental health, pointing to key mechanisms of the brain-gut axis and discussing the possibilities of using probiotics in the treatment of depression, schizophrenia and bipolar disorder.
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Antosik-Wójcińska, A. Z., & Jankowska, A. (2025). Why does health start with the gut? The importance of microbiota and the use of probiotics in the context of maintaining mental health and supportive treatment of mental disorders. Part II. Medycyna Faktow (J EBM), 18(2(67), 183-188. https://doi.org/10.24292/01.MF.0225.03
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References
1. Burokas A, Arboleya S, Moloney RD et al. Targeting the Microbiota-Gut-Brain Axis: Prebiotics Have Anxiolytic and Antidepressant-like Effects and Reverse the Impact of Chronic Stress in Mice. Biol Psychiatry. 2017; 82(7): 472-87.
2. Bravo JA, Forsythe P, Chew MV et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Nat Acad Sci. 2011; 108(38): 16050-55.
3. Desbonnet L, Garrett L, Clarke G et al. Effects of the probiotic Bifidobacterium infantis in the maternal separation model of depression. Neuroscience. 2010; 170(4): 1179-88.
4. Tillmann S, Abildgaard A, Winther G et al. Altered fecal microbiota composition in the Flinders sensitive line rat model of depression. Psychopharmacology. 2019; 236(5): 1445-57.
5. Aizawa E, Tsuji H, Asahara T et al. Possible association of Bifidobacterium and Lactobacillus in the gut microbiota of patients with major depressive disorder. J Affect Dis. 2016; 202: 254-7.
6. Jiang H, Ling Z, Zhang Y et al. Altered fecal microbiota composition in patients with major depressive disorder. Brain Behavior and Immunity. 2015; 48: 186-94.
7. Kelly JR, Borre Y, O’ Brien C et al. Transferring the blues: Depression-associated gut microbiota induces neurobehavioural changes in the rat. J Psych Res. 2016; 82: 109-18.
8. Valles-Colomer M, Falony G, Darzi Y et al. The neuroactive potential of the human gut microbiota in quality of life and depression. Nat Microbiol. 2019; 4(4): 623-32.
9. Liśkiewicz P, Pełka-Wysiecka J, Kaczmarczyk M et al. Fecal Microbiota Analysis in Patients Going through a Depressive Episode during Treatment in a Psychiatric Hospital Setting. J Clin Med. 2019; 8(2): 164.
10. Liśkiewicz P, Kaczmarczyk M, Misiak B et al. Analysis of gut microbiota and intestinal integrity markers of inpatients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2021; 106: 110076.
11. Huang R, Wang K, Hu J. Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2016; 8(8): 483.
12. Ng QX, Peters C, Ho CYX et al. A meta-analysis of the use of probiotics to alleviate depressive symptoms. J Affect Disord. 2018; 228: 13-9.
13. Romijn AR, Rucklidge JJ, Kuijer RG et al. A double-blind, randomized, placebo-controlled trial of Lactobacillus helveticus and Bifidobacterium longum for the symptoms of depression. Aust N Z J Psychiatry. 2017; 51(8): 810-21.
14. Zheng P, Zeng B, Liu M et al. The gut microbiome from patients with schizophrenia modulates the glutamate-glutamine-GABA cycle and schizophrenia- relevant behaviors in mice. Sci Adv. 2019; 5(2): eaau8317.
15. He Y, Kosciolek T, Tang J et al. Gut microbiome and magnetic resonance spectroscopy study of subjects at ultra-high risk for psychosis may support the membrane hypothesis. Eur Psychiatry. 2018; 53: 37-45.
16. Castro-Nallar E, Bendall ML, Perez-Losada M et al. Composition, taxonomy and functional diversity of the oropharynx microbiome in individuals with schizophrenia and controls. PeerJ. 2015; 3: e1140.
17. Pełka-Wysiecka J, Kaczmarczyk M, Bąba-Kubiś A et al. Analysis of Gut Microbiota and Their Metabolic Potential in Patients with Schizophrenia Treated with Olanzapine: Results from a Six-Week Observational Prospective Cohort Study. J Clin Med. 2019; 8(10): 1605.
18. Li S, Zhuo M, Huang X et al. Altered gut microbiota associated with symptom severity in schizophrenia. PeerJ. 2020; 8: e9574.
19. Tomasik J, Yolken RH, Bahn S et al. Immunomodulatory Effects of Probiotic Supplementation in Schizophrenia Patients: A Randomized, Placebo- Controlled Trial. Biomark Insights. 2015; 10: 47-54.
20. Severance EG, Gressitt KL, Stallings CR et al. Probiotic normalization of Candida albicans in schizophrenia: A randomized, placebo-controlled, longitudinal pilot study. Brain Behav Immun. 2017; 62: 41-5.
21. Coello K, Hansen TH, Sorensen N et al. Gut microbiota composition in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives. Brain Behav Immun. 2019; 75: 112-18.
22. Dickerson F, Adamos M, Katsafanas E et al. Adjunctive probiotic microorganisms to prevent rehospitalization in patients with acute mania: A randomized controlled trial. Bipolar Disorders. 2018; 20(7): 614-21.
23. Wichniak A, Dudek D, Heitzman J et al. Redukcja ryzyka metabolicznego u chorych na schizofrenię przyjmujących leki przeciwpsychotyczne – zalecenia Polskiego Towarzystwa Psychiatrycznego. Psych Pol. 2019; 53(6): 1191-218.
24. Skonieczna-Żydecka K, Łoniewski I, Misera A et al. Second-generation antipsychotics and metabolism alterations: a systematic review of the role of the gut microbiome, Psychopharmacology (Berl). 2018; 236(5): 1491-512.
25. Wu H, Tremaroli V, Backhed F. Linking Microbiota to Human Diseases: A Systems Biology Perspective. Trends Endocrinol Metab. 2015; 26(12): 758-70.
26. Lynch SV, Pedersen O. The Human Intestinal Microbiome in Health and Disease. N Engl J Med. 2016; 375(24): 2369-79.
27. Dinan TG, Stanton C, Cryan JF. Psychobiotics: a novel class of psychotropic. Biol Psych. 2013; 74(10): 720-6.
28. Breit S, Kupferberg A, Rogler G et al. Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders. Front Psych. 2018; 9: 44.
29. Skonieczna-Żydecka K, Łoniewski I, Marlicz W et al. Mikrobiota jelitowa jako potencjalna przyczyna zaburzeń funkcjonowania emocjonalnego człowieka. Medycyna Doświadczalna i Mikrobiologia. 2017; 69(2): 163-76.
30. Zareie M, Johnson-Henry K, Jury J et al. Probiotics prevent bacterial translocation and improve intestinal barrier function in rats following chronic psychological stress. Gut. 2006; 55(11): 1553-60.
31. Ait-Belgnaoui A, Colom A, Braniste V et al. Probiotic gut effect prevents the chronic psychological stress-induced brain activity abnormality in mice. Neurogastroenterol Motil. 2014; 26(4): 510-20.
32. Callaghan BL, Cowan CSM, Richardson R. Treating Generational Stress: Effect of Paternal Stress on Development of Memory and Extinction in Offspring Is Reversed by Probiotic Treatment. Psychol Sci. 2016; 27(9): 1171-80.
33. Kazemi A, Noorbala AA, Azam K et al. Effect of probiotic and prebiotic vs placebo on psychological outcomes in patients with major depressive disorder: A randomized clinical trial. Clin Nutrition. 2019; 38(2): 522-8.
34. Gawlik-Kotelnicka O, Margulska A, Płeska K et al. Metabolic Status Influences Probiotic Efficacy for Depression-PRO-DEMET Randomized Clinical Trial Results. Nutrients. 2024; 16(9): 1389.
35. Gawlik-Kotelnicka O. Rogalski J, Czarnecka-Chrebelska KH et al. The Interplay Between Depression, Probiotics, Diet, Immunometabolic Health, the Gut, and the Liver-A Secondary Analysis of the Pro-Demet Randomized Clinical Trial. Nutrients. 2024; 16(23): 4024.
36. Gawlik-Kotelnicka O, Burzyński J, Rogalski J et al. Probiotics may be useful for drug-induced liver dysfunction in patients with depression – A secondary analysis of a randomized clinical trial. Clin Nutr ESPEN. 2024; 63: 604-14.
37. Steenbergen L, Sellaro R, van Hemert S et al. A randomized controlled trial to test the effect of multispecies probiotics on cognitive reactivity to sad mood. Brain Behav Immun. 2015; 48: 258-64.
38. Chahwan B, Kwan S, Isik A et al. Gut feelings: A randomised, triple-blind, placebo-controlled trial of probiotics for depressive symptoms. J Affect Dis. 2019; 253: 317-26.
39. Rudzki L, Ostrowska L, Pawlak D et al. Probiotic Lactobacillus Plantarum 299v decreases kynurenine concentration and improves cognitive functions in patients with major depression: A double-blind, randomized, placebo controlled study. Psychoneuroendocrinology. 2019; 100: 213-22.
40. Marlicz W, Skonieczna-Żydecka K, Krynicka P et al. Probiotics in irritable bowel syndrome – is the quest for the right strain over? Rapid review of existing guidelines and recommendations. Prz Gastroenterol. 2021; 16(4): 369-82.
2. Bravo JA, Forsythe P, Chew MV et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Nat Acad Sci. 2011; 108(38): 16050-55.
3. Desbonnet L, Garrett L, Clarke G et al. Effects of the probiotic Bifidobacterium infantis in the maternal separation model of depression. Neuroscience. 2010; 170(4): 1179-88.
4. Tillmann S, Abildgaard A, Winther G et al. Altered fecal microbiota composition in the Flinders sensitive line rat model of depression. Psychopharmacology. 2019; 236(5): 1445-57.
5. Aizawa E, Tsuji H, Asahara T et al. Possible association of Bifidobacterium and Lactobacillus in the gut microbiota of patients with major depressive disorder. J Affect Dis. 2016; 202: 254-7.
6. Jiang H, Ling Z, Zhang Y et al. Altered fecal microbiota composition in patients with major depressive disorder. Brain Behavior and Immunity. 2015; 48: 186-94.
7. Kelly JR, Borre Y, O’ Brien C et al. Transferring the blues: Depression-associated gut microbiota induces neurobehavioural changes in the rat. J Psych Res. 2016; 82: 109-18.
8. Valles-Colomer M, Falony G, Darzi Y et al. The neuroactive potential of the human gut microbiota in quality of life and depression. Nat Microbiol. 2019; 4(4): 623-32.
9. Liśkiewicz P, Pełka-Wysiecka J, Kaczmarczyk M et al. Fecal Microbiota Analysis in Patients Going through a Depressive Episode during Treatment in a Psychiatric Hospital Setting. J Clin Med. 2019; 8(2): 164.
10. Liśkiewicz P, Kaczmarczyk M, Misiak B et al. Analysis of gut microbiota and intestinal integrity markers of inpatients with major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2021; 106: 110076.
11. Huang R, Wang K, Hu J. Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2016; 8(8): 483.
12. Ng QX, Peters C, Ho CYX et al. A meta-analysis of the use of probiotics to alleviate depressive symptoms. J Affect Disord. 2018; 228: 13-9.
13. Romijn AR, Rucklidge JJ, Kuijer RG et al. A double-blind, randomized, placebo-controlled trial of Lactobacillus helveticus and Bifidobacterium longum for the symptoms of depression. Aust N Z J Psychiatry. 2017; 51(8): 810-21.
14. Zheng P, Zeng B, Liu M et al. The gut microbiome from patients with schizophrenia modulates the glutamate-glutamine-GABA cycle and schizophrenia- relevant behaviors in mice. Sci Adv. 2019; 5(2): eaau8317.
15. He Y, Kosciolek T, Tang J et al. Gut microbiome and magnetic resonance spectroscopy study of subjects at ultra-high risk for psychosis may support the membrane hypothesis. Eur Psychiatry. 2018; 53: 37-45.
16. Castro-Nallar E, Bendall ML, Perez-Losada M et al. Composition, taxonomy and functional diversity of the oropharynx microbiome in individuals with schizophrenia and controls. PeerJ. 2015; 3: e1140.
17. Pełka-Wysiecka J, Kaczmarczyk M, Bąba-Kubiś A et al. Analysis of Gut Microbiota and Their Metabolic Potential in Patients with Schizophrenia Treated with Olanzapine: Results from a Six-Week Observational Prospective Cohort Study. J Clin Med. 2019; 8(10): 1605.
18. Li S, Zhuo M, Huang X et al. Altered gut microbiota associated with symptom severity in schizophrenia. PeerJ. 2020; 8: e9574.
19. Tomasik J, Yolken RH, Bahn S et al. Immunomodulatory Effects of Probiotic Supplementation in Schizophrenia Patients: A Randomized, Placebo- Controlled Trial. Biomark Insights. 2015; 10: 47-54.
20. Severance EG, Gressitt KL, Stallings CR et al. Probiotic normalization of Candida albicans in schizophrenia: A randomized, placebo-controlled, longitudinal pilot study. Brain Behav Immun. 2017; 62: 41-5.
21. Coello K, Hansen TH, Sorensen N et al. Gut microbiota composition in patients with newly diagnosed bipolar disorder and their unaffected first-degree relatives. Brain Behav Immun. 2019; 75: 112-18.
22. Dickerson F, Adamos M, Katsafanas E et al. Adjunctive probiotic microorganisms to prevent rehospitalization in patients with acute mania: A randomized controlled trial. Bipolar Disorders. 2018; 20(7): 614-21.
23. Wichniak A, Dudek D, Heitzman J et al. Redukcja ryzyka metabolicznego u chorych na schizofrenię przyjmujących leki przeciwpsychotyczne – zalecenia Polskiego Towarzystwa Psychiatrycznego. Psych Pol. 2019; 53(6): 1191-218.
24. Skonieczna-Żydecka K, Łoniewski I, Misera A et al. Second-generation antipsychotics and metabolism alterations: a systematic review of the role of the gut microbiome, Psychopharmacology (Berl). 2018; 236(5): 1491-512.
25. Wu H, Tremaroli V, Backhed F. Linking Microbiota to Human Diseases: A Systems Biology Perspective. Trends Endocrinol Metab. 2015; 26(12): 758-70.
26. Lynch SV, Pedersen O. The Human Intestinal Microbiome in Health and Disease. N Engl J Med. 2016; 375(24): 2369-79.
27. Dinan TG, Stanton C, Cryan JF. Psychobiotics: a novel class of psychotropic. Biol Psych. 2013; 74(10): 720-6.
28. Breit S, Kupferberg A, Rogler G et al. Vagus Nerve as Modulator of the Brain–Gut Axis in Psychiatric and Inflammatory Disorders. Front Psych. 2018; 9: 44.
29. Skonieczna-Żydecka K, Łoniewski I, Marlicz W et al. Mikrobiota jelitowa jako potencjalna przyczyna zaburzeń funkcjonowania emocjonalnego człowieka. Medycyna Doświadczalna i Mikrobiologia. 2017; 69(2): 163-76.
30. Zareie M, Johnson-Henry K, Jury J et al. Probiotics prevent bacterial translocation and improve intestinal barrier function in rats following chronic psychological stress. Gut. 2006; 55(11): 1553-60.
31. Ait-Belgnaoui A, Colom A, Braniste V et al. Probiotic gut effect prevents the chronic psychological stress-induced brain activity abnormality in mice. Neurogastroenterol Motil. 2014; 26(4): 510-20.
32. Callaghan BL, Cowan CSM, Richardson R. Treating Generational Stress: Effect of Paternal Stress on Development of Memory and Extinction in Offspring Is Reversed by Probiotic Treatment. Psychol Sci. 2016; 27(9): 1171-80.
33. Kazemi A, Noorbala AA, Azam K et al. Effect of probiotic and prebiotic vs placebo on psychological outcomes in patients with major depressive disorder: A randomized clinical trial. Clin Nutrition. 2019; 38(2): 522-8.
34. Gawlik-Kotelnicka O, Margulska A, Płeska K et al. Metabolic Status Influences Probiotic Efficacy for Depression-PRO-DEMET Randomized Clinical Trial Results. Nutrients. 2024; 16(9): 1389.
35. Gawlik-Kotelnicka O. Rogalski J, Czarnecka-Chrebelska KH et al. The Interplay Between Depression, Probiotics, Diet, Immunometabolic Health, the Gut, and the Liver-A Secondary Analysis of the Pro-Demet Randomized Clinical Trial. Nutrients. 2024; 16(23): 4024.
36. Gawlik-Kotelnicka O, Burzyński J, Rogalski J et al. Probiotics may be useful for drug-induced liver dysfunction in patients with depression – A secondary analysis of a randomized clinical trial. Clin Nutr ESPEN. 2024; 63: 604-14.
37. Steenbergen L, Sellaro R, van Hemert S et al. A randomized controlled trial to test the effect of multispecies probiotics on cognitive reactivity to sad mood. Brain Behav Immun. 2015; 48: 258-64.
38. Chahwan B, Kwan S, Isik A et al. Gut feelings: A randomised, triple-blind, placebo-controlled trial of probiotics for depressive symptoms. J Affect Dis. 2019; 253: 317-26.
39. Rudzki L, Ostrowska L, Pawlak D et al. Probiotic Lactobacillus Plantarum 299v decreases kynurenine concentration and improves cognitive functions in patients with major depression: A double-blind, randomized, placebo controlled study. Psychoneuroendocrinology. 2019; 100: 213-22.
40. Marlicz W, Skonieczna-Żydecka K, Krynicka P et al. Probiotics in irritable bowel syndrome – is the quest for the right strain over? Rapid review of existing guidelines and recommendations. Prz Gastroenterol. 2021; 16(4): 369-82.