Potential clinical benefits of probiotics, prebiotics, synbiotics, and postbiotics for depression via the microbiota-gut-brain axis

doi:10.5498/wjp.v15.i5.98436

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World Journal of Psychiatry

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2220-3206

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World J Psychiatry. May 19, 2025; 15(5): 98436
Published online May 19, 2025. doi: 10.5498/wjp.v15.i5.98436

Table 1 Comparison of nutritional status and depression scores between the two groups of patients, mean ± SD

Ref.	Country	Study design	Population (diagnosis criteria)	Mean age (year)	Sex (% female)	Intervention	Control	Intervention duration	Outcome measures	Trial No.
Aslan Çİn et al[15], 2024	Turkey	Double-blind RCT	Depressive symptoms (BDI)	Probiotics: 45.4 ± 10.7; Prebiotic: 47.0 ± 11.1; Control: 46.0 ± 8.4	Probiotics: 100.0; Prebiotic: 100.0; Control: 100.0	Probiotics (n = 18); Prebiotics (n = 17)	Placebo (n = 18)	8 weeks	BDI	NCT04607278
Nikolova et al[14], 2023	United Kingdom	Double-blind RCT	MDD (HDRS-17 ≥ 13)	Probiotics: 32.5 (24.3-39.0); Control: 27.0 (23.0-41.0)	Probiotics: 75.0; Control: 84.0	Probiotics (n = 24)	Placebo (n = 25)	8 weeks	HDRS; IDS	NCT03893162
Tian et al[16], 2022	China	Double-blind RCT	MDD (HDRS-24 > 14)	Probiotics: 51.32 ± 16.11; Control: 48.15 ± 13.96	Probiotics: 70.0; Control: 64.0	Probiotics (n = 20)	Placebo (n = 25)	4 weeks	HDRS; MADRS; BPRS	ChiCTR2100046321
Zhang et al[17], 2021	China	Double-blind RCT	MDD (DSM-V or HDRS-17 > 8)	Probiotics: 45.8 ± 12.3; Control: 49.7 ± 9.6	Probiotics: 63.2; Control: 64.5	Probiotics (n = 38)	Placebo (n = 31)	9 weeks	HDRS; BDI	ChiCTR1900025972
Haghighat et al[18], 2021	Iran	Double-blind RCT	MDD (HADS-14 > 8)	Probiotics + Synbiotics + Control: 46.64 (10.69)	Probiotics + Synbiotics + Control: 52.0	Probiotics (n = 25); Synbiotics (n = 25)	Placebo (n = 25)	12 weeks	HADS	IRCT2017041233393N1
Reiter et al[19], 2020	Austria	Double-blind RCT	MDD (M.I.N.I.)	Probiotics: 43.00 (14.31); Control: 40.11 (11.45)	Probiotics: 71.4; Control: 81.8	Probiotics (n = 28)	Placebo (n = 33)	4 weeks	HDRS; BDI	NCT03300440
Heidarzadeh-Rad et al[20], 2020	Iran	Double-blind RCT	MDD (DSM-IV)	Probiotics: 37.8 ± 7.9; Prebiotic: 36.6 ± 8.4; Control: 36.0 ± 8.5	Probiotics: 71.4; Prebiotic: 80.0; Control: 60.0	Probiotics (n = 28) or prebiotics (n = 25)	Placebo (n = 25)	8 weeks	BDI	IRCT2015092924271N1
Rudzki L et al[21], 2019	Poland	Double-blind RCT	MDD (DSM-IV)	Probiotics: 39.1(10.0); Control: 38.9 (12.0)	Probiotics: 76.7; Control: 66.7	Probiotics (n = 30)	Placebo (n = 30)	8 weeks	HDRS	NCT02469545
Kazemi et al[23], 2019	Iran	Double-blind RCT	MDD (ICD-10)	Probiotics: 36.2 (7.9); Prebiotics: 37.4 (8.0); Control: 36.0 (8.5)	Probiotics: 71.1; Prebiotics: 75.0; Control: 66.7	Probiotics (n = 38); Prebiotics (n = 36)	Placebo (n = 36)	8 weeks	BDI	IRCT2015092924271N1
Chahwan et al[22], 2019	Australia	Triple-blind RCT	Clinical and sub-clinical depression (M.I.N.I.)	Probiotics: 36.65 (11.75); Control: 35.49 (12.34)	Probiotics: 21.0; Control: 28.0	Probiotics (n = 34)	Placebo (n = 37)	8 weeks	BDI	ACTRN12615001081505
Hadi et al[24], 2019	Iran	Double-blind RCT	Depression (DASS-21)	Synbiotics: 34.49 (6.02); Control: 36.64 (7.26)	Synbiotics: 36.6; Control: 31.0	Synbiotics (n = 30)	Placebo (n = 29)	8 weeks	DASS	IRCT20180201038585N3
Nishida et al[25], 2019	Japan	Double-blind RCT	Depressive moods (HADS)	Postbiotics: 24.9 (0.5); Control: 25.3 (0.6)	Postbiotics: 32.3; Control: 30.0	Postbiotics (n = 31)	Placebo (n = 29)	24 weeks	HADS	UMIN000027303
Ghorbani et al[26], 2018	Iran	Double-blind RCT	MDD (DSM-V and HDRS-17 of 17–23)	Synbiotics: 34.5 (4.0); Control: 35.5 (5.27)	Synbiotics: 70.0; Control: 70.0	Synbiotics (n = 20)	Placebo (n = 20)	6 weeks	HDRS	NR
Romijn et al[27], 2017	New Zealand	Double-blind RCT	Low mood (QIDS-SR16 > 11; DASS-42-D > 14)	Probiotics: 35.8 (14.0); Control: 35.1(14.5)	Probiotics: 80.0; Control: 76.9	Probiotics (n = 40)	Placebo (n = 39)	8 weeks	MADRS; QIDS; DASS	ACTRN12613000438752

RCT: Randomized clinical trials; MDD: Major depressive disorder; HDRS: Hamilton Depression Rating Scale; IDS: Inventory of depressive symptomatology; BDI: Beck Depression Inventory; ICD: The International Statistical Classification of Diseases and Related Health Problems; MADRS: Montgomery-Asberg depression rating scale; BPRS: Brief psychiatric rating scalfe; QIDS: Quick inventory of depressive symptomatology; DSM: Diagnostic and Statistical Manual of Mental Disorders; M.I.N.I.: Mini-International Neuropsychiatric Interview; DASS: Depression, Anxiety and Stress Scale; HADS: Hospital Anxiety and Depression Scale; NR: Not reported.

Citation: 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
URL: https://www.wjgnet.com/2220-3206/full/v15/i5/98436.htm
DOI: https://dx.doi.org/10.5498/wjp.v15.i5.98436