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The effect and safety of probiotics on depression: a systematic review and meta-analysis of randomized controlled trials

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Abstract

Purpose

With the escalating social pressures, there has been a continuous rise in the prevalence of depression among the population, leading to substantial healthcare burdens. Moreover, conventional pharmacological interventions still exhibit certain limitations. Therefore, the primary objective of this study is to systematically evaluate the clinical efficacy of probiotics in the treatment of depression.

Methods

Randomized controlled trials of probiotics in treating depressive symptoms were retrieved from Pubmed, Cochrane Library, Web of Science, Wan Fang database, and CNKI between the establishment of the database and March 2022. The primary outcome was Beck’s depression rating scale (BDI) scores, while the secondary outcomes were depression scores on the DASS-21 scale, biochemical indicators (IL-6, NO, and TNF-α levels), and adverse events. In addition, Revman 5.3 was used for Meta-analysis and quality evaluation, and Stata 17 was used for the Egger test and Begg’s test. A total of 776 patients, including 397 and 379 patients in the experimental and control groups, respectively, were included.

Results

The total BDI score of the experimental group was lower than that of the control group (MD = − 1.98, 95%CI − 3.14 to − 0.82), and the score of DASS (MD = 0.90, 95%CI − 1.17 to 2.98), the IL-6 level (SMD = − 0.55, 95%CI − 0.88 to − 0.23), the NO level (MD = 5.27, 95% CI 2.51 to 8.03), and the TNF-α level (SMD = 0.19, 95% CI − 0.25 to 0.63).

Conclusion

The findings substantiate the therapeutic potential of probiotics in mitigating depressive symptoms by significantly reducing Beck's Depression Inventory (BDI) scores and alleviating the overall manifestation of depression.

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Data availability

The datasets generated for this study are available on request to the corresponding author.

Abbreviations

BDI:

Beck depression rating scale scores

DASS:

Depression Anxiety Stress Scale

SSRI:

Selective Serotonin Reuptake Inhibitor

MD:

Mean difference

CI:

Confidence interval

SMD:

Standardized mean difference

IL-6:

Interleukin-6

NO:

Plasma nitric oxide

TNF-α:

Tumor necrosis factor-α

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Acknowledgements

We would like to thank the native speakers and professionals at Editage (editage.com) for polishing this paper.

Funding

This work was supported by the National Natural Science Foundation of China [grant number 82004143], Medical Health Science and Technology Project of Zhejiang Province [grant number 2018KY545], Natural Science Foundation of Zhejiang Province [grant number Q18H260001].

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Authors and Affiliations

  1. School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China

    Junjie Lin, Yu Zhang, Kunyi Wang, Junping Wang, Shuo Kou, Kan Chen, Weijun Zheng & Rucheng Chen

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  1. Junjie Lin
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  2. Yu Zhang
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  3. Kunyi Wang
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  4. Junping Wang
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  6. Kan Chen
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  7. Weijun Zheng
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  8. Rucheng Chen
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Contributions

JL conceived the study and designed the protocol and performed the literature search. JL, YZ, JW, and WZ selected the studies and extracted the relevant information. LJ, SK, and KW synthesized the data. JL wrote the first draft of the paper, all authors (JL, YZ, KW, JW, SK, KC, and WJ) critically revised successive drafts of the paper and approved the final version. JL and RC are the study guarantors. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Corresponding author

Correspondence to Rucheng Chen.

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Conflict of interest

The authors report no conflicts of interest. The authors are responsible for the content and writing of the article.

Ethical approval

Not applicable, but the protocol of this systematic review was registered at PROSPERO (CRD42022321014).

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Lin, J., Zhang, Y., Wang, K. et al. The effect and safety of probiotics on depression: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr 62, 2709–2721 (2023). https://doi.org/10.1007/s00394-023-03184-y

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  • DOI: https://doi.org/10.1007/s00394-023-03184-y

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