| Background & aims: Depression is a major debilitating health problem with high global prevalence. Gut
microbiota dysbiosis might be implicated in pathophysiology of depression. Hence, probiotics, prebiotics
and synbiotics (psychobiotics) have been administered in clinical trials in attempt to relieve depressive
symptoms. This update systematic review aimed to evaluate the current body of research concerning the
effects of psychobiotics on depression.
Methods: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines
were followed in this review. Search was performed in MEDLINE, ProQuest, EMBASE, PsycNET, and
Scopus databases for randomized clinical trials which assessed the effects of psychobiotics on depressive
symptoms among adults, and were published in English language, since inception until September 2018.
Results: Out of 3374 records screened, 32 articles met the study criteria; only seven studies reported
significant anti-depressant effects of psychobiotics. Some probiotic strains showed beneficial effects on
depressive symptoms; the results were inconsistent, though. Few studies investigated the effects of
prebiotics or synbiotics on depression, and did not come up with much promising results The overall risk
of bias was judged to be unclear across the included studies, and major confounding factors were not
considered in their design.
Conclusion: Since probiotics may affect depression in strain-specific manner, the current evidence is not
sufficient to either support or decline anti-depressant effects of probiotics; results of studies on prebiotics
and synbiotics are not conclusive, either. More well-designed studies with emphasis on specific
probiotic strains, inter-individual gut microbiota variations, and depression subtypes are warranted. |