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Gut-brain axis in adolescent depression: a systematic review of psychological implications and behavioral interventions

Forfatter(e)
Liu, H., Li, X., Shi, Y., Hong, K., Wang, X., Huang, C.
År
2025
DOI
10.3389/fnut.2025.1644245
Tidsskrift
Frontiers in Nutrition
Volum
12
Sider
1644245
Kategori(er)
Depresjon og nedstemthet (inkl. både vansker og lidelse)
Tiltakstype(r)
Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi
Abstract

Background

Adolescent depression affects 13% of youths globally, with 30-40% exhibiting treatment resistance. Emerging evidence implicates gut microbiome dysbiosis in core behavioral symptoms (e.g., anhedonia, social withdrawal) via gut-brain axis (GBA) pathways. This systematic review synthesizes clinical and preclinical evidence (2014-2025) to delineate the microbiota-behavior interactions and evaluate microbiome-targeted interventions.

Methods

Following PRISMA 2020 guidelines, 45 studies (29 clinical trials, 11 animal models, 5 meta-analyses) were analyzed from PubMed, Web of Science, and Embase. Data extraction focused on microbiome composition, neurobehavioral outcomes, and intervention efficacy. Random-effects meta-analyses pooled effect sizes (95% CIs).

Results

Depressed adolescents showed reduced gut microbiota alpha-diversity (Shannon index SMD=-0.92; 95% CI: -1.24, -0.60) and altered taxa abundance (e.g., Bacteroidetes depletion: DELTA=-32%). Dysbiosis correlated with anhedonia severity (r=0.42; 95% CI: 0.28, 0.55) and impaired social functioning. Psychobiotics (e.g., Lactobacillus plantarum PS128) significantly reduced depressive symptoms (HAM-D DELTA=-4.2; 95% CI: -5.1, -3.3) vs. placebo and improved emotion recognition (+18%; 95% CI: 2.1, 33.9). Sex-specific effects were prominent: Bifidobacterium breve enhanced reward responsiveness in females (SMD=0.61; 95% CI: 0.22, 1.00). Current data lack large-scale RCTs for fecal microbiota transplantation (FMT) in adolescents.

Conclusion

Gut microbiome modulation shows promise as an adjunct to behavioral therapies (e.g., CBT). Bifidobacterium breve's female-predominant effects suggest hormonal modulation. Future research must address gaps in FMT safety, developmental mechanisms, personalized nutritional interventions.