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Open Access 12-04-2025 | Anxiety | REVIEW

The Gut Microbiome in Anxiety Disorders

Authors: Mary I. Butler, Sarah Kittel-Schneider, Jolana Wagner-Skacel, Sabrina Mörkl, Gerard Clarke

Published in: Current Psychiatry Reports | Issue 5/2025

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Abstract

Purpose of review

We aim to update readers on the latest evidence regarding the role of the gut microbiome in generalized anxiety disorder (GAD), panic disorder (PD), agoraphobia, and social anxiety disorder (SAD). This review summarises the literature on microbiome composition and function in these conditions, provides insights about causality and mechanisms and evaluates current evidence for microbiome-based interventions in anxiety disorders.

Recent findings

Most studies exploring the microbiome in anxiety disorders are small, cross-sectional studies. Nevertheless, some consistent findings emerge. Bacterial taxa such as Eubacterium, Coprococcus and Faecalibacterium may be depleted in GAD. Studies in PD and SAD are scarce and, to our knowledge, there have been no studies conducted in agoraphobia. Probiotics may help reduce anxiety symptoms, although the majority of studies have been in non-clinical cohorts.

Summary

Large, prospective studies are required to further elucidate the role of the microbiome-gut-brain axis in anxiety disorders. Microbiome-based interventions hold promise, but randomised controlled trials in clinical populations with relevant diagnoses are now warranted and urgently required.
Literature
2.
go back to reference APA, A.P.A., Diagnostic and statistical manual for mental disorders, 5th edition(DSM-V). 2013, Arlington, VA: American Psychiatric Publishing. APA, A.P.A., Diagnostic and statistical manual for mental disorders, 5th edition(DSM-V). 2013, Arlington, VA: American Psychiatric Publishing.
4.
go back to reference Wilmes L, et al. Of bowels, brain and behavior: A role for the gut microbiota in psychiatric comorbidities in irritable bowel syndrome. Neurogastroenterol Motil. 2021;33(3):e14095.PubMedCrossRef Wilmes L, et al. Of bowels, brain and behavior: A role for the gut microbiota in psychiatric comorbidities in irritable bowel syndrome. Neurogastroenterol Motil. 2021;33(3):e14095.PubMedCrossRef
5.
go back to reference Penninx BWJH, et al. Anxiety disorders. The Lancet. 2021;397(10277):914–27.CrossRef Penninx BWJH, et al. Anxiety disorders. The Lancet. 2021;397(10277):914–27.CrossRef
6.
go back to reference Butler MI, Cryan JF, Dinan TG. Man and the microbiome: A new theory of everything? Annu Rev Clin Psychol. 2019;15:371–98.PubMedCrossRef Butler MI, Cryan JF, Dinan TG. Man and the microbiome: A new theory of everything? Annu Rev Clin Psychol. 2019;15:371–98.PubMedCrossRef
8.
go back to reference Morais LH, Schreiber HL, Mazmanian SK. The gut microbiota–brain axis in behaviour and brain disorders. Nat Rev Microbiol. 2021;19(4):241–55.PubMedCrossRef Morais LH, Schreiber HL, Mazmanian SK. The gut microbiota–brain axis in behaviour and brain disorders. Nat Rev Microbiol. 2021;19(4):241–55.PubMedCrossRef
9.
go back to reference Margolis KG, Cryan JF, Mayer EA. The microbiota-gut-brain axis: From motility to mood. Gastroenterology. 2021;160(5):1486–501.PubMedCrossRef Margolis KG, Cryan JF, Mayer EA. The microbiota-gut-brain axis: From motility to mood. Gastroenterology. 2021;160(5):1486–501.PubMedCrossRef
10.
go back to reference Koskinen M-K, Hovatta I. Genetic insights into the neurobiology of anxiety. Trends Neurosci. 2023;46(4):318–31.PubMedCrossRef Koskinen M-K, Hovatta I. Genetic insights into the neurobiology of anxiety. Trends Neurosci. 2023;46(4):318–31.PubMedCrossRef
12.
go back to reference Zorn JV, et al. Cortisol stress reactivity across psychiatric disorders: A systematic review and meta-analysis. Psychoneuroendocrinology. 2017;77:25–36.PubMedCrossRef Zorn JV, et al. Cortisol stress reactivity across psychiatric disorders: A systematic review and meta-analysis. Psychoneuroendocrinology. 2017;77:25–36.PubMedCrossRef
13.
go back to reference Costello H, et al. Systematic review and meta-analysis of the association between peripheral inflammatory cytokines and generalised anxiety disorder. BMJ Open. 2019;9(7):e027925.PubMedPubMedCentralCrossRef Costello H, et al. Systematic review and meta-analysis of the association between peripheral inflammatory cytokines and generalised anxiety disorder. BMJ Open. 2019;9(7):e027925.PubMedPubMedCentralCrossRef
14.
go back to reference Michopoulos V, et al. Inflammation in fear- and anxiety-based disorders: PTSD, GAD, and beyond. Neuropsychopharmacology. 2017;42(1):254–70.PubMedCrossRef Michopoulos V, et al. Inflammation in fear- and anxiety-based disorders: PTSD, GAD, and beyond. Neuropsychopharmacology. 2017;42(1):254–70.PubMedCrossRef
16.
go back to reference Sartori SB, Singewald N. Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders. Pharmacol Ther. 2019;204:107402.PubMedCrossRef Sartori SB, Singewald N. Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders. Pharmacol Ther. 2019;204:107402.PubMedCrossRef
17.
go back to reference Savage K, et al. GABA-modulating phytomedicines for anxiety: A systematic review of preclinical and clinical evidence. Phytother Res. 2018;32(1):3–18.PubMedCrossRef Savage K, et al. GABA-modulating phytomedicines for anxiety: A systematic review of preclinical and clinical evidence. Phytother Res. 2018;32(1):3–18.PubMedCrossRef
18.
go back to reference Sarris J, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce. World J Biol Psychiatry. 2022;23(6):424–55.PubMedCrossRef Sarris J, et al. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce. World J Biol Psychiatry. 2022;23(6):424–55.PubMedCrossRef
20.
go back to reference Ratsika A, et al. Microbiota-immune-brain interactions: A lifespan perspective. Curr Opin Neurobiol. 2023;78:102652.PubMedCrossRef Ratsika A, et al. Microbiota-immune-brain interactions: A lifespan perspective. Curr Opin Neurobiol. 2023;78:102652.PubMedCrossRef
21.
go back to reference Gheorghe CE, et al. Focus on the essentials: tryptophan metabolism and the microbiome-gut-brain axis. Curr Opin Pharmacol. 2019;48:137–45.PubMedCrossRef Gheorghe CE, et al. Focus on the essentials: tryptophan metabolism and the microbiome-gut-brain axis. Curr Opin Pharmacol. 2019;48:137–45.PubMedCrossRef
22.
go back to reference Butler MI, et al. The immune-kynurenine pathway in social anxiety disorder. Brain Behav Immun. 2022;99:317–26.PubMedCrossRef Butler MI, et al. The immune-kynurenine pathway in social anxiety disorder. Brain Behav Immun. 2022;99:317–26.PubMedCrossRef
23.
go back to reference O’Riordan KJ, et al. Short chain fatty acids: Microbial metabolites for gut-brain axis signalling. Mol Cell Endocrinol. 2022;546:111572.PubMedCrossRef O’Riordan KJ, et al. Short chain fatty acids: Microbial metabolites for gut-brain axis signalling. Mol Cell Endocrinol. 2022;546:111572.PubMedCrossRef
24.
go back to reference Erny D, et al. Microbiota-derived acetate enables the metabolic fitness of the brain innate immune system during health and disease. Cell Metab. 2021;33(11):2260-2276.e7.PubMedCrossRef Erny D, et al. Microbiota-derived acetate enables the metabolic fitness of the brain innate immune system during health and disease. Cell Metab. 2021;33(11):2260-2276.e7.PubMedCrossRef
25.
go back to reference Lynch CMK, Clarke G, Cryan JF. Powering up microbiome-microglia interactions. Cell Metab. 2021;33(11):2097–9.PubMedCrossRef Lynch CMK, Clarke G, Cryan JF. Powering up microbiome-microglia interactions. Cell Metab. 2021;33(11):2097–9.PubMedCrossRef
26.
go back to reference Morena M, et al. Neurobiological interactions between stress and the endocannabinoid system. Neuropsychopharmacology. 2016;41(1):80–102.PubMedCrossRef Morena M, et al. Neurobiological interactions between stress and the endocannabinoid system. Neuropsychopharmacology. 2016;41(1):80–102.PubMedCrossRef
27.
go back to reference Cani PD, et al. Endocannabinoids–at the crossroads between the gut microbiota and host metabolism. Nat Rev Endocrinol. 2016;12(3):133–43.PubMedCrossRef Cani PD, et al. Endocannabinoids–at the crossroads between the gut microbiota and host metabolism. Nat Rev Endocrinol. 2016;12(3):133–43.PubMedCrossRef
28.
go back to reference Chevalier G, et al. Effect of gut microbiota on depressive-like behaviors in mice is mediated by the endocannabinoid system. Nat Commun. 2020;11(1):6363.PubMedPubMedCentralCrossRef Chevalier G, et al. Effect of gut microbiota on depressive-like behaviors in mice is mediated by the endocannabinoid system. Nat Commun. 2020;11(1):6363.PubMedPubMedCentralCrossRef
29.
30.
go back to reference Nikolova VL, et al. Perturbations in gut microbiota composition in psychiatric disorders: A review and meta-analysis. JAMA Psychiat. 2021;78(12):1343–54.CrossRef Nikolova VL, et al. Perturbations in gut microbiota composition in psychiatric disorders: A review and meta-analysis. JAMA Psychiat. 2021;78(12):1343–54.CrossRef
31.
go back to reference Bastiaanssen TFS, et al. Making sense of … the microbiome in psychiatry. Int J Neuropsychopharmacol. 2019;22(1):37–52.PubMedCrossRef Bastiaanssen TFS, et al. Making sense of … the microbiome in psychiatry. Int J Neuropsychopharmacol. 2019;22(1):37–52.PubMedCrossRef
32.
go back to reference Bastiaanssen TFS, Quinn TP, Loughman A. Bugs as features (part 1): concepts and foundations for the compositional data analysis of the microbiome–gut–brain axis. Nature Mental Health. 2023;1(12):930–8.CrossRef Bastiaanssen TFS, Quinn TP, Loughman A. Bugs as features (part 1): concepts and foundations for the compositional data analysis of the microbiome–gut–brain axis. Nature Mental Health. 2023;1(12):930–8.CrossRef
33.
go back to reference Bastiaanssen TFS, Quinn TP, Loughman A. Bugs as features (part 2): a perspective on enriching microbiome–gut–brain axis analyses. Nature Mental Health. 2023;1(12):939–49.CrossRef Bastiaanssen TFS, Quinn TP, Loughman A. Bugs as features (part 2): a perspective on enriching microbiome–gut–brain axis analyses. Nature Mental Health. 2023;1(12):939–49.CrossRef
34.
go back to reference Bang S, et al. Establishment and evaluation of prediction model for multiple disease classification based on gut microbial data. Sci Rep. 2019;9(1):10189.PubMedPubMedCentralCrossRef Bang S, et al. Establishment and evaluation of prediction model for multiple disease classification based on gut microbial data. Sci Rep. 2019;9(1):10189.PubMedPubMedCentralCrossRef
35.
go back to reference Wakita Y, et al. Taxonomic classification for microbiome analysis, which correlates well with the metabolite milieu of the gut. BMC Microbiol. 2018;18(1):188.PubMedPubMedCentralCrossRef Wakita Y, et al. Taxonomic classification for microbiome analysis, which correlates well with the metabolite milieu of the gut. BMC Microbiol. 2018;18(1):188.PubMedPubMedCentralCrossRef
36.
go back to reference Jiang HY, et al. Altered gut microbiota profile in patients with generalized anxiety disorder. J Psychiatr Res. 2018;104:130–6.PubMedCrossRef Jiang HY, et al. Altered gut microbiota profile in patients with generalized anxiety disorder. J Psychiatr Res. 2018;104:130–6.PubMedCrossRef
37.
go back to reference Chen YH, et al. Association between fecal microbiota and generalized anxiety disorder: Severity and early treatment response. J Affect Disord. 2019;259:56–66.PubMedCrossRef Chen YH, et al. Association between fecal microbiota and generalized anxiety disorder: Severity and early treatment response. J Affect Disord. 2019;259:56–66.PubMedCrossRef
38.
go back to reference Dong Z et al., Gut microbiome: A potential indicator for differential diagnosis of major depressive disorder and general anxiety disorder. Front Psych. 2021;12. Dong Z et al., Gut microbiome: A potential indicator for differential diagnosis of major depressive disorder and general anxiety disorder. Front Psych. 2021;12.
39.
go back to reference Mason BL, et al. Reduced anti-inflammatory gut microbiota are associated with depression and anhedonia. J Affect Disord. 2020;266:394–401.PubMedCrossRef Mason BL, et al. Reduced anti-inflammatory gut microbiota are associated with depression and anhedonia. J Affect Disord. 2020;266:394–401.PubMedCrossRef
40.
go back to reference Mukherjee A, et al. Gut microbes from the phylogenetically diverse genus Eubacterium and their various contributions to gut health. Gut Microbes. 2020;12(1):1802866.PubMedPubMedCentralCrossRef Mukherjee A, et al. Gut microbes from the phylogenetically diverse genus Eubacterium and their various contributions to gut health. Gut Microbes. 2020;12(1):1802866.PubMedPubMedCentralCrossRef
41.
go back to reference Gao F, et al. Stressful events induce long-term gut microbiota dysbiosis and associated post-traumatic stress symptoms in healthcare workers fighting against COVID-19. J Affect Disord. 2022;303:187–95.PubMedPubMedCentralCrossRef Gao F, et al. Stressful events induce long-term gut microbiota dysbiosis and associated post-traumatic stress symptoms in healthcare workers fighting against COVID-19. J Affect Disord. 2022;303:187–95.PubMedPubMedCentralCrossRef
43.
go back to reference Brushett S, et al. Gut feelings: the relations between depression, anxiety, psychotropic drugs and the gut microbiome. Gut Microbes. 2023;15(2):2281360.PubMedPubMedCentralCrossRef Brushett S, et al. Gut feelings: the relations between depression, anxiety, psychotropic drugs and the gut microbiome. Gut Microbes. 2023;15(2):2281360.PubMedPubMedCentralCrossRef
44.
go back to reference Valles-Colomer M, et al. The neuroactive potential of the human gut microbiota in quality of life and depression. Nature Microbiol. 2019. Valles-Colomer M, et al. The neuroactive potential of the human gut microbiota in quality of life and depression. Nature Microbiol. 2019.
45.
go back to reference Zafar H, Saier MH Jr. Gut Bacteroides species in health and disease. Gut Microbes. 2021;13(1):1–20.PubMedCrossRef Zafar H, Saier MH Jr. Gut Bacteroides species in health and disease. Gut Microbes. 2021;13(1):1–20.PubMedCrossRef
46.
go back to reference Kaper JB, Nataro JP, Mobley HLT. Pathogenic Escherichia coli. Nat Rev Microbiol. 2004;2(2):123–40.PubMedCrossRef Kaper JB, Nataro JP, Mobley HLT. Pathogenic Escherichia coli. Nat Rev Microbiol. 2004;2(2):123–40.PubMedCrossRef
47.
go back to reference Jang H-M, et al. Immobilization stress-induced Escherichia coli causes anxiety by inducing NF-κB activation through gut microbiota disturbance. Sci Rep. 2018;8(1):13897.PubMedPubMedCentralCrossRef Jang H-M, et al. Immobilization stress-induced Escherichia coli causes anxiety by inducing NF-κB activation through gut microbiota disturbance. Sci Rep. 2018;8(1):13897.PubMedPubMedCentralCrossRef
49.
go back to reference Butler MI, et al. The gut microbiome in social anxiety disorder: evidence of altered composition and function. Transl Psych. 2023;13(1):95.CrossRef Butler MI, et al. The gut microbiome in social anxiety disorder: evidence of altered composition and function. Transl Psych. 2023;13(1):95.CrossRef
51.
go back to reference Li J, et al. Clostridiales are predominant microbes that mediate psychiatric disorders. J Psychiatr Res. 2020;130:48–56.PubMedCrossRef Li J, et al. Clostridiales are predominant microbes that mediate psychiatric disorders. J Psychiatr Res. 2020;130:48–56.PubMedCrossRef
52.
go back to reference Gheorghe CE, et al. Investigating causality with fecal microbiota transplantation in rodents: applications, recommendations and pitfalls. Gut Microbes. 2021;13(1):1941711.PubMedPubMedCentralCrossRef Gheorghe CE, et al. Investigating causality with fecal microbiota transplantation in rodents: applications, recommendations and pitfalls. Gut Microbes. 2021;13(1):1941711.PubMedPubMedCentralCrossRef
53.
go back to reference Secombe KR, et al. Guidelines for reporting on animal fecal transplantation (GRAFT) studies: recommendations from a systematic review of murine transplantation protocols. Gut Microbes. 2021;13(1):1979878.PubMedPubMedCentralCrossRef Secombe KR, et al. Guidelines for reporting on animal fecal transplantation (GRAFT) studies: recommendations from a systematic review of murine transplantation protocols. Gut Microbes. 2021;13(1):1979878.PubMedPubMedCentralCrossRef
54.
go back to reference Ritz NL, et al. Social anxiety disorder-associated gut microbiota increases social fear. Proc Natl Acad Sci. 2024;121(1):e2308706120.PubMedCrossRef Ritz NL, et al. Social anxiety disorder-associated gut microbiota increases social fear. Proc Natl Acad Sci. 2024;121(1):e2308706120.PubMedCrossRef
55.
go back to reference Toth I, Neumann ID, Slattery DA. Social fear conditioning: a novel and specific animal model to study social anxiety disorder. Neuropsychopharmacology. 2012;37(6):1433–43.PubMedPubMedCentralCrossRef Toth I, Neumann ID, Slattery DA. Social fear conditioning: a novel and specific animal model to study social anxiety disorder. Neuropsychopharmacology. 2012;37(6):1433–43.PubMedPubMedCentralCrossRef
56.
go back to reference Liu RT, Walsh RFL, Sheehan AE. Prebiotics and probiotics for depression and anxiety: A systematic review and meta-analysis of controlled clinical trials. Neurosci Biobehav Rev. 2019;102:13–23.PubMedPubMedCentralCrossRef Liu RT, Walsh RFL, Sheehan AE. Prebiotics and probiotics for depression and anxiety: A systematic review and meta-analysis of controlled clinical trials. Neurosci Biobehav Rev. 2019;102:13–23.PubMedPubMedCentralCrossRef
57.
go back to reference Chao L, et al. Effects of probiotics on depressive or anxiety variables in healthy participants under stress conditions or with a depressive or anxiety diagnosis: A meta-analysis of randomized controlled trials. Front Neurol. 2020;11:421.PubMedPubMedCentralCrossRef Chao L, et al. Effects of probiotics on depressive or anxiety variables in healthy participants under stress conditions or with a depressive or anxiety diagnosis: A meta-analysis of randomized controlled trials. Front Neurol. 2020;11:421.PubMedPubMedCentralCrossRef
58.
go back to reference Zhang N, et al. Efficacy of probiotics on stress in healthy volunteers: A systematic review and meta-analysis based on randomized controlled trials. Brain Behav. 2020;10(9):e01699.PubMedPubMedCentralCrossRef Zhang N, et al. Efficacy of probiotics on stress in healthy volunteers: A systematic review and meta-analysis based on randomized controlled trials. Brain Behav. 2020;10(9):e01699.PubMedPubMedCentralCrossRef
59.
go back to reference Zhao Z, et al. Effectiveness of probiotic/prebiotic/synbiotic treatments on anxiety: A systematic review and meta-analysis of randomized controlled trials. J Affect Disord. 2023;343:9–21.PubMedCrossRef Zhao Z, et al. Effectiveness of probiotic/prebiotic/synbiotic treatments on anxiety: A systematic review and meta-analysis of randomized controlled trials. J Affect Disord. 2023;343:9–21.PubMedCrossRef
60.
go back to reference Halemani K, et al. Impact of probiotic on anxiety and depression symptoms in pregnant and lactating women and microbiota of infants: A systematic review and meta-analysis. J Glob Health. 2023;13:04038.PubMedPubMedCentralCrossRef Halemani K, et al. Impact of probiotic on anxiety and depression symptoms in pregnant and lactating women and microbiota of infants: A systematic review and meta-analysis. J Glob Health. 2023;13:04038.PubMedPubMedCentralCrossRef
61.
go back to reference Ribera C, et al. Probiotic, prebiotic, synbiotic and fermented food supplementation in psychiatric disorders: A systematic review of clinical trials. Neurosci Biobehav Rev. 2024;158:105561.PubMedCrossRef Ribera C, et al. Probiotic, prebiotic, synbiotic and fermented food supplementation in psychiatric disorders: A systematic review of clinical trials. Neurosci Biobehav Rev. 2024;158:105561.PubMedCrossRef
62.
go back to reference Kim JY, et al. Environmental risk factors and biomarkers for autism spectrum disorder: an umbrella review of the evidence. Lancet Psychiatry. 2019;6(7):590–600.PubMedCrossRef Kim JY, et al. Environmental risk factors and biomarkers for autism spectrum disorder: an umbrella review of the evidence. Lancet Psychiatry. 2019;6(7):590–600.PubMedCrossRef
63.
go back to reference Eskandarzadeh S, et al. Efficacy of a multispecies probiotic as adjunctive therapy in generalized anxiety disorder: a double blind, randomized, placebo-controlled trial. Nutr Neurosci. 2021;24(2):102–8.PubMedCrossRef Eskandarzadeh S, et al. Efficacy of a multispecies probiotic as adjunctive therapy in generalized anxiety disorder: a double blind, randomized, placebo-controlled trial. Nutr Neurosci. 2021;24(2):102–8.PubMedCrossRef
64.
go back to reference Hilimire MR, DeVylder JE, Forestell CA. Fermented foods, neuroticism, and social anxiety: An interaction model. Psychiatry Res. 2015;228(2):203–8.PubMedCrossRef Hilimire MR, DeVylder JE, Forestell CA. Fermented foods, neuroticism, and social anxiety: An interaction model. Psychiatry Res. 2015;228(2):203–8.PubMedCrossRef
65.
go back to reference Sousa RJM, Baptista JAB, Silva CCG. Consumption of fermented dairy products is associated with lower anxiety levels in Azorean university students. Front Nutr. 2022;9:930949.PubMedPubMedCentralCrossRef Sousa RJM, Baptista JAB, Silva CCG. Consumption of fermented dairy products is associated with lower anxiety levels in Azorean university students. Front Nutr. 2022;9:930949.PubMedPubMedCentralCrossRef
66.
go back to reference Nithya A, et al. Probiotic potential of fermented foods and their role in non-communicable diseases management: An understanding through recent clinical evidences. Food Chemistry Advances. 2023;3:100381.CrossRef Nithya A, et al. Probiotic potential of fermented foods and their role in non-communicable diseases management: An understanding through recent clinical evidences. Food Chemistry Advances. 2023;3:100381.CrossRef
68.
go back to reference Johnson AJ, et al. Daily sampling reveals personalized diet-microbiome associations in humans. Cell Host Microbe. 2019;25(6):789-802.e5.PubMedCrossRef Johnson AJ, et al. Daily sampling reveals personalized diet-microbiome associations in humans. Cell Host Microbe. 2019;25(6):789-802.e5.PubMedCrossRef
70.
go back to reference Lassale C, et al. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psych. 2018. Lassale C, et al. Healthy dietary indices and risk of depressive outcomes: a systematic review and meta-analysis of observational studies. Mol Psych. 2018.
71.
go back to reference Dinu M, et al. Association between psychological disorders, Mediterranean diet, and Chronotype in a group of Italian adults. Int J Environ Res Public Health. 2022;20(1). Dinu M, et al. Association between psychological disorders, Mediterranean diet, and Chronotype in a group of Italian adults. Int J Environ Res Public Health. 2022;20(1).
72.
go back to reference Sadeghi O, et al. Adherence to Mediterranean dietary pattern is inversely associated with depression, anxiety and psychological distress. Nutr Neurosci. 2021;24(4):248–59.PubMedCrossRef Sadeghi O, et al. Adherence to Mediterranean dietary pattern is inversely associated with depression, anxiety and psychological distress. Nutr Neurosci. 2021;24(4):248–59.PubMedCrossRef
73.
go back to reference Allcock L, Mantzioris E, Villani A. Adherence to a Mediterranean diet is inversely associated with anxiety and stress but not depression: A cross-sectional analysis of community-dwelling older Australians. Nutrients. 2024;16(3). Allcock L, Mantzioris E, Villani A. Adherence to a Mediterranean diet is inversely associated with anxiety and stress but not depression: A cross-sectional analysis of community-dwelling older Australians. Nutrients. 2024;16(3).
74.
go back to reference Torabynasab K, et al. Adherence to the MIND diet is inversely associated with odds and severity of anxiety disorders: a case-control study. BMC Psychiatry. 2023;23(1):330.PubMedPubMedCentralCrossRef Torabynasab K, et al. Adherence to the MIND diet is inversely associated with odds and severity of anxiety disorders: a case-control study. BMC Psychiatry. 2023;23(1):330.PubMedPubMedCentralCrossRef
76.
go back to reference Jacka FN, et al. A randomised controlled trial of dietary improvement for adults with major depression (the “SMILES” trial). BMC Med. 2017;15(1):23.PubMedPubMedCentralCrossRef Jacka FN, et al. A randomised controlled trial of dietary improvement for adults with major depression (the “SMILES” trial). BMC Med. 2017;15(1):23.PubMedPubMedCentralCrossRef
77.
go back to reference Parletta N, et al. A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED). Nutr Neurosci. 2019;22(7):474–87.PubMedCrossRef Parletta N, et al. A Mediterranean-style dietary intervention supplemented with fish oil improves diet quality and mental health in people with depression: A randomized controlled trial (HELFIMED). Nutr Neurosci. 2019;22(7):474–87.PubMedCrossRef
78.
go back to reference Bayes J, Schloss J, Sibbritt D. A randomised controlled trial assessing the effect of a Mediterranean diet on the symptoms of depression in young men (the ‘AMMEND’ study): a study protocol. Br J Nutr. 2021;126(5):730–7.PubMedCrossRef Bayes J, Schloss J, Sibbritt D. A randomised controlled trial assessing the effect of a Mediterranean diet on the symptoms of depression in young men (the ‘AMMEND’ study): a study protocol. Br J Nutr. 2021;126(5):730–7.PubMedCrossRef
79.
go back to reference Francis HM, et al. A brief diet intervention can reduce symptoms of depression in young adults - A randomised controlled trial. PLoS ONE. 2019;14(10):e0222768.PubMedPubMedCentralCrossRef Francis HM, et al. A brief diet intervention can reduce symptoms of depression in young adults - A randomised controlled trial. PLoS ONE. 2019;14(10):e0222768.PubMedPubMedCentralCrossRef
80.
go back to reference Ghosh TS, et al. Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU-AGE 1-year dietary intervention across five European countries. Gut. 2020;69(7):1218.PubMedCrossRef Ghosh TS, et al. Mediterranean diet intervention alters the gut microbiome in older people reducing frailty and improving health status: the NU-AGE 1-year dietary intervention across five European countries. Gut. 2020;69(7):1218.PubMedCrossRef
81.
go back to reference Meslier V, et al. Mediterranean diet intervention in overweight and obese subjects lowers plasma cholesterol and causes changes in the gut microbiome and metabolome independently of energy intake. Gut. 2020;69(7):1258–68.PubMedCrossRef Meslier V, et al. Mediterranean diet intervention in overweight and obese subjects lowers plasma cholesterol and causes changes in the gut microbiome and metabolome independently of energy intake. Gut. 2020;69(7):1258–68.PubMedCrossRef
82.
go back to reference Berding K, et al. Feed your microbes to deal with stress: a psychobiotic diet impacts microbial stability and perceived stress in a healthy adult population. Mol Psychiatry. 2023;28(2):601–10.PubMedCrossRef Berding K, et al. Feed your microbes to deal with stress: a psychobiotic diet impacts microbial stability and perceived stress in a healthy adult population. Mol Psychiatry. 2023;28(2):601–10.PubMedCrossRef
83.
go back to reference Nikolova VL et al. Updated review and meta-analysis of probiotics for the treatment of clinical depression: Adjunctive vs. stand-alone treatment. J Clin Med. 2021;10(4). Nikolova VL et al. Updated review and meta-analysis of probiotics for the treatment of clinical depression: Adjunctive vs. stand-alone treatment. J Clin Med. 2021;10(4).
85.
go back to reference Butler MI, Mörkl S. The Mediterranean Diet and Mental Health. In: Dinan T, editor. Nutritional Psychiatry: A Primer for Clinicians. Cambridge: Cambridge University Press; 2023. p. 39–54.CrossRef Butler MI, Mörkl S. The Mediterranean Diet and Mental Health. In: Dinan T, editor. Nutritional Psychiatry: A Primer for Clinicians. Cambridge: Cambridge University Press; 2023. p. 39–54.CrossRef
86.
go back to reference Dalile B, et al. Colon-delivered short-chain fatty acids attenuate the cortisol response to psychosocial stress in healthy men: a randomized, placebo-controlled trial. Neuropsychopharmacology. 2020;45(13):2257–66.PubMedPubMedCentralCrossRef Dalile B, et al. Colon-delivered short-chain fatty acids attenuate the cortisol response to psychosocial stress in healthy men: a randomized, placebo-controlled trial. Neuropsychopharmacology. 2020;45(13):2257–66.PubMedPubMedCentralCrossRef
87.
go back to reference Dalile B, et al. Colonic butyrate administration modulates fear memory but not the acute stress response in men: A randomized, triple-blind, placebo-controlled trial. Prog Neuropsychopharmacol Biol Psychiatry. 2024;131:110939.PubMedCrossRef Dalile B, et al. Colonic butyrate administration modulates fear memory but not the acute stress response in men: A randomized, triple-blind, placebo-controlled trial. Prog Neuropsychopharmacol Biol Psychiatry. 2024;131:110939.PubMedCrossRef
88.
Metadata
Title
The Gut Microbiome in Anxiety Disorders
Authors
Mary I. Butler
Sarah Kittel-Schneider
Jolana Wagner-Skacel
Sabrina Mörkl
Gerard Clarke
Publication date
12-04-2025