@article{4f6dfaa64482445d9b44676f60fc8a6b,
title = "The gut microbiota is associated with psychiatric symptom severity and treatment outcome among individuals with serious mental illness",
abstract = "Background: Emerging evidence implicates the gut microbiota in central nervous system functioning via its effects on inflammation, the hypothalamic-pituitary axis, and/or neurotransmission. Our understanding of the cellular underpinnings of the brain-gut relationship is based almost exclusively on animal models with some small-scale human studies. This study examined the relationship between the gut microbiota and psychiatric symptom severity and treatment response among inpatients with serious mental illness. Method: We collected data from adult inpatients (N = 111). Measures of diagnoses, suicide severity, trauma, depression, and anxiety were collected shortly after admission, while self-collected fecal swabs were collected early in the course of hospitalization and processed using 16S rRNA gene sequencing and whole genome shotgun sequencing methods. Results: Results indicate that depression and anxiety severity shortly after admission were negatively associated with bacterial richness and alpha diversity. Additional analyses revealed a number of bacterial taxa associated with depression and anxiety severity. Gut microbiota richness and alpha diversity early in the course of hospitalization was a significant predictor of depression remission at discharge. Conclusions: This study is among the first to demonstrate a gut microbiota relationship with symptom severity among psychiatric inpatients as well as a relationship to remission of depression post-treatment. These findings are consistent with animal models and limited human studies as well as with the broader literature implicating inflammation in the pathophysiology of depression. These findings offer the foundation for further studies of novel therapeutic approaches to the treatment, prevention of, or recurrence of serious mental illness.",
keywords = "Anxiety, Depression, Microbiome, Microbiota, Outcomes, Serious mental illness",
author = "A. Madan and D. Thompson and Fowler, {James Chris} and Ajami, {N. J.} and R. Salas and Frueh, {B. C.} and Bradshaw, {M. R.} and Weinstein, {B. L.} and Oldham, {J. M.} and Petrosino, {J. F.}",
note = "Funding Information: This research was partially supported by the Houston Methodist Foundation, The Sam Field Foundation, The Menninger Clinic Foundation, McNair Medical Institute, and Baylor College of Medicine's Alkek Center for Metagenomics and Microbiome Research. Dr. Madan is the John S. Dunn Foundation Distinguished Centennial Clinical Academic Scholar in Behavioral Health at Houston Methodist Hospital. Dr. Weinstein is the C. James and Carole Walter Looke Presidential Distinguished Centennial Clinical Academic Scholar in Behavioral Health at Houston Methodist Hospital. At the time of data collection Drs. Madan, Fowler, Frueh, and Weinstein were affiliated with the Menninger Clinic and the Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX. This material is partly the result of work supported with resources and the use of facilities at the Michael E. DeBakey VA Medical Center, Houston, TX. This study follows the guidelines on good publication practices ( Battisti, 2015 ). The study sponsors were not involved in any aspect of the research activities and did not approve the specific protocol or presentation. Thus, the authors were independent from study sponsors in the context of the research. The authors have no other conflicts of interest to report. Funding Information: This research was partially supported by the Houston Methodist Foundation , The Sam Field Foundation , The Menninger Clinic Foundation , McNair Medical Institute , and Baylor College of Medicine {\textquoteright}s Alkek Center for Metagenomics and Microbiome Research. Dr. Madan is the John S. Dunn Foundation Distinguished Centennial Clinical Academic Scholar in Behavioral Health at Houston Methodist Hospital. At the time of data collection Drs. Madan, Fowler, Frueh, and Weinstein were affiliated with the Menninger Clinic and the Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX. This material is partly the result of work supported with resources and the use of facilities at the Michael E. DeBakey VA Medical Center, Houston, TX. This study follows the guidelines on good publication practices ( Battisti, 2015 ). The study sponsors were not involved in any aspect of the research activities and did not approve the specific protocol or presentation. Thus, the authors were independent from study sponsors in the context of the research. The authors have no other conflicts of interest to report. The authors are thankful to Michelle Patriquin, PhD and Humsini Viswanath, MPH, MS for their assistance with pharmacy data abstraction. Funding Information: This research was partially supported by the Houston Methodist Foundation, The Sam Field Foundation, The Menninger Clinic Foundation, McNair Medical Institute, and Baylor College of Medicine's Alkek Center for Metagenomics and Microbiome Research. Dr. Madan is the John S. Dunn Foundation Distinguished Centennial Clinical Academic Scholar in Behavioral Health at Houston Methodist Hospital. At the time of data collection Drs. Madan, Fowler, Frueh, and Weinstein were affiliated with the Menninger Clinic and the Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX. This material is partly the result of work supported with resources and the use of facilities at the Michael E. DeBakey VA Medical Center, Houston, TX. This study follows the guidelines on good publication practices (Battisti, 2015). The study sponsors were not involved in any aspect of the research activities and did not approve the specific protocol or presentation. Thus, the authors were independent from study sponsors in the context of the research. The authors have no other conflicts of interest to report. The authors are thankful to Michelle Patriquin, PhD and Humsini Viswanath, MPH, MS for their assistance with pharmacy data abstraction. Publisher Copyright: {\textcopyright} 2019 Elsevier B.V. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.",
year = "2020",
month = mar,
day = "1",
doi = "10.1016/j.jad.2019.12.020",
language = "English (US)",
volume = "264",
pages = "98--106",
journal = "J Affect Disord",
issn = "0165-0327",
publisher = "Elsevier",
}