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Annu Rev Clin Psychol. 2019 May 7;15:371-398. doi: 10.1146/annurev-clinpsy-050718-095432. Epub 2019 Feb 20.

Man and the Microbiome: A New Theory of Everything?

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Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork T12 K8AF, Ireland; email:
APC Microbiome Ireland, University College Cork, Cork T12 K8AF, Ireland.
Department of Anatomy and Neuroscience, University College Cork, Cork T12 K8AF, Ireland.


The gut microbiome is implicated in the pathophysiology of a wide range of psychological disorders. Preclinical studies have provided us with key insights into the mechanisms by which the microbiome influences bidirectional gut-brain communication. There are many signaling pathways involved, including the hypothalamic-pituitary-adrenal axis, immune modulation, tryptophan and serotonin metabolism, bile acid transformation, microbial production of neuroactive compounds, and regulation of the endocannabinoid system. The complex and widespread influence of the microbiome on many physiological and psychological processes has generated a keen interest in its therapeutic potential for depression, anxiety, autism, and other psychiatric disorders. It has been shown that the microbiome composition of people suffering with such conditions differs significantly from that of healthy controls, and although the area is in its infancy, interventional studies that alter a person's microbiome through the use of probiotics, prebiotics, or dietary change can alleviate psychopathological symptoms.


anxiety; depression; gut–brain axis; microbiome; microbiota; probiotics

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