Schizophrenia

The gut microbiota

Chronic inflammation in the brain is suspected in schizophrenia. Disruptions in the gastrointestinal microbiota and the immune system may also be involved.

Actu GP : Schizophrénie et microbiote : un lien confirmé ?

About this article

Created 15 October 2020

Updated 28 October 2021

Schizophrenia affects around 0.7% of the world’s population. This psychiatric disease is characterized by delirium and hallucinations, social isolation, and psychological disruption. Onset is most often in adolescence or young adulthood, between ages 15 and 25.

The gut-brain axis involved?

Schizophrenia is very often accompanied by gastrointestinal disorders. In fact the likelihood of experiencing psychiatric diseases such as schizophrenia may be related to chronic intestinal inflammation involving the immune system. The origin may be an imbalance in the intestinal microbiota (intestinal flora) that favors this inflammation. Disruptions in the microbiota have been found in schizophrenic patients, associated with an increase in intestinal permeability (bacteria and other substances that pass into the blood stream through the intestinal wall). These studies seem to indicate a key role played by the gut-brain axis in the development of the disease.

Acting on the composition of the microbiota

With these results, prevention and treatment options emerge: one of them being rebalancing the microbiota to reduce chronic inflammation. Studies have shown that the administration of probiotics can have anti-inflammatory properties by affecting the immune reaction, although to date, no treatment of this type has demonstrated its effectiveness on schizophrenia.

Sources

^{Inserm. Schizophrenie, dossier d'information réalisé avec Marie-Odile Krebs, Mai 2014}

^{Severance EG, Gressitt KL, Stallings CR, et al. Discordant patterns of bacterial translocation markers and implications for innate immune imbalances in schizophrenia. Schizophr Res. 2013;148(1-3):130-137.}

^{Ellul P, Fond G, « Focus sur la schizophrénie : infections, auto-immunité et dysbiose intestinale », L'information psychiatrique, 2016/10 (Volume 93), p. 797-802.}

^{Sherwin E, Sandhu KV, Dinan TG, Cryan JF. May the Force Be With You: The Light and Dark Sides of the Microbiota-Gut-Brain Axis in Neuropsychiatry. CNS Drugs. 2016;30(11):1019-1041.}

^{Nemani K, Hosseini Ghomi R, McCormick B, et al. Schizophrenia and the gut-brain axis. Prog Neuropsychopharmacol Biol Psychiatry. 2015;56:155-160.}

^{Severance EG, Yolken RH, Eaton WW. Autoimmune diseases, gastrointestinal disorders and the microbiome in schizophrenia: more than a gut feeling. Schizophr Res [Internet]. Elsevier B.V. 2014.}

^{Severance EG, Prandovszky E, Castiglione J, Yolken RH, et al. Gastroenterology issues in schizophrenia: why the gut matters. Curr Psychiatry Rep. 2015 ; 17(5):1–10.}

^{Caso JR, Balanzá-Martínez V, Palomo T, et al. The Microbiota and Gut-Brain Axis: Contributions to the Immunopathogenesis of Schizophrenia. Curr Pharm Des. 2016 ; 22(40):6122-6133.}

^{Dickerson FB, Stallings C, Origoni A, et al. Effect of probiotic supplementation on schizophrenia symptoms and association with gastrointestinal functioning: a randomized, placebo-controlled trial. Prim Care Companion CNS Disord. 2014;16(1):PCC.13m01579.}

^{Joseph J, Depp C, Shih PB, et al. Modified Mediterranean Diet for Enrichment of Short Chain Fatty Acids: Potential Adjunctive Therapeutic to Target Immune and Metabolic Dysfunction in Schizophrenia? Front Neurosci. 2017 Mar 27;11:155.}

^{Tomasik J, Yolken RH, Bahn S, et al. Immunomodulatory Effects of Probiotic Supplementation in Schizophrenia Patients: A Randomized, Placebo-Controlled Trial. Biomark Insights. 2015 Jun 1;10:47-54.}