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The effect of fecal microbiota transplantation on psychiatric symptoms among patients with irritable bowel syndrome, functional diarrhea and functional constipation: An open-label observational study.
J Affect Disord. 2018 08 01; 235:506-512.JA

Abstract

BACKGROUNDS

The intestinal microbiota is considered as a potential common underpinning pathophysiology of Functional Gastrointestinal Disorders (FGIDs) and psychiatric disorders such as depression and anxiety. Fecal Microbiota Transplantation (FMT) has been reported to have therapeutic effects on diseases related to dysbiosis, but few studies have evaluated its effect on psychiatric symptoms.

METHODS

We followed 17 patients with either Irritable Bowel Syndrome (IBS), Functional Diarrhea (FDr) or Functional Constipation (FC) who underwent FMT for the treatment of gastrointestinal symptoms and observation of psychiatric symptoms. Changes in Hamilton Rating Scale for Depression (HAM-D) and subscale of sleep-related items, Hamilton Rating Scale for Anxiety (HAM-A) and Quick Inventory for Depressive Symptoms (QIDS) between baseline and 4 weeks after FMT, and relationship with the intestinal microbiota were measured.

RESULTS

At baseline, 12 out of 17 patients were rated with HAM-D ≥ 8. Significant improvement in HAM-D total and sleep subscale score, HAM-A and QIDS were observed (p = 0.007, p = 0.007, p = 0.01, p = 0.007, respectively). Baseline Shannon index indicated that microbiota showed lower diversity in patients with HAM-D ≥ 8 compared to those of healthy donors and patients with HAM-D < 8. There was a significant correlation between baseline Shannon index and HAM-D score, and a correlation between Shannon index change and HAM-D improvement after FMT.

LIMITATIONS

The small sample size with no control group.

CONCLUSIONS

Our results suggest that depression and anxiety symptoms may be improved by FMT regardless of gastrointestinal symptom change in patients with IBS, FDr and FC, and the increase of microbiota diversity may help to improve patient's mood.

Authors+Show Affiliations

Department of Psychiatry, Keio University School of Medicine, Tokyo, Japan.Department of Psychiatry, Keio University School of Medicine, Tokyo, Japan. Electronic address: tkishimoto@keio.jp.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.Department of Psychiatry, Keio University School of Medicine, Tokyo, Japan.Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan; Laboratory of Metagenomics, Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan.Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan; Laboratory of Metagenomics, Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan.Laboratory of Metagenomics, Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan; Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.Department of Psychiatry, Keio University School of Medicine, Tokyo, Japan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29684865

Citation

Kurokawa, Shunya, et al. "The Effect of Fecal Microbiota Transplantation On Psychiatric Symptoms Among Patients With Irritable Bowel Syndrome, Functional Diarrhea and Functional Constipation: an Open-label Observational Study." Journal of Affective Disorders, vol. 235, 2018, pp. 506-512.
Kurokawa S, Kishimoto T, Mizuno S, et al. The effect of fecal microbiota transplantation on psychiatric symptoms among patients with irritable bowel syndrome, functional diarrhea and functional constipation: An open-label observational study. J Affect Disord. 2018;235:506-512.
Kurokawa, S., Kishimoto, T., Mizuno, S., Masaoka, T., Naganuma, M., Liang, K. C., Kitazawa, M., Nakashima, M., Shindo, C., Suda, W., Hattori, M., Kanai, T., & Mimura, M. (2018). The effect of fecal microbiota transplantation on psychiatric symptoms among patients with irritable bowel syndrome, functional diarrhea and functional constipation: An open-label observational study. Journal of Affective Disorders, 235, 506-512. https://doi.org/10.1016/j.jad.2018.04.038
Kurokawa S, et al. The Effect of Fecal Microbiota Transplantation On Psychiatric Symptoms Among Patients With Irritable Bowel Syndrome, Functional Diarrhea and Functional Constipation: an Open-label Observational Study. J Affect Disord. 2018 08 1;235:506-512. PubMed PMID: 29684865.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of fecal microbiota transplantation on psychiatric symptoms among patients with irritable bowel syndrome, functional diarrhea and functional constipation: An open-label observational study. AU - Kurokawa,Shunya, AU - Kishimoto,Taishiro, AU - Mizuno,Shinta, AU - Masaoka,Tatsuhiro, AU - Naganuma,Makoto, AU - Liang,Kuo-Ching, AU - Kitazawa,Momoko, AU - Nakashima,Moeko, AU - Shindo,Chie, AU - Suda,Wataru, AU - Hattori,Masahira, AU - Kanai,Takanori, AU - Mimura,Masaru, Y1 - 2018/04/12/ PY - 2018/01/30/received PY - 2018/03/24/revised PY - 2018/04/04/accepted PY - 2018/4/24/pubmed PY - 2019/1/1/medline PY - 2018/4/24/entrez KW - Anxiety KW - Depression KW - Fecal microbiota transplant KW - Functional gastrointestinal disorders KW - Irritable bowel syndrome KW - Microbiome SP - 506 EP - 512 JF - Journal of affective disorders JO - J Affect Disord VL - 235 N2 - BACKGROUNDS: The intestinal microbiota is considered as a potential common underpinning pathophysiology of Functional Gastrointestinal Disorders (FGIDs) and psychiatric disorders such as depression and anxiety. Fecal Microbiota Transplantation (FMT) has been reported to have therapeutic effects on diseases related to dysbiosis, but few studies have evaluated its effect on psychiatric symptoms. METHODS: We followed 17 patients with either Irritable Bowel Syndrome (IBS), Functional Diarrhea (FDr) or Functional Constipation (FC) who underwent FMT for the treatment of gastrointestinal symptoms and observation of psychiatric symptoms. Changes in Hamilton Rating Scale for Depression (HAM-D) and subscale of sleep-related items, Hamilton Rating Scale for Anxiety (HAM-A) and Quick Inventory for Depressive Symptoms (QIDS) between baseline and 4 weeks after FMT, and relationship with the intestinal microbiota were measured. RESULTS: At baseline, 12 out of 17 patients were rated with HAM-D ≥ 8. Significant improvement in HAM-D total and sleep subscale score, HAM-A and QIDS were observed (p = 0.007, p = 0.007, p = 0.01, p = 0.007, respectively). Baseline Shannon index indicated that microbiota showed lower diversity in patients with HAM-D ≥ 8 compared to those of healthy donors and patients with HAM-D < 8. There was a significant correlation between baseline Shannon index and HAM-D score, and a correlation between Shannon index change and HAM-D improvement after FMT. LIMITATIONS: The small sample size with no control group. CONCLUSIONS: Our results suggest that depression and anxiety symptoms may be improved by FMT regardless of gastrointestinal symptom change in patients with IBS, FDr and FC, and the increase of microbiota diversity may help to improve patient's mood. SN - 1573-2517 UR - https://www.unboundmedicine.com/medline/citation/29684865/The_effect_of_fecal_microbiota_transplantation_on_psychiatric_symptoms_among_patients_with_irritable_bowel_syndrome_functional_diarrhea_and_functional_constipation:_An_open_label_observational_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-0327(18)30193-9 DB - PRIME DP - Unbound Medicine ER -