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Review
. 2019 Nov;9(11):e01408.
doi: 10.1002/brb3.1408. Epub 2019 Sep 30.

The role of the brain-gut-microbiota axis in psychology: The importance of considering gut microbiota in the development, perpetuation, and treatment of psychological disorders

Affiliations
Review

The role of the brain-gut-microbiota axis in psychology: The importance of considering gut microbiota in the development, perpetuation, and treatment of psychological disorders

Michael Ganci et al. Brain Behav. 2019 Nov.

Abstract

Introduction: The prevalence of psychological disorders remains stable despite steady increases in pharmacological treatments suggesting the need for auxiliary treatment options. Consideration of the brain-gut-microbiota axis (BGMA) has made inroads into reconceptualizing psychological illness from a more holistic perspective. While our understanding of the precise role of gut microbiota (GM) in psychological illness is in its infancy, it represents an attractive target for novel interventions.

Method: An extensive review of relevant literature was undertaken.

Results: Gut microbiota are proposed to directly and indirectly influence mood, cognition, and behavior which are key components of mental health. This paper outlines how GM may be implicated in psychological disorders from etiology through to treatment and prevention using the Four P model of case formulation.

Conclusion: Moving forward, integration of GM into the conceptualization and treatment of psychological illness will require the discipline of psychology to undergo a significant paradigm shift. While the importance of the GM in psychological well-being must be respected, it is not proposed to be a panacea, but instead, an additional arm to a multidisciplinary approach to treatment and prevention.

Keywords: allostatic load; gut microbiota; precipitating factors; predisposing factors; protective factors; psychology.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Factors influencing the multidirectional communication between the brain and the gut. Double‐headed arrows demonstrate a bidirectional relationship, with broken arrows demonstrating proposed but not yet established relationships. The figure demonstrates the three main well‐established pathways of communication between the brain and the gut, being endocrinological, neuronal, and immunological. The figure also illustrates the bidirectional relationships between microbial dysbiosis and the HPA axis, neurotransmitter production, the function of the blood–brain barrier, and inflammation which are believed to alter their functioning as an allostatic response to homeostatic emotions. It is proposed that microbial dysbiosis itself is able to be detected via the interoceptive system which then triggers these homeostatic emotions

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