Table 3.

Probiotics and prebiotics in mood disorders.

Participants	Treatment	Length of Trial	Measurements	Outcomes	References
40 healthy participants without current mood disorders.	Probiotic food-supplement containing B. bifidum W23, B. lactis W52, L. acidophilus W37, L. brevis W63, L. casei W56, L. salivarius W24, and Lactococcus lactis (W19 and W58) (2.5×109CFU/g); placebo.	4 weeks.	Cognitive reactivity to sad mood using the LEIDS-R.	↓ overall cognitive reactivity to sad mood by minimizing aggressive thoughts.	[42]
25 subjects with UFC levels less than 50ng/ml.	L. helveticus R0052 and B. longum R0175 (PF).	30 days.	HADS, and perceived stress.	↑ HADS score, ↓ anger, depression and anxiety in the UFC patients	[44]
45 healthy patients.	5.5g of FOS, or B- GOS, or placebo (maldextrin).	3 weeks.	Salivary cortisol awakening response before and after treatments; processing of emotionally salient information.	Salivary cortisol awakening response ↓ after treatment with B-GOS when compared to placebo.	[45]
25 healthy women.	FMPP containing species B. animalis subsp Lactis, Streptococcus thermophiles, L. bulgaricus, and Lactococcus lactis subsp Lactis (1.2×109 cfu/cup) or a non- fermented milk product twice daily.	4 weeks.	Brain response to an emotional faces attention task and resting brain activity.	↓ task-related response of a distributed functional network containing affective, viscerosensory, and somatosensory cortices. FMPP treated women also showed changes in midbrain connectivity.	[46]
172 students undergoing a day medical school exam.	Stressed medical students received LcS-fermented milk or placebo daily.	8 weeks prior to exam.	Subjective anxiety scores, salivary cortisol levels, and the presence of physical symptoms during the intervention.	↓ salivary cortisol levels; ↓ rate of physical symptoms.	[47]
40 MDD patients.	Probiotic cocktail (L. acidophilus (2 × 109 CFU/g), L. casei (2 × 109 CFU/g), and B. bifidum (2 × 109CFU/g)); placebo.	8 weeks.	Dietary intake, depression symptoms, insulin resistance, and glutathione concentrations.	↓ BDI total scores, ↓ insulin levels and insulin resistance, and ↑ plasma total glutathione levels.	[48]
39 CFS patients.	24 × 1010 cfu/g of L. casei strain Shirota (LcS); placebo daily.	2 months.	Flora in stool samples, BDI and BAI scores.	LcS ↑ in both L. and B. and ↓ anxiety symptoms.	[50]
710 young adults (445 females).	Questionnaire on food consumption.	30 days.	Patients completed self- report measures of fermented food consumption, neuroticism, and social anxiety.	Fermented food consumption correlates with reduced social anxiety and neuroticism.	[51]
66 healthy individuals with <13 HADS-A, and <21 HADS-D scores.	Probiotic mixture containing L. helveticus R0052 and B. longum R0175 (PF).	30 days	HSCL-90, HADS, PSS, CCL and 24 h UFC level.	Treatment with PF alleviated psychological distress, depression, anger, somatization, and anxiety.	[43]

Abbreviations: LEID-S, Leiden index of depression sensitivity scale; UFC, Urinary Free Cortisol; HADS, Hospital Anxiety and Depression Scale; FOS, Fructooligosaccharide; B_GOS, Bimuno^®-Galactooligosaccharides; FMPP, Fermented Milk Product with Probiotic; MDD, Major Depressive Disorder; BDI, Beck Depression Inventory; CFS, Chronic Fatigue Syndrome; BAI, Beck Anxiety inventory; HSCL-90, Hopkins Symptom Checklist; PSS, Perceived Stress Scale; CCL, Coping Checklist; HADS-A, HADS-anxiety subscale; HADS-D, HADS-depression subscale.