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SYSTEMATIC REVIEW article

Front. Microbiol.

Sec. Microorganisms in Vertebrate Digestive Systems

Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1681559

This article is part of the Research TopicExploring the gut-brain axis in neurodevelopmental disorders: Microbiome insights and therapy advancementsView all 3 articles

Effects of Gut Microbiota Interventions on Patients with Schizophrenia: A Systematic Review and Meta-Analysis

Provisionally accepted
Nianhua  YeNianhua Ye1Xin  SongXin Song1Jing  YuJing Yu1Xiaolei  BaoXiaolei Bao1Minghua  YeMinghua Ye2Lisheng  JiangLisheng Jiang1*
  • 1Jiangxi University of Traditional Chinese Medicine, Nanchang, China
  • 2Beijing University of Chinese Medicine, Beijing, China

The final, formatted version of the article will be published soon.

Introduction: Schizophrenia (SCH) is a chronic psychiatric disorder characterized by disturbances in thought, emotion, perception, and behavior. Although gut microbiota interventions (eg. probiotics, prebiotics, synbiotics, dietary modifications and fecal microbiota transplantation) have been widely applied in the treatment of SCH, the most effective intervention strategy remains uncertain. Methods: By searching four databases, only randomized controlled trials (RCTs) were included to examine the impacts of gut microbiota interventions on SCH. The Cochrane risk-of-bias tool for randomized trials (RoB 2.0) was employed to assess the methodological quality of the included studies, RevMan5.4 was used for the meta-analysis, Stata 18 was used for sensitivity analysis, Engauge Digitizer was used to convert pictures to numbers and GRADEPro3.6 was used to grade the evidence quality. Results: This study incorporated RCTs published from the earliest records up to December 2024. A total of 10 RCTs, encompassing 585 participants, were analyzed. The meta-analysis demonstrated that interventions primarily utilizing probiotics to modulate gut microbiota significantly lowered the total Positive and Negative Syndrome Scale (PANSS) scores among patients (P=0.001). Furthermore, substantial improvements were observed across multiple metabolic parameters: Fasting Blood Sugar, Triglycerides, Total Cholesterol, homeostasis model assessment of insulin resistance, and Quantitative Insulin Sensitivity Check Index (all P<0.05). While no significant effects were observed on high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, Body Weight, Body Mass Index, and Insulin. Conclusion: This meta-analysis suggests that auxiliary probiotic interventions hold promise as an adjunctive therapy for schizophrenia, potentially yielding benefits in psychopathological, metabolic, and physiological domains. However, the current evidence remains inconclusive due to the limited number of studies, small sample sizes, and methodological variations. Firm therapeutic recommendations cannot be made at this time. The findings underscore the need for more robust, large-scale, and rigorously designed randomized controlled trials to definitively establish the efficacy and optimal protocols of auxiliary probiotic supplementation for SCH.

Keywords: Gut Microbiota, Probiotics, Schizophrenia, Effects, Meta-analysis

Received: 08 Aug 2025; Accepted: 30 Sep 2025.

Copyright: © 2025 Ye, Song, Yu, Bao, Ye and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Lisheng Jiang, 1494739846@qq.com

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