Effect of bifidobacterium breve A-1 on anxiety and depressive symptoms in schizophrenia: A proof-of-concept study

J Affect Disord. 2019 Feb 15:245:377-385. doi: 10.1016/j.jad.2018.11.011. Epub 2018 Nov 5.


Background: Studies of probiotics have suggested they have a positive effect on anxiety and depressive symptoms in humans. This study investigated the effect of consuming the probiotic Bifidobacterium breve A-1 on anxiety and depressive symptoms in patients with schizophrenia and explored its effect on immune products such as cytokines and chemokines.

Methods: In this open-label single-arm study, all participants received B. breve strain A-1 (1011 cfu/day) for 4 weeks followed by 4 weeks of observation. The primary outcome was the Hospital Anxiety and Depression Scale (HADS) score. Secondary outcomes were anxiety and depressive symptoms on the Positive and Negative Syndrome Scale (PANSS), blood test findings, and fecal microbiome composition.

Results: Twenty-nine outpatients completed the study. HADS total score and PANSS anxiety/depression score were significantly improved at 4 weeks. Based on the criterion of a greater than 25% reduction in HADS total score at 4 weeks from baseline, there were 12 responders and 17 non-responders. Responders were found to have fewer negative symptoms, reduced intake of dairy products, and higher relative abundance of Parabacteroides in the gut microbiome than non-responders. Moreover, IL-22 and TRANCE expression was significantly increased at 4 weeks from baseline in responders but not in non-responders.

Limitations: This open-label, single-arm study cannot exclude a placebo effect.

Conclusions: The results suggest the potential effect of B. breve A-1 in improving anxiety and depressive symptoms in patients with schizophrenia. Further studies should investigate this effect in patients with other psychiatric conditions and assess dietary habits and the gut microbiome.

Keywords: Anxiety; Cytokines; Depression; Microbiome; Probiotics; Schizophrenia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antipsychotic Agents / therapeutic use
  • Anxiety Disorders / drug therapy*
  • Anxiety Disorders / physiopathology
  • Bifidobacterium breve / chemistry*
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / physiopathology
  • Feces / microbiology
  • Female
  • Gastrointestinal Microbiome
  • Humans
  • Male
  • Microbiota
  • Middle Aged
  • Probiotics / administration & dosage*
  • Proof of Concept Study
  • Schizophrenia / complications
  • Schizophrenia / drug therapy


  • Antipsychotic Agents