Yogurt Helps Ease Psychiatric Symptoms in Schizophrenia Patients

Probiotics or foods containing live culture of bacteria such as yogurt helps maintain a healthy gut microbiota. A latest study done at the Johns Hopkins Medicine and Sheppard Pratt Health System adds on to the benefits of probiotics. The evidence show that adding probiotics - microorganisms, such as bacteria found in yogurts to the diets of those with schizophrenia may help treat yeast infections and ease bowel problems.

The investigators caution that larger and more rigorous studies are needed to validate their findings and determine if women with schizophrenia respond similarly to probiotics before this fairly simple and cost-effective treatment strategy should be recommended widely to people with schizophrenia.

"The mental health field is in desperate need of new treatments for psychiatric disorders, yet there’s been very little progress toward this goal for too long a time. The tiny living organisms that make up the human microbiome and the overwhelming evidence for a gut-brain axis together represent a new frontier for schizophrenia research," says Emily Severance, Ph.D., assistant professor of pediatrics and part of the Stanley Division of Developmental Neurovirology at the Johns Hopkins University School of Medicine.

"We need to rethink how we study brain disorders such as schizophrenia by looking at clues offered by a whole-body approach and identifying and understanding the basis for dysfunctions that are occurring outside the brain."

What are Probiotics?

Probiotics are live microorganisms that resemble the beneficial bacteria inhabiting human gut.

• The World Health Organization and the Food and Agriculture Organization of the United Nations define probiotics as “live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host." 
• Most of the probiotic bacteria belong to two groups - Lactobacillus or Bifidobacterium, each of which further contains several species. Another probiotic, Saccharomyces boulardii, a type of yeast, belongs to the fungi family. 
• Yogurt is a good source of probiotic bacteria. Probiotic bacteria are also present in other foods such as fermented and unfermented milk, tempeh, miso, certain varieties of juices and soy beverages. In these foods, the bacteria may have been originally present or might have been added during preparation.
• Probiotics are also available as dietary supplements in the form of capsules, tablets, or powders in sachets. 

Supplementing Probiotics

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The analysis included 56 adult women participants with an average age of 46. All the participants gave a blood sample at the beginning of the study.

They also completed the Positive and Negative Syndrome Scale (PANSS) exam used for measuring a standard set of symptoms of schizophrenia.

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Each participant were given one placebo pill once per day with a meal for the next two weeks and then were split into groups so that neither the researchers nor the participants could tell who would be given a real probiotic or the placebo for the next 14 weeks.

The commercially available probiotic contained over 1 billion colony-forming units of Lactobacillus rhamnosus and Bifidobacterium animalis in each pill.

People with schizophrenia have two types of yeast causing infections. The researchers measured antibody levels with the blood samples and tested for Saccharomyces cerevisiae and Candida albicans, before and after the probiotic treatment.

The probiotic treatment showed a 43% drop in Candida antibody levels while the placebo decreased antibodies by only 3%.

Antibody levels for the brewer’s yeast didn’t change over the course of the study in the participants after probiotic treatment. A treatment effect wasn’t detected in the women because their starting Candida antibody levels were already much higher in those on the placebo than in those taking the probiotics, which the researchers attributed to the small sample size of the trial.

Link Between Probiotics And Schizophrenia

Gastrointestinal problems, mainly constipation is a common problem in individuals with schizophrenia.

Clozapine is tried when schizophrenia does not improve with several antipsychotics. It is the most effective medication for reducing schizophrenia symptoms, but it causes more side effects than other antipsychotics. One among the side effects is constipation.

The immune response to external antigens is determined in part by the composition of the bacterial flora of the intestinal tract. Elevated levels of antibodies are found in individuals with schizophrenia. Probiotic microorganisms alter the balance of the gut microbiota and prevent the aberrant immune response to food-derived and other harmful antigens.

Positive and Negative Syndrome Scale (PANSS)

Schizophrenia is a mental disorder characterized by breakdown of the thought process and the inability to act normally in social situations due to poor emotional responsiveness. People with schizophrenia may hear voices, see things that are not there or believe that others are reading or controlling their minds.

The symptoms of schizophrenia are measured on three scales:

• Positive symptoms, such as delusions, hostility, grandiosity and hallucinations
• Negative symptoms, like social withdrawal and poor socialization
• General psychological symptoms, such as guilt, anxiety and depression.

To check the effect of probiotics on PANSS score, researchers examined previous data from a larger study of schizophrenia and found that 165 men with Candida infections had higher levels of positive symptoms, like delusions and hostility\.

The average PANSS score was 19.5 out of 24, compared to those 219 men without Candida infections who scored on average less than 18.5.

After probiotic treatment, PANSS scores on positive symptom, dropped from an average of 18 to 14.6.

"The biggest change in psychiatric symptoms over time by probiotics in men without elevated Candida levels suggests that introduced bacteria via probiotics might shift the resident bacterial community dynamics more easily to a balanced state when fungal competitors such as Candida are not present," says Severance.

 "Compared to the bacterial microbiome, relatively little is known about the fungal community in the gut and how it interacts with other classes of microbiota."

"We hope that with additional studies, we can show that something as cost-effective and easy to access as probiotics would be a way to lessen some symptoms of schizophrenia," says Severance.

Reference:

1. Effect of Probiotic Supplementation on Schizophrenia Symptoms and Association With Gastrointestinal Functioning: A Randomized, Placebo-Controlled Trial - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4048142/)

Source-Medindia