{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:13:18Z","timestamp":1791216798654,"version":"4.1.0"},"reference-count":91,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background\/Objectives: This umbrella review critically evaluates the available evidence on psychobiotics for depressive and anxiety symptoms, emphasizing methodological quality, consistency of findings, and persistent gaps in the literature. Methods: A comprehensive search was conducted across PubMed\/MEDLINE, Scopus, Web of Science, SciELO, Cochrane, and EBSCO (May\u2013June 2025) to identify systematic reviews with meta-analyses of randomized controlled trials examining probiotic, prebiotic, and synbiotic interventions in adults with depressive and\/or anxiety symptoms or diagnoses. Two reviewers independently screened studies, extracted data, and evaluated methodological quality using AMSTAR-2. Additional bibliometric, conceptual, and psychometric features were mapped, including geographical origin, publication timeline, scale distribution, and citation-based connectivity. Results: Thirty systematic reviews and meta-analyses were included. Methodological quality was predominantly moderate, low, or critically low in 76.6% of reviews. Probiotic interventions demonstrated consistent benefits for MDD (SMD = \u22120.50 [95% CI: \u22120.58 to \u22120.42], p = 0.0001). However, findings for anxiety were markedly inconsistent, despite the modest improvements in specific subgroups (SMD = \u22120.19 [95% CI: \u22120.28 to \u22120.10]; p &lt; 0.01). Prebiotics for MDD interventions showed limited positive results (SMD = \u22120.25 [95% CI: \u22120.47 to \u22120.03]; p = 0.03). For anxiety, the effects are inconclusive (SMD = \u22120.07 [95% CI: \u22120.30 to 0.10]; p = 0.18). Evidence for synbiotics was scarce. Citation-mapping revealed a fragmented and unevenly connected evidence base. Conclusions: The current evidence suggests that probiotics may confer beneficial effects on depressive and anxiety symptoms; however, the same cannot be said for prebiotics and synbiotics. Evidence for the efficacy of prebiotics and synbiotics to treat depression and anxiety is still insufficient or heterogeneous. Registration: CRD420251164884.<\/jats:p>","DOI":"10.3390\/ph19010156","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T14:35:38Z","timestamp":1768487738000},"page":"156","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["\u201cAttacking\u201d the Gut\u2013Brain Axis with Psychobiotics: An Umbrella Review of Depressive and Anxiety Symptoms"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9434-4231","authenticated-orcid":false,"given":"Alberto Souza","family":"S\u00e1 Filho","sequence":"first","affiliation":[{"name":"Graduate Program in Pharmaceutical Sciences, Evangelical University of Goi\u00e1s, An\u00e1polis 75080-000, Brazil"},{"name":"Graduate Program in Human Movement and Rehabilitation, Evangelical University of Goi\u00e1s, An\u00e1polis 75080-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiane Bastos","family":"Souza","sequence":"additional","affiliation":[{"name":"Graduate Program in Pharmaceutical Sciences, Evangelical University of Goi\u00e1s, An\u00e1polis 75080-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Lu\u00eds Rodrigues","family":"Martins","sequence":"additional","affiliation":[{"name":"Graduate Program in Pharmaceutical Sciences, Evangelical University of Goi\u00e1s, An\u00e1polis 75080-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9395-8442","authenticated-orcid":false,"given":"Gunnar P. H.","family":"Dietz","sequence":"additional","affiliation":[{"name":"Georg-August-Universit\u00e4t G\u00f6ttingen Medical School, D-37075 G\u00f6ttingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6558-5447","authenticated-orcid":false,"given":"Katia Fl\u00e1via","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Graduate Program in Pharmaceutical Sciences, Evangelical University of Goi\u00e1s, An\u00e1polis 75080-000, Brazil"},{"name":"Institute of Biological Sciences, Federal University of Goi\u00e1s, Goi\u00e1s 74605-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stone de","family":"S\u00e1","sequence":"additional","affiliation":[{"name":"Graduate Program in Pharmaceutical Sciences, Evangelical University of Goi\u00e1s, An\u00e1polis 75080-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9354-1460","authenticated-orcid":false,"given":"Pedro Augusto","family":"Inacio","sequence":"additional","affiliation":[{"name":"Graduate Program in Human Movement and Rehabilitation, Evangelical University of Goi\u00e1s, An\u00e1polis 75080-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2692-1548","authenticated-orcid":false,"given":"Irans\u00e9","family":"Oliveira-Silva","sequence":"additional","affiliation":[{"name":"Graduate Program in Human Movement and Rehabilitation, Evangelical University of Goi\u00e1s, An\u00e1polis 75080-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0488-5400","authenticated-orcid":false,"given":"Gustavo","family":"Pedrino","sequence":"additional","affiliation":[{"name":"Institute of Biological Sciences, Federal University of Goi\u00e1s, Goi\u00e1s 74605-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7285-2742","authenticated-orcid":false,"given":"Vicente","family":"Aprigliano","sequence":"additional","affiliation":[{"name":"Escuela de Ingenier\u00eda de Construcci\u00f3n y Transporte, Pontificia Universidad Cat\u00f3lica de Valpara\u00edso, Avda Brasil 2147, Valpara\u00edso 2362804, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0440-8404","authenticated-orcid":false,"given":"Gaspar R.","family":"Chiappa","sequence":"additional","affiliation":[{"name":"Graduate Program in Human Movement and Rehabilitation, Evangelical University of Goi\u00e1s, An\u00e1polis 75080-000, Brazil"},{"name":"Faculty of Health Sciences, Universidad Aut\u00f3noma de Chile, Providencia 7500912, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7440-7581","authenticated-orcid":false,"given":"James Oluwagbamigbe","family":"Fajemiroye","sequence":"additional","affiliation":[{"name":"Graduate Program in Pharmaceutical Sciences, Evangelical University of Goi\u00e1s, An\u00e1polis 75080-000, Brazil"},{"name":"Institute of Biological Sciences, Federal University of Goi\u00e1s, Goi\u00e1s 74605-010, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.nut.2015.09.003","article-title":"Clinical and metabolic response to probiotic administration in patients with major depressive disorder: A randomized, double-blind, placebo-controlled trial","volume":"32","author":"Akkasheh","year":"2016","journal-title":"Nutrition"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Del Toro-Barbosa, M., Hurtado-Romero, A., Garcia-Amezquita, L.E., and Garcia-Cayuela, T. 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