Microbiome and Schizophrenia: Current Evidence and Future Challenges

Purpose of Review This review aims to summarize the current evidence for the link between schizophrenia and alterations in the microbiome. Recent Findings Available data show microbiome alterations in patients with schizophrenia, especially in the gut microbiome compared with healthy individuals. Changes were observed in diversity, with associations noted between the microbiome and metabolic and immune pathways. However, results showed specific community structure patterns of the microbiome varied among patients with schizophrenia. The observed changes reflected disease-related processes (e.g., nicotine use), and also appeared to play a role in pathophysiology. Prebiotics and probiotics have been investigated as adjunctive strategies in the management of symptoms. Summary Future studies will need to control confounding factors, such as treatment, diet, and comorbidities in order to define primary (i.e., intrinsically implicated in schizophrenia pathophysiology) or secondary (e.g., to life habits) microbiome changes. Prebiotics and probiotics in clinical practice merit exploration, notably to investigate symptomatic dimensions or patient subgroups benefiting from them. This new area of investigation should prove valuable for management of patients, as well as advancing understanding of the biological basis of schizophrenia.