Cited by 158Gut microbiota and healthGastrointestinal motility and disordersProbiotics and Fermented Foods

Psychological comorbidity in gastrointestinal diseases: Update on the brain-gut-microbiome axis

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Person, Hannibal, Keefer, Laurie·2021·Progress in Neuro-Psychopharmacology and Biological Psychiatry

Abstract

The high comorbidity of psychological disorders in both functional and organic gastrointestinal diseases suggests the intimate and complex link between the brain and the gut. Termed the brain-gut axis, this bidirectional communication between the central nervous system and enteric nervous system relies on immune, endocrine, neural, and metabolic pathways. There is increasing evidence that the gut microbiome is a key part of this system, and dysregulation of the brain-gut-microbiome axis (BGMA) has been implicated in disorders of brain-gut interaction, including irritable bowel syndrome, and in neuropsychiatric disorders, including depression, Alzheimer's disease, and autism spectrum disorder. Further, alterations in the gut microbiome have been implicated in the pathogenesis of organic gastrointestinal diseases, including inflammatory bowel disease. The BGMA is an attractive therapeutic target, as using prebiotics, probiotics, or postbiotics to modify the gut microbiome or mimic gut microbial signals could provide novel treatment options to address these debilitating diseases. However, despite significant advancements in our understanding of the BGMA, clinical data is lacking. In this article, we will review current understanding of the comorbidity of gastrointestinal diseases and psychological disorders. We will also review the current evidence supporting the key role of the BGMA in this pathology. Finally, we will discuss the clinical implications of the BGMA in the evaluation and management of psychological and gastrointestinal disorders.

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  • Gastrointestinal disorders such as IBD and IBS are frequently accompanied by persistent psychiatric comorbidities.

    “Furthermore, gastrointestinal disorders such as IBD and IBS are frequently accompanied by persistent psychiatric comorbidities[6], [7], reinforcing the need for an integrated perspective in investigating these interconnected systems. [8].”

    From The hidden genetic and microbial networks connecting neuropsychiatric and digestive disorders (2025) · cites this paper as [7]

    The Introduction describes significant, persistent psychological comorbidity in organic gastrointestinal disorders, including IBD. The Irritable bowel syndrome section reports frequent comorbidity with depression and anxiety, but does not establish that those comorbidities are persistent in IBS. Page numbers are unavailable in our copy. (LLM, conf=0.85)

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  1. Garland EL, Gaylord SA, Palsson O, Faurot K, Douglas Mann J, Whitehead WE, 2012b. Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations. J Behav Med 35 (6), 591– 602. 10.1007/s10865-011-9391-z. 22161025 PMC3883954 · DOI · Paper page

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Authors
Person, H., & Keefer, L.
Affiliations
Icahn School of Medicine at Mount Sinai (US)
Corresponding author
Person, Hannibal
Venue
Progress in Neuro-Psychopharmacology and Biological Psychiatry
Publisher
Elsevier BV
Published
2021-04
Volume
107
Pages
110209
ISSN
0278-5846 (ISSN-L)
OpenAlex
W3111424608
Cited by
158
References
229
Citations by year
2026: 31 · 2025: 52 · 2024: 28 · 2023: 23 · 2022: 19 · 2021: 5
FWCI
1.12
Type
journal article
Language
en
Open access
Locations
  • Progress in Neuro-Psychopharmacology and Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (TL1TR001434)
  • National Center for Advancing Translational Sciences
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
Keywords
gut-brain axis, psychological comorbidity, gastrointestinal diseases, irritable bowel syndrome, depression, Alzheimer's disease, autism spectrum disorder, inflammatory bowel disease, enteric nervous system, prebiotics, probiotics, postbiotics, gut dysbiosis
MeSH terms
Gastrointestinal Microbiome, Brain-Gut Axis, Mental Disorders, Brain, Gastrointestinal Diseases, Humans, Comorbidity, Enteric Nervous System, Probiotics, Irritable Bowel Syndrome, Prebiotics

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