{"doi":"10.1111/bdi.13049","title":"Bipolar disorder and the gut microbiome: A systematic review","abstract":"OBJECTIVES: The microbiome is a rapidly advancing biomedical frontier with relevance for psychiatric illness. The gut microbiota interact with the central nervous system bidirectionally through the gut-brain axis and generate substances that may influence host metabolism, including short-chain fatty acids such as butyrate. Understanding gut microbiota in bipolar disorder (BD) may suggest new disease markers and treatment approaches. METHODS: A PubMed search was performed on January 7, 2020 using terms \"bipolar AND (microbiome OR microbiota)\", for articles in English in which the study population included a distinct BD group and the gut microbiota/microbiome was assessed. RESULTS: Thirteen articles met the inclusion criteria. In four of five studies that reported on group comparisons with respect to diversity, lower α-diversity was observed in BD relative to healthy controls (HC). The most convergent taxonomic finding was that in four studies, one particular clade distinguished gut microbiota between BD and HC: family Ruminococcaceae, genus Faecalibacterium, and species Faecalibacterium prausnitzii. Members of this clade, known for butyrate production, were reduced in BD relative to HC in three studies but elevated in a fourth. Additionally, genera Bacteroides or Bacteroides-Prevotella group species were elevated in BD in two studies but lower in a third. CONCLUSIONS: Despite few studies and modest sample sizes, salient findings suggest that low α-diversity and dysbiosis with respect to abundance of Faecalibacterium and Bacteroides may characterize BD in both a trait and state-dependent fashion. Decreased richness and butyrate production also foster inflammation, which may be a hitherto unrecognized part of the pathophysiology underlying BD.","journal":"Bipolar Disorders","year":2021,"id":154003,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":65,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.948,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":653063,"name":"Stephanie Cheung","orcid":"0000-0001-9796-2932","position":1,"is_corresponding":false},{"id":653064,"name":"Evan Lieberman","orcid":"0009-0003-1131-7759","position":2,"is_corresponding":false},{"id":37244,"name":"Shaohua Hu","orcid":"0000-0003-0570-670X","position":3,"is_corresponding":false},{"id":6272,"name":"J. John Mann","orcid":"0000-0002-0265-6586","position":4,"is_corresponding":false},{"id":246804,"name":"Anne‐Catrin Uhlemann","orcid":"0000-0002-9798-4768","position":5,"is_corresponding":false},{"id":372305,"name":"Jeffrey M. Miller","orcid":"0000-0002-2206-9311","position":6,"is_corresponding":false},{"id":372306,"name":"M. Elizabeth Sublette","orcid":"0000-0001-7378-4262","position":0,"is_corresponding":true}],"reference_count":87,"raw_metadata":null,"created_at":"2026-07-18T23:43:49.684414Z","pmid":"33512753","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}