Research by Amsterdam UMC, the University of Amsterdam and Erasmus MC has delivered the most extensive evidence to date of a relationship between the composition of the microbiome and instances of depression.


This composition also plays a role in the differing rates of depression across different ethnic groups. These studies, based partly on data from the HELIUS study, appear as a double publication in Nature Communications

 The microbiome is necessary for optimal physical functioning; for example, through the production of essential nutrients and protection against pathogens. Disturbances in the microbiome increase the risk of numerous diseases. For example, there is increasing evidence that various brain diseases are also related to disturbances in the microbiome.

These results come from the most extensive study into the relationship between the microbiome and depression, involving 3,211 participants from the HELIUS study, led by Professor Max Nieuwdorp. 

A microbiome containing less diverse bacteria, or in which certain bacterial species are underrepresented, was associated with having depression or more depressive symptoms. This association was as strong as established risk factors for depression such as smoking, alcohol consumption, a lack of exercise and being overweight. Influencing the microbiome may therefore be hugely relevant for the treatment of depression.

“Now that we know which disturbances in the microbiome are significant for depression, this opens up new possibilities for treatment and prevention, which is urgently needed,” says Anja Lok, psychiatrist and researcher at the Department of Psychiatry at Amsterdam UMC.

Ethnic differences

Previous research from the HELIUS study has illustrated ethnic differences in both the composition of the microbiome and the occurrence of depression. 

Researcher Jos Bosch from the University of Amsterdam’s Department of Psychology says: “The substantial ethnic differences in depression do indeed appear to be related to ethnic differences in the microbiome. We don’t know exactly why this is yet. This association was not caused by differences in lifestyle such as smoking, drinking, weight or exercise, and merits further investigation. For example, diet could play a role.”

This is the first study to show that the disparity in depression between population groups is related to the composition of the microbiome.

It is important to determine whether the relationships found between the microbiome and depression can be confirmed by other studies. In the second article in Nature Communications, by researchers from Erasmus MC, the data from the HELIUS study and ERGO study were compared.

This comparison confirmed a consistent association between twelve groups of bacteria and the occurrence of depression, and offered an explanation: the twelve bacterial groups produce substances such as glutamate, butyrate, serotonin and gamma amino butyric acid. These so-called ‘neurotransmitters’ play an important role in depression.

“These results therefore clearly provide direction for future research into possible treatments, such as the use of probiotics, prebiotics and synbiotics or faecal microbiota transplantation as well as changes to lifestyle and diet,” says Anja Lok.

Amsterdam UMC and the GGD Amsterdam started the HELIUS (Healthy Life in an Urban Setting) study in 2010 and is a prospective cohort of 23,000 people. The aim of the study is to gain insight into health differences among Amsterdammers with a multi-ethnic background in an urban environment.

HELIUS looks at the common chronic conditions: heart disease, infectious diseases and mental disorders. The knowledge generated by the HELIUS research helps to better tackle health problems and improve medical care.

ERGO (Erasmus Rotterdam Health Research) is a long-term population study by Erasmus MC among nearly 20,000 people aged 40 and older in the Ommoord district of Rotterdam. The study investigates health problems that are common in old age.