文献类型：期刊文献

英文题名：Efficacy of Sertraline Combined With Intestinal Microecological Therapy in Adolescents With Moderate Depression and Suicidal Ideation and Its Effects on Serum Inflammatory Factors

作者：Zhang, Lei[1];Zhao, Dongrong[2];Huang, Jiayu[3];Liu, Sha[1];Xu, Naihong[2]

第一作者：张雷;张磊

通信作者：Xu, NH[1]

机构：[1]Gansu Univ Chinese Med, Sch Clin Med 1, Lanzhou 730000, Gansu, Peoples R China;[2]Gansu Prov Hosp, Dept Mental Hlth, Lanzhou 730000, Gansu, Peoples R China;[3]Northwest Minzu Univ, Clin Med Coll 1, Lanzhou 730030, Gansu, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Prov Hosp, Dept Mental Hlth, Lanzhou 730000, Gansu, Peoples R China.

年份：2026

卷号：54

期号：1

起止页码：152

外文期刊名：ACTAS ESPANOLAS DE PSIQUIATRIA

收录：;WOS:【SCI-EXPANDED(收录号:WOS:001698384600013)】；

语种：英文

外文关键词：adolescent depression; suicidal ideation; sertraline; intestinal microecology; inflammatory factor; gut-brain axis

摘要：Background: Adolescents with moderate depression and suicidal ideation constitute a high-risk psychiatric population. Major depressive disorder with suicidal ideation in this age group is a disabling psychiatric disorder. Current selective serotonin reuptake inhibitor treatments are limited by their low efficacy rates (approximately 50%-60%) and delayed onset of action. Informed by the gut-brain axis theory, this study aimed to evaluate the synergistic efficacy and anti-inflammatory mechanisms of sertraline combined with a Bacillus subtilis probiotic preparation in this high-risk population. Methods: This retrospective cohort study included 160 adolescents meeting International Classification of Diseases 10th Revision diagnostic criteria were identified and categorised into either monotherapy (sertraline) or combination therapy (sertraline + probiotics) groups. Over a 12-week treatment period, clinical symptoms were assessed using the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and Beck Scale for Suicide Ideation-Chinese Version, and serum inflammatory factors, namely, interleukin-6 (IL-6), interleukin-1/3 (IL-1/3), tumour necrosis factor-cx (TNF-cx) and C-reactive protein (CRP) and peripheral blood inflammatory ratios, namely, platelet-to-lymphocyte, neutrophil-to-lymphocyte and monocyte-tolymphocyte ratios, were measured.Results: The proportion of patients with severe depression was significantly reduced in the combination group (1.25% vs. 7.5%, p = 0.004), and anxiety symptoms showed significant improvement (severe anxiety proportion: 1.25% vs. 11.25%, p = 0.008). Biomarker analysis revealed significantly reduced levels of IL-6 (p = 0.007), IL-1/3 (p = 0.002), TNF-cx (p = 0.005) and CRP (p = 0.001) in the combination group, and IL-6 and CRP showed strong positive correlations with depression scores (r = 0.35-0.39). Conclusions: This study confirms that modulating the intestinal smicroecology can enhance antidepressant efficacy by reducing neuroinflammation.