Pilot study of gut microbiome composition and outcomes to interpersonal psychotherapy treatment for depression among adults in Uganda

This project is a pilot study investigating the relationship between gut microbiome composition and clinical outcomes following interpersonal psychotherapy (IPT) for depression among adults in Uganda. The study aims to explore whether variations in gut microbial communities are associated with differential symptom response to a culturally adapted, evidence-based psychotherapeutic intervention. As a pilot, the work will establish feasibility, acceptability, and preliminary signals of biological-behavioral associations that could justify larger, more definitive trials. The study builds on an interdisciplinary perspective that situates depression as a multidimensional condition influenced by psychosocial, behavioral, and biological factors. By examining the gut microbiome in the context of a psychosocial treatment, the project seeks to bridge mental health research with emerging microbiome science, opening pathways to mechanistic insights and potential adjunctive interventions that target the microbiota to enhance psychotherapy outcomes.

The research is situated in Uganda, where culturally appropriate delivery of interpersonal psychotherapy will be matched with rigorous biological sampling and clinical measurement. The pilot design emphasizes community engagement and adaptation to local contexts, ensuring that IPT delivery aligns with local linguistic, cultural and health-system realities. Clinical outcomes will focus on standard measures of depressive symptom severity and functioning appropriate for the study population, while microbiome assessment will characterize gut microbial taxa and their relative abundances using accepted sequencing approaches. The project will examine associations between baseline microbiome profiles and subsequent treatment response, as well as any shifts in microbial composition that coincide with clinical improvement or nonresponse. These analyses aim to identify candidate microbial signatures that correlate with resilience, vulnerability, or modulation of treatment effects.

As pilot work, the study will inform methodological considerations for future research: optimal sampling strategies, timing of biospecimen collection relative to psychotherapy sessions, logistics for cold-chain and laboratory processing in low-resource settings, and culturally informed consent procedures for biological research. The investigation will also assess the acceptability of microbiome sampling among participants receiving mental health services and document any operational challenges encountered in integrating biological data collection into psychotherapy research in Uganda. Findings will be used to refine hypotheses about biological mechanisms—such as inflammatory, metabolic, or neuroactive microbial metabolites—that could mediate psychotherapy response, but the pilot will deliberately focus on descriptive and correlational evidence rather than causal claims.

Ultimately, this pilot aims to lay foundational evidence for interdisciplinary, globally relevant research linking mental health treatments and the microbiome. If promising associations are observed, subsequent studies could evaluate whether microbiome-informed approaches enhance personalized treatment selection or whether adjunctive strategies (dietary, probiotic or other microbiota-targeted interventions) might augment psychotherapy outcomes.