Psychiatry is evolving. There are key turning points in how we have conceptualised and managed illness. History looks back at the work of Freud (psychotherapy), Cade (mood stabilisers) and Charpentier (antipsychotics) as such landmarks. This century may well be one that marks advances in our understanding of illness and health in ways that go further. This book looks at one such development, making a compelling case for the gut as the ‘second brain’, and therefore a target for optimising health and managing illness.

Scott Anderson, a science journalist from Ohio has compiled this fascinating manuscript alongside two frontline doctor-scientists, John Cryan and Ted Dinan who are the principal investigators for the Alimentary Pharmabiotic Centre at University College Cork.

The book begins with an introduction to the microbiome and proceeds to describe how the gut microbiome evolves through the cycle of human life. A journey through the alimentary canal is followed by a chapter on the Gut-Brain axis and thereafter the development of ‘psychobiotics’ (a team coined by Dinan). The final, thought provoking part of the book brings together the evidence for psychobiotic led modulation of responses to stress as well as a role for psychobiotics in illnesses such as depression and anxiety. An analysis of commonly available psychobiotics including those found in supermarkets is followed by a balanced position on the state of science as it is now and its potential limitations.

Anderson’s writing style is informal, logical and persuasive particularly where supported by findings of frontline research by Cryan and Dinan, which appears in italics throughout the text. Research findings from models including germ free studies, infective models, probiotic and antibiotic studies as well as faecal transplantation studies are used to support theoretical assertions.

The book can be read by anyone, with no prior knowledge of psychiatry or microbiology although a background in medicine did make reading much easier. Complex microbiological, anatomical and genetic concepts are simplified for the lay reader.

The promise of a future with biologically plausible interventions that may improve mental health with little associated stigma and potentially without side effects makes the subject matter of this book most appealing to a practising psychiatrist. Although the book clearly states that this is a developing field, reading it will likely change the way you think about the gut, the brain and simple interventions that may well make a difference to patients.

Conflicts of Interest

G.G. is a Clinical Senior Lecturer at University College Cork. D.M. has no conflicts of interest to declare.