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Microbiota matters: a cross-sectional study protocol for mapping gut microbiome diversity in Malaysian major depressive disorder cases

Zuraifah Asrah Mohamad, S. K. Bakon, Nur Fatihah Sholehah Zakaria, Nur Faizzatul Akma Mas'ud, M. Johari, N. H. Ma'amor, Norni Abdullah, N. Chemi et al.

BMJ Open, 2026

Abstract

Introduction Mental health is now recognised as a major global concern affecting people from diverse backgrounds. There is growing evidence that the gut microbiota plays a crucial role by producing metabolites that significantly influence a person’s mood and behaviour. Despite its importance, there is a significant gap in the profiling and understanding of the gut microbiota’s influence on mental health among Malaysians. Therefore, this study aims to determine gut microbiome profiles among patients with major depressive disorders (MDD) of different treatment groups attending psychiatric clinics in the state hospitals and compare them to healthy individuals in the community of Klang Valley, Malaysia. Methods and analysis This cross-sectional study will be carried out in Klang Valley, Malaysia. Eligibility of the patients will be assessed by the psychiatrists prior to recruitment of patients. Patients with MDD will be categorised into monotherapy and polypharmacy while healthy individuals will be used as a comparison group. Demographic data will be recorded. Stool samples will be subjected to DNA extraction and 16S rRNA gene-sequencing analysis to determine the microbial compositions of the gut microbiome. Ethics and dissemination This study will be conducted following the procedure set by the National Medical Research Register Malaysia. The Medical Research Ethics Committee (MREC), Ministry of Health Malaysia, has ratified this study and granted ethical approval to conduct…

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