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Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis.

Abstract

OBJECTIVE

To perform a meta-analysis on studies reporting prevalence of Toxoplasma gondii (T. gondii) infection in any psychiatric disorder compared with healthy controls. Our secondary objective was to analyze factors possibly moderating heterogeneity.

METHOD

A systematic search was performed to identify studies into T. gondii infection for all major psychiatric disorders versus healthy controls. Methodological quality, publication bias, and possible moderators were assessed.

RESULTS

A total of 2866 citations were retrieved and 50 studies finally included. Significant odds ratios (ORs) with IgG antibodies were found in schizophrenia (OR 1.81, P < 0.00001), bipolar disorder (OR 1.52, P = 0.02), obsessive-compulsive disorder (OR 3.4, P < 0.001), and addiction (OR 1.91, P < 0.00001), but not for major depression (OR 1.21, P = 0.28). Exploration of the association between T. gondii and schizophrenia yielded a significant effect of seropositivity before onset and serointensity, but not IgM antibodies or gender. The amplitude of the OR was influenced by region and general seroprevalence. Moderators together accounted for 56% of the observed variance in study effects. After controlling for publication bias, the adjusted OR (1.43) in schizophrenia remained significant.

CONCLUSION

These findings suggest that T. gondii infection is associated with several psychiatric disorders and that in schizophrenia reactivation of latent T. gondii infection may occur.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Psychiatry, Academic Medical Centre (AMC), Amsterdam, the Netherlands.

    ,

    AP-HP, DHU Pe-PSY, Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15 Psychiatrie Translationnelle, Université Paris Est-Créteil, Créteil, France. Fondation Fondamental, Créteil, France.

    ,

    Department of Psychiatry, Academic Medical Centre (AMC), Amsterdam, the Netherlands.

    ,

    Department of Psychiatry, Academic Medical Centre (AMC), Amsterdam, the Netherlands.

    ,

    Departments of Experimental Immunology and Respiratory Medicine, Academic Medical Centre (AMC), Amsterdam, the Netherlands.

    ,

    Department of Parasitology, Academic Medical Centre (AMC), Amsterdam, the Netherlands.

    ,

    Stanley Neurovirology Laboratory, Johns Hopkins School of Medicine, Baltimore, MD, USA.

    ,

    AP-HP, DHU Pe-PSY, Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15 Psychiatrie Translationnelle, Université Paris Est-Créteil, Créteil, France. Fondation Fondamental, Créteil, France.

    ,

    AP-HP, DHU Pe-PSY, Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15 Psychiatrie Translationnelle, Université Paris Est-Créteil, Créteil, France. Fondation Fondamental, Créteil, France.

    Department of Psychiatry, Academic Medical Centre (AMC), Amsterdam, the Netherlands.

    Source

    Acta psychiatrica Scandinavica 132:3 2015 Sep pg 161-79

    MeSH

    Behavior, Addictive
    Bipolar Disorder
    Case-Control Studies
    Depressive Disorder, Major
    Humans
    Obsessive-Compulsive Disorder
    Schizophrenia
    Substance-Related Disorders
    Toxoplasma
    Toxoplasmosis

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    25877655

    Citation

    Sutterland, A L., et al. "Beyond the Association. Toxoplasma Gondii in Schizophrenia, Bipolar Disorder, and Addiction: Systematic Review and Meta-analysis." Acta Psychiatrica Scandinavica, vol. 132, no. 3, 2015, pp. 161-79.
    Sutterland AL, Fond G, Kuin A, et al. Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis. Acta Psychiatr Scand. 2015;132(3):161-79.
    Sutterland, A. L., Fond, G., Kuin, A., Koeter, M. W., Lutter, R., van Gool, T., ... de Haan, L. (2015). Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 132(3), pp. 161-79. doi:10.1111/acps.12423.
    Sutterland AL, et al. Beyond the Association. Toxoplasma Gondii in Schizophrenia, Bipolar Disorder, and Addiction: Systematic Review and Meta-analysis. Acta Psychiatr Scand. 2015;132(3):161-79. PubMed PMID: 25877655.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis. AU - Sutterland,A L, AU - Fond,G, AU - Kuin,A, AU - Koeter,M W J, AU - Lutter,R, AU - van Gool,T, AU - Yolken,R, AU - Szoke,A, AU - Leboyer,M, AU - de Haan,L, Y1 - 2015/04/15/ PY - 2015/03/17/accepted PY - 2015/4/17/entrez PY - 2015/4/17/pubmed PY - 2016/5/11/medline KW - Toxoplasma gondii KW - bipolar disorder KW - meta-analysis KW - schizophrenia KW - substance abuse disorder SP - 161 EP - 79 JF - Acta psychiatrica Scandinavica JO - Acta Psychiatr Scand VL - 132 IS - 3 N2 - OBJECTIVE: To perform a meta-analysis on studies reporting prevalence of Toxoplasma gondii (T. gondii) infection in any psychiatric disorder compared with healthy controls. Our secondary objective was to analyze factors possibly moderating heterogeneity. METHOD: A systematic search was performed to identify studies into T. gondii infection for all major psychiatric disorders versus healthy controls. Methodological quality, publication bias, and possible moderators were assessed. RESULTS: A total of 2866 citations were retrieved and 50 studies finally included. Significant odds ratios (ORs) with IgG antibodies were found in schizophrenia (OR 1.81, P < 0.00001), bipolar disorder (OR 1.52, P = 0.02), obsessive-compulsive disorder (OR 3.4, P < 0.001), and addiction (OR 1.91, P < 0.00001), but not for major depression (OR 1.21, P = 0.28). Exploration of the association between T. gondii and schizophrenia yielded a significant effect of seropositivity before onset and serointensity, but not IgM antibodies or gender. The amplitude of the OR was influenced by region and general seroprevalence. Moderators together accounted for 56% of the observed variance in study effects. After controlling for publication bias, the adjusted OR (1.43) in schizophrenia remained significant. CONCLUSION: These findings suggest that T. gondii infection is associated with several psychiatric disorders and that in schizophrenia reactivation of latent T. gondii infection may occur. SN - 1600-0447 UR - https://www.unboundmedicine.com/medline/citation/25877655/full_citation L2 - https://doi.org/10.1111/acps.12423 DB - PRIME DP - Unbound Medicine ER -