Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis
Version of Record online: 15 APR 2015
© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Acta Psychiatrica Scandinavica
Special Issue: Immuno-inflammation in bipolar disorder and suicidal behaviour
Volume 132, Issue 3, pages 161–179, September 2015
How to Cite
Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis., , , , , , , , , .
- Issue online: 8 AUG 2015
- Version of Record online: 15 APR 2015
- Manuscript Accepted: 17 MAR 2015
- Assistance publique–Hopitaux de Paris
- RTRS Sante Mentale (Fondation Fondamental)
- Agence Nationale Pour la Recherche. Grant Numbers: ANR-11-IDEX-0004-02, ANR-10-COHO-10-01
- bipolar disorder;
- substance abuse disorder;
- Toxoplasma gondii
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.
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.
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.
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.