<i>Toxoplasma gondii</i> infection and chronic schizophrenia: is there any association?

Campos-Carli, Salvina Maria de; Vieira, Érica Leandro Marciano; Rocha, Natalia Pessoa; Oliveira, Keliane de; Guimarães, Fernanda Carneiro; Barbosa, Izabela Guimarães; Barros, João Luís Vieira Monteiro de; Okusaga, Olaoluwa; Martins-Filho, Olindo Assis; Salgado, João Vinícius; Teixeira, Antônio Lúcio

doi:10.1590/0101-60830000000140

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Archives of Clinical Psychiatry (São Paulo)

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Original Article • Arc. Clin. Psychiatr. 44 (6) • Nov-Dec 2017 • https://doi.org/10.1590/0101-60830000000140 copy

Toxoplasma gondii infection and chronic schizophrenia: is there any association?

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Background:

Toxoplasma gondii (T. gondii) infection has been identified as a risk factor for schizophrenia.

Objectives:

Herein, we sought to evaluate the association between T. gondii infection and clinical symptoms and quality of life in patients with schizophrenia.

Methods:

We conducted a cross-sectional study with 48 patients with chronic schizophrenia and 40 controls. Peripheral blood was drawn, and IgM and IgG anti-T. gondii antibodies were evaluated by Enzyme-Linked Immunosorbent Assay (ELISA). Depressive, positive and negative symptoms were assessed, respectively, by the Calgary Depression Scale (CDS) and the Positive and Negative Syndrome Scale (PANSS). Cognitive performance was assessed in patients by the Brazilian version of the Schizophrenia Cognition Rating Scale (SCoRS-BR). Quality of life was assessed by the Brazilian version of the Quality of Life in Schizophrenia scale (QLS-BR).

Results:

The prevalence and titers of T. gondii IgM and IgG antibodies did not differ between patients and controls. The positive serology for T. gondii IgG antibodies was not associated with illness symptoms, cognitive performance, depressive symptoms or quality of life.

Discussion:

Our findings suggest that toxoplasmosis infection is not associated with severity of symptoms, quality of life, cognitive or depressive symptoms in schizophrenia patients.

Keywords:
Toxoplasma gondii; schizophrenia; cognition; depression; quality of life

		Controls (N = 40)	Patients SZ (N = 48)	p values
Male gender [frequency in % (N)]		42.50 (17)	56.25 (27)	0.284^a a Fisher's exact test;
Age in years (mean ±SD)		40.62 ± 10.29	40.21 ± 9.59	0.845^b b Student's t test;
Educational levels in years (mean ±SD)		12.25 ± 4.77	8.04 ± 4.25	< 0.001^c c Mann-Whitney test;
Age of onset in years (mean ±SD)		_	24.58 ± 9.91	_
Length of illness in years (mean ±SD)		_	15.20 ± 10.50	_
Medication in use [frequency in % (N)]
	Potent typical antipsychotics	_	60.86 (28)	_
	Sedatives typical antipsychotics	_	39.13 (18)	_
	Atypical antipsychotics	_	34.78 (16)	_
	Clozapine	_	4.34 (2)	_
	Mood stabilizers	_	8.69 (4)	_
	Antidepressants	_	6.52 (3)	_
Chlorpromazine equivalent (mean ±SD)		_	351.74 ± 232.29	_
Preview electroconvulsive therapy [frequency in % (N)]		_	8.33 (4)	_
PANSS (mean ±SD)
	Positive	_	10.28 ± 2.78	_
	Negative	_	19.67 ± 7.73	_
	General	_	26.22 ± 7.27	_
	Total	_	56.55 ± 12.07	_
CDS (mean ±SD)		_	1.95 ± 2.54	_
SCoRS-BR (mean ±SD)
	SCoRS-BR patient	_	37.48 ± 11.12	_
	SCoRS-BR informant	_	36.59 ± 10.40	_
	SCoRS-BR interviewer	_	40.49 ± 11.38	_
	SCoRS-BR global	_	5.64 ± 1.58	_
QLS-BR total /126 (mean ±SD)		_	54.41 ± 24.76	_
Positive IgM antiboties anti-T. gondii (%) (N)		7.50 (3)	4.17 (2)	0.656^a a Fisher's exact test;
Positive IgG antibodies anti-T. gondii (%) (N)		56.41 (22)^d d One individual presented indeterminate results for IgG.	56.25 (27)	1.000^a a Fisher's exact test;
IgM IU/mL (mean ± SD)		130.67 ± 114.82	121.31 ± 97.99	0.630^c c Mann-Whitney test;
IgG IU/mL (mean ± SD)		115.59 ± 166.53	127.58 ± 218.12	0.785^c c Mann-Whitney test;

		Seronegative (N = 21)	Seropositive (N = 27)	p value
Male gender [frequency in % (N)]		66.67 (14)	48.15 (13)	0.249^a a Fisher's exact test;
Age in years (mean ±SD)		39.71 ± 10.10	40.59 ± 9.35	0.757^b b Student's t test;
Educational level in years (mean ±SD)		8.10 ± 4.81	8.00 ± 3.86	0.940^b b Student's t test;
Age of onset in years (mean ±SD)		23.25 ± 9.81	25.61 ± 10.04	0.428^b b Student's t test;
Length of illness in years (mean ±SD)		15.94 ± 11.19	14.69 ± 10.37	0.715^b b Student's t test;
Chlorpromazine equivalent (mean ±SD)		375.78 ± 233.31	333.71 ± 234.49	0.637^c c Mann-Whitney test.
PANSS (mean ±SD)
	Positive	10.67 ± 2.82	9.96 ± 2.76	0.306^c c Mann-Whitney test.
	Negative	21.24 ± 7.97	18.36 ± 7.41	0.212^b b Student's t test;
	General	28.05 ± 6.49	24.76 ± 7.66	0.133^b b Student's t test;
	Total	58.50 ± 11.75	54.77 ± 12.35	0.324^b b Student's t test;
CDS (mean ±SD)		1.81 ± 2.31	2.04 ± 2.72	0.777^c c Mann-Whitney test.
SCoRS-BR (mean ±SD)
	SCoRS-BR patient	35.70 ± 9.19	38.85 ± 12.40	0.431^c c Mann-Whitney test.
	SCoRS-BR informant	32.65 ± 6.57	39.64 ± 11.86	0.072^c c Mann-Whitney test.
	SCoRS-BR interviewer	36.71 ± 7.65	43.41 ± 13.01	0.124^c c Mann-Whitney test.
	SCoRS-BR global	5.27 ± 1.07	5.95 ± 1.88	0.591^b b Student's t test;
QLS-BR total/126 (mean ±SD)		60.65 ± 25.76	49.10 ± 23.20	0.160^b b Student's t test;

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[1] Address for correspondence: Antônio Lúcio Teixeira. Department of Psychiatry and Behavioral Sciences. The University of Texas Health Science Center at Houston 1941 East Road, Houston, TX 77054, USA. BBSB 3140. Telephone: +1 71 486-2555. Email: Antonio.L.Teixeira@uth.tmc.edu