TY - JOUR
T1 - Meta-Analysis of Anti-Toxoplasma gondii IgM Antibodies in Acute Psychosis
AU - Monroe, Joel M.
AU - Buckley, Peter F.
AU - Miller, Brian J.
N1 - Publisher Copyright:
© 2014 The Author 2014. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Introduction: A number of different infections are associated with acute psychosis. However, relationships between infections and acute psychosis in patients with schizophrenia have not been extensively explored. Exposure to Toxoplasma gondii is a replicated risk factor for schizophrenia. Previous studies have focused on T. gondii IgG antibodies, which are a marker of lifetime exposure, whereas IgM antibodies are a marker of acute/recent exposure, persistent infection, or reinfection. We performed a meta-analysis of T. gondii IgM antibodies and acute psychosis, to further investigate whether infections may be associated with relapse in schizophrenia. Methods: We identified articles by systematic searches of PubMed, PsycINFO, and ISI databases. We included studies, in English, of serum T. gondii IgM antibodies in patients with acute psychosis and controls. Results: Sixteen independent samples (2353 patients and 1707 controls) met inclusion criteria. Data were pooled using a random effects model. There was a significant increase in risk of positive T. gondii IgM antibodies in acute psychosis compared with controls (7.6% vs 5.7%, OR = 1.68, 95% CI = 1.23-2.27, P =. 001). The association was stronger for patients with chronic schizophrenia (8.7% vs 4.6%, OR = 2.54, 95% CI = 1.63-3.96, P <. 001) than first-episode psychosis. In meta-regression analyses, age, sex, and publication year were unrelated to the association; however, there was a significant association with geographic region. Discussion: An increased seroprevalence of T. gondii IgM in patients with acute psychosis complements and extends previous findings, suggesting that infections may be relevant to the etiopathophysiology of relapse in some patients with schizophrenia.
AB - Introduction: A number of different infections are associated with acute psychosis. However, relationships between infections and acute psychosis in patients with schizophrenia have not been extensively explored. Exposure to Toxoplasma gondii is a replicated risk factor for schizophrenia. Previous studies have focused on T. gondii IgG antibodies, which are a marker of lifetime exposure, whereas IgM antibodies are a marker of acute/recent exposure, persistent infection, or reinfection. We performed a meta-analysis of T. gondii IgM antibodies and acute psychosis, to further investigate whether infections may be associated with relapse in schizophrenia. Methods: We identified articles by systematic searches of PubMed, PsycINFO, and ISI databases. We included studies, in English, of serum T. gondii IgM antibodies in patients with acute psychosis and controls. Results: Sixteen independent samples (2353 patients and 1707 controls) met inclusion criteria. Data were pooled using a random effects model. There was a significant increase in risk of positive T. gondii IgM antibodies in acute psychosis compared with controls (7.6% vs 5.7%, OR = 1.68, 95% CI = 1.23-2.27, P =. 001). The association was stronger for patients with chronic schizophrenia (8.7% vs 4.6%, OR = 2.54, 95% CI = 1.63-3.96, P <. 001) than first-episode psychosis. In meta-regression analyses, age, sex, and publication year were unrelated to the association; however, there was a significant association with geographic region. Discussion: An increased seroprevalence of T. gondii IgM in patients with acute psychosis complements and extends previous findings, suggesting that infections may be relevant to the etiopathophysiology of relapse in some patients with schizophrenia.
KW - infection
KW - meta-analysis
KW - psychosis
KW - relapse
KW - toxoplasmosis
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U2 - 10.1093/schbul/sbu159
DO - 10.1093/schbul/sbu159
M3 - Article
C2 - 25385789
AN - SCOPUS:84936745168
SN - 0586-7614
VL - 41
SP - 989
EP - 998
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
IS - 4
ER -