Association of Depressed Mood With Herpes Simplex Virus-2 Immunoglobulin-G Levels in Pregnancy.

OBJECTIVE: Depressed mood is common in pregnancy, is associated with stress, and could result in immune suppression that may lead to latent herpes viral reactivation. This study investigated whether depressed mood is associated with higher herpes viral IgG levels in pregnant women. METHODS: Complete cross-sectional data from 247 pregnant women were available for this substudy. The data included demographics, scores on the Perceived Stress Scale and Profile of Mood States (POMS), and a panel of serum IgG levels for human herpesviruses. RESULTS: Only the herpes simplex virus type 2 (HSV-2) (genital herpes) IgG level was associated with Perceived Stress Scale and POMS-Depression/Dejection (POMS-D) score. Hierarchical multiple regression analysis was used to examine the association of POMS-D with herpesviral IgG levels adjusting for demographic variables. In the final model, African American race (ß = .251, p < .001), older age (ß = .199, p = .002), single marital status (ß = -.304, p < .001), and depressed mood (ß = .122, p = .04) were associated with HSV-2 IgG levels. In logistic regression, the strongest correlates of HSV IgG positivity were single marital status, followed by POMS-D scores and African American race. CONCLUSION: Genital herpes is a concern in pregnancy. Antibody titers may indicate asymptomatic viral shedding, viral reactivation, or primary viral infection. Antibody levels may be higher because of the immune changes during pregnancy and potential immune effects of depressed mood causing reactivation of latent HSV-2.

New findings: depression, suicide, and Toxoplasma gondii infection.

PURPOSE: This article provides an overview of the evidence of a potential pathophysiological relationship between depression, suicide, and the Toxoplasma gondii (T. gondii) infection. It discusses the role of inflammatory processes in depressive illness and the infection theory of psychiatric disease. It also provides guidelines for the screening, diagnosis, and treatment of depression for nurse practitioners (NPs). DATA SOURCE: A narrative review was conducted of the literature from PubMed, PsycINFO, and Google Scholar. References of identified articles were also reviewed. CONCLUSIONS: Seropositivity of the obligate intracellular protozoan parasite, T. gondii is related to various mental health disorders including schizophrenia, suicide attempt, depression, and other neuropsychiatric diseases. Depressive symptoms have been linked to interferon-γ (IFN-γ) blocking T. gondii growth by inducing indoleamine-2,3-dioxygenase (IDO) activation and tryptophan depletion, which results in a decrease of serotonin production in the brain. Although exposure to T. gondii was considered unlikely to reactivate in immune-competent individuals, new findings report that this reactivation may be triggered by immune imbalance. IMPLICATIONS FOR PRACTICE: NPs caring for patients with psychiatric illness need to understand the potential mechanisms associated with depression and the T. gondii infection in order to provide effective screening, treatment, and disease prevention.