RESUMO
BACKGROUND: Infections during fetal life or neonatal period, including infections with Toxoplasma gondii, may be associated with a risk for schizophrenia and other mental disorders. The objectives of this study were to study the association between serological markers for maternal and neonatal infection and the risk for schizophrenia, related psychoses, and affective disorders in a national cohort of newborns. METHODS: This study was a cohort-based, case-control study combining data from national population registers and patient registers and a national neonatal screening biobank in Denmark. Patients included persons born in Denmark in 1981 or later followed up through 1999 with respect to inpatient or outpatient treatment for schizophrenia or related disorders (ICD-10 F2) or affective disorders (ICD-10 F3). RESULTS: Toxoplasma gondii immunoglobulin G (IgG) levels corresponding to the upper quartile among control subjects were significantly associated with schizophrenia risk (odds ratio [OR] = 1.79, p = .045) after adjustment for urbanicity of place of birth, year of birth, gender, and psychiatric diagnoses among first-degree relatives. There was no significant association between any marker of infection and other schizophrenia-like disorders or affective disorders. CONCLUSIONS: Our study supports an association between Toxoplasma gondii and early-onset schizophrenia. Further studies are needed to establish if the association is causal and if it generalizes to cases with onset after age 18.
Assuntos
Anticorpos Antiprotozoários/sangue , Complicações Parasitárias na Gravidez , Esquizofrenia/sangue , Esquizofrenia/microbiologia , Toxoplasma/imunologia , Animais , Estudos de Casos e Controles , Estudos de Coortes , Planejamento em Saúde Comunitária , Intervalos de Confiança , Dinamarca/epidemiologia , Feminino , Humanos , Recém-Nascido , Masculino , Transtornos do Humor/sangue , Transtornos do Humor/mortalidade , Triagem Neonatal , Gravidez , Estudos Retrospectivos , Fatores de Risco , Esquizofrenia/epidemiologiaRESUMO
Early exposure to several infectious agents has been associated with the later development of schizophrenia. Two recent studies assessed in utero or early postnatal exposure to Toxoplasma gondii. In one study of 63 individuals, who developed schizophrenia spectrum disorders, maternal sera obtained during pregnancy showed an increased risk (OR 2.61) of having IgG antibodies to T. gondii. In the other study of 71 individuals who developed schizophrenia, sera obtained shortly after birth also showed an increased risk (OR 1.79) of having IgG antibodies to T. gondii. Causal linking mechanisms are at present speculative but include possible direct effects of maternal IgG on the developing central nervous system (CNS) of the offspring. Additional studies are underway.