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Beyond the association. T oxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta‐analysis
Author(s) -
Sutterland A. L.,
Fond G.,
Kuin A.,
Koeter M. W. J.,
Lutter R.,
Gool T.,
Yolken R.,
Szoke A.,
Leboyer M.,
Haan L.
Publication year - 2015
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12423
Subject(s) - meta analysis , schizophrenia (object oriented programming) , bipolar disorder , psychiatry , depression (economics) , toxoplasma gondii , odds ratio , mania , addiction , psychology , medicine , publication bias , clinical psychology , immunology , cognition , antibody , economics , macroeconomics
Objective To perform a meta‐analysis on studies reporting prevalence of T oxoplasma gondii ( T . gondii ) infection in any psychiatric disorder compared with healthy controls. Our secondary objective was to analyze factors possibly moderating heterogeneity. Method 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. Results A total of 2866 citations were retrieved and 50 studies finally included. Significant odds ratios ( OR s) with I g G 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 I g M 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. Conclusion 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.