Meta-Analysis of Anti-Toxoplasma gondii IgM Antibodies in Acute Psychosis

Joel M. Monroe, Peter F Buckley, Brian J Miller

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)989-998
Number of pages10
JournalSchizophrenia Bulletin
Volume41
Issue number4
DOIs
StatePublished - Jul 1 2015

Fingerprint

Toxoplasma
Psychotic Disorders
Immunoglobulin M
Meta-Analysis
Schizophrenia
Antibodies
Infection
Recurrence
Seroepidemiologic Studies
PubMed
Publications
Immunoglobulin G
Regression Analysis
Databases
Serum

Keywords

  • infection
  • meta-analysis
  • psychosis
  • relapse
  • toxoplasmosis

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Meta-Analysis of Anti-Toxoplasma gondii IgM Antibodies in Acute Psychosis. / Monroe, Joel M.; Buckley, Peter F; Miller, Brian J.

In: Schizophrenia Bulletin, Vol. 41, No. 4, 01.07.2015, p. 989-998.

Research output: Contribution to journalArticle

Monroe, Joel M. ; Buckley, Peter F ; Miller, Brian J. / Meta-Analysis of Anti-Toxoplasma gondii IgM Antibodies in Acute Psychosis. In: Schizophrenia Bulletin. 2015 ; Vol. 41, No. 4. pp. 989-998.
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