Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-24T00:46:18.170Z Has data issue: false hasContentIssue false
  • English
  • Français

Toxoplasma-Infected Subjects Report an Obsessive-Compulsive Disorder Diagnosis More Often and Score Higher in Obsessive-Compulsive Inventory

Published online by Cambridge University Press:  16 December 2016

J. Flegr  and
J. Horáček
J. Flegr*
Affiliation:
Division of Biology, Faculty of Science, Charles University, Vinicna 7PragueCZ-128 44, Czech Republic National Institute of Mental Health Topolová 748KlecanyCZ-250 67, Czech Republic
J. Horáček
Affiliation:
National Institute of Mental Health Topolová 748KlecanyCZ-250 67, Czech Republic
*
*Corresponding author at: Division of Biology, Faculty of Science, Charles University, Vinicna 7, CZ-128 44 Prague, Czech Republic. E-mail address:flegr@cesnet.cz (J. Flegr).
Get access

Abstract

Background

Latent toxoplasmosis, the life-long presence of dormant stages of Toxoplasma in immunoprivileged organs and of anamnestic IgG antibodies in blood, affects about 30% of humans. Infected subjects have an increased incidence of various disorders, including schizophrenia. Several studies, as well as the character of toxoplasmosis-associated disturbance of neurotransmitters, suggest that toxoplasmosis could also play an etiological role in Obsessive-Compulsive Disorder (OCD).

Methods

The aim of the present cross-sectional study performed on a population of 7471 volunteers was to confirm the association between toxoplasmosis and OCD, and toxoplasmosis and psychological symptoms of OCD estimated by the standard Obsessive-Compulsive Inventory-Revised (OCI-R).

Results

Incidence of OCD was 2.18% (n = 39) in men and 2.28% (n = 83) in women. Subjects with toxoplasmosis had about a 2.5 times higher odds of OCD and about a 2.7 times higher odds of learning disabilities. The incidence of 18 other neuropsychiatric disorders did not differ between Toxoplasma-infected and Toxoplasma-free subjects. The infected subjects, even the OCD-free subjects, scored higher on the OCI-R.

Limitations: Examined subjects provided the information about their toxoplasmosis and OCD statuses themselves, which could result in underrating the strength of observed associations.

Conclusions

The results confirmed earlier reports of the association between toxoplasmosis and OCD. They also support recent claims that latent toxoplasmosis is in fact a serious disease with many impacts on quality of life of patients.

Keywords

ParasitesMental disorderInfectionToxoplasmosisRisk factorsLearning disabilities
Type
Original article
Information
European Psychiatry , Volume 40 , February 2017 , pp. 82 - 87
Copyright
Copyright © Elsevier Masson SAS 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Tenter, A.M.Heckeroth, A.R.Weiss, L.M.Toxoplasma gondii: from animals to humans. Int J Parasitol 2000; 30: 1217–1258CrossRefGoogle Scholar
Flegr, J.Prandota, J.Sovickova, M.Israili, Z.H.Toxoplasmosis – a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countries. PLoS ONE 9 2014CrossRefGoogle Scholar
Prandota, J.Metabolic, immune, epigenetic, endocrine and phenotypic abnormalities found in individuals with autism spectrum disorders, Down syndrome and Alzheimer disease may be caused by congenital and/or acquired chronic cerebral toxoplasmosis. Res Autism Spectr Disord 2011; 5: 14–59CrossRefGoogle Scholar
Torrey, E.F.Bartko, J.J.Yolken, R.H.Toxoplasma gondii and other risk factors for schizophrenia: an update. Schizophr Bull 2012; 38: 642–647CrossRefGoogle ScholarPubMed
Flegr, J.How and why Toxoplasma makes us crazy. Trends Parasitol 2013; 29: 156–163CrossRefGoogle ScholarPubMed
Sutterland, A.L.Fond, G.Kuin, A.Koeter, M.W.Lutter, R.van Gool, T.et al.Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis. Acta Psychiatr Scand 2015; 132: 161–17910.1111/acps.12423CrossRefGoogle ScholarPubMed
Niebuhr, D.W.Cowan, D.N.Millikan, A.M.Yolken, R.Li, Y.Weber, N.Risk of schizophrenia and antibodies to Toxoplasma gondii among U.S. military personnel. Schizophr Bull 2007; 33: 243–244Google Scholar
Gaskell, E.A.Smith, J.E.Pinney, J.W.Westhead, D.R.McConkey, G.A.A unique dual activity amino acid hydroxylase in Toxoplasma gondii. PLoS ONE 4 2009 e4801CrossRefGoogle ScholarPubMed
Prandovszky, E.Gaskell, E.Martin, H.Dubey, J.P.Webster, J.P.McConkey, G.A.The neurotropic parasite Toxoplasma gondii increases dopamine metabolism. PLoS ONE 6 2011 e2386610.1371/journal.pone.0023866CrossRefGoogle ScholarPubMed
Martin, H.L.Alsaady, I.Howell, G.Prandovszky, E.Peers, C.Robinson, P.et al.Effect of parasitic infection on dopamine biosznthesis in dopaminergic cells. Neuroscience 2015; 306: 50–6210.1016/j.neuroscience.2015.08.005CrossRefGoogle ScholarPubMed
Westenberg, H.G.M.Fineberg, N.A.Denys, D.Neurobiology of obsessive-compulsive disorder: serotonin and beyond. CNS Spectr 2007; 12: 14–27CrossRefGoogle Scholar
Wittchen, H.U.Jacobi, F.Rehm, J.Gustavsson, A.Svensson, M.Jonsson, B.et al.The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol 2011; 21: 655–679CrossRefGoogle ScholarPubMed
Stein, D.J.Obsessive-compulsive disorder. Lancet 2002; 360: 397–405CrossRefGoogle ScholarPubMed
Miman, O.Mutlu, E.A.Ozcan, O.Atambay, M.Karlidag, R.Unal, S.Is there any role of Toxoplasma gondii in the etiology of obsessive-compulsive disorder?. Psychiatry Res 2010; 177: 263–265CrossRefGoogle ScholarPubMed
Cong, W.Dong, W.Bai, L.Wang, X.Y.Ni, X.T.Qian, A.D.et al.Seroprevalence and associated risk factors of Toxoplasma gondii infection in psychiatric patients: a case–control study in eastern China. Epidemiol Infect 2015; 143: 3103–3109CrossRefGoogle ScholarPubMed
Flegr, J.Neurological and neuropsychiatric consequences of chronic Toxoplasma infection. Parasitology 2015; 2: 163–172Google Scholar
Kankova, S.Flegr, J.Calda, P.The influence of latent toxoplasmosis on women’s reproductive function: four cross-sectional studies. Folia Parasitol 2015 62CrossRefGoogle Scholar
Villard, O.Cimon, B.L’Ollivier, C.Fricker-Hidalgo, H.Godineau, N.Houze, S.et al.Serological diagnosis of Toxoplasma gondii infection recommendations from the French National Reference Center for Toxoplasmosis. Diagn Microbiol Infect Dis 2016; 84: 22–3310.1016/j.diagmicrobio.2015.09.009CrossRefGoogle ScholarPubMed
Foa, E.B.Huppert, J.D.Leiberg, S.Langner, R.Kichic, R.Hajcak, G.et al.The obsessive-compulsive inventory: development and validation of a short version. Psychol Assess 2002; 14: 485–496CrossRefGoogle ScholarPubMed
Flegr, J.Novotná, M.Fialová, A.Kolbeková, P.Gašová, Z.The influence of RhD phenotype on toxoplasmosis- and age-associated changes in personality profile of blood donors. Folia Parasitol 2010; 57: 143–15010.14411/fp.2010.018CrossRefGoogle ScholarPubMed
van Grootheest, D.S.Cath, D.C.Beekman, A.T.Boomsma, D.I.Twin studies on obsessive-compulsive disorder: a review. Twin Res Hum Genet 2005; 8: 450–458CrossRefGoogle ScholarPubMed
Olver, J.S.O’Keefe, G.Jones, G.R.Burrows, G.D.Tochon-Danguy, H.J.Ackermann, U.et al.Dopamine D-1 receptor binding in the anterior cingulate cortex of patients with obsessive-compulsive disorder. Psychiat Res Neuroimaging 2010; 183: 85–8810.1016/j.pscychresns.2010.04.004CrossRefGoogle ScholarPubMed
Szechtman, H.Sulis, W.Eilam, D.Quinpirole induces compulsive checking behavior in rats: a potential animal model of obsessive-compulsive disorder (OCD). Behav Neurosci 1998; 112: 1475–1485CrossRefGoogle Scholar
Ducasse, D.Boyer, L.Michel, P.Loundou, A.Macgregor, A.Micoulaud-Franchi, J.A.et al.D2 and D3 dopamine receptor affinity predicts effectiveness of antipsychotic drugs in obsessive-compulsive disorders: a metaregression analysis. Psychopharmacology (Berl) 2014; 231: 3765–3770CrossRefGoogle ScholarPubMed
Wu, M.Hanna, G.L.Rosenberg, D.R.Arnold, P.D.The role of glutamate signaling in the pathogenesis and treatment of obsessive-compulsive disorder. Pharmacol Biochem Behav 2012; 100: 726–735CrossRefGoogle ScholarPubMed
Yucel, M.Wood, S.J.Wellard, R.M.Harrison, B.J.Fornito, A.Pujol, J.et al.Anterior cingulate glutamate-glutamine levels predict symptom severity in women with obsessive-compulsive disorder. Aust N Z J Psychiatry 2008; 42: 467–477CrossRefGoogle ScholarPubMed
Simpson, H.B.Shungu, D.C.Bender, J.Mao, X.L.Xu, X.Y.Slifstein, M.et al.Investigation of cortical glutamate-gutamine and gamma-aminobutyric acid in obsessive-compulsive disorder by proton magnetic resonance spectroscopy. Neuropsychopharmacology 2012; 37: 2684–2692CrossRefGoogle ScholarPubMed
Zhu, Y.J.Fan, Q.Han, X.Zhang, H.Y.Chen, J.Wang, Z.et al.Decreased thalamic glutamate level in unmedicated adult obsessive-compulsive disorder patients detected by proton magnetic resonance spectroscopy. J Affect Disord 2015; 178: 193–200CrossRefGoogle ScholarPubMed
Bloch, M.H.Wasylink, S.Landeros-Weisenberger, A.Panza, K.E.Billingslea, E.Leckman, J.F.et al.Effects of ketamine in treatment-refractory obsessive-compulsive disorder. Biol Psychiatry 2012; 72: 964–970CrossRefGoogle ScholarPubMed
Wang, Z.T.Harmon, S.O’Malley, K.L.Sibley, L.D.Reassessment of the role of aromatic amino acid hydroxylases and the effect of infection by Toxoplasma gondii on host dopamine. Infect Immun 2015; 83: 1039–104710.1128/IAI.02465-14CrossRefGoogle ScholarPubMed
Flegr, J.Preiss, M.Klose, J.Havlíček, J.Vitáková, M.Kodym, P.Decreased level of psychobiological factor novelty seeking and lower intelligence in men latently infected with the protozoan parasite Toxoplasma gondii. Dopamine, a missing link between schizophrenia and toxoplasmosis?. Biol Psychol 2003; 63: 253–268CrossRefGoogle ScholarPubMed
Skallová, A.Novotná, M.Kolbeková, P.Gašová, Z.Veselý, V.Flegr, J.Decreased level of novelty seeking in blood donors infected with Toxoplasma. Neuroendocrinol Lett 2005; 26: 480–486Google ScholarPubMed
Nagineni, C.N.Pardhasaradhi, K.Martins, M.C.Detrick, B.Hooks, J.J.Mechanisms of interferon-induced inhibition of Toxoplasma gondii replication in human retinal pigment epithelial cells. Infect Immun 1996; 64: 4188–4196CrossRefGoogle ScholarPubMed
Kessler, M.Terramani, T.Lynch, G.Baudry, M.A glycine site associated with N-methyl-d-aspartic acid receptors – characterization and identification of a new class of antagonists. J Neurochem 1989; 52: 1319–1328CrossRefGoogle ScholarPubMed
Eldefrawy, S.R.Boegman, R.J.Jhamandas, K.Beninger, R.J.The neurotoxic actions of quinolinic acid in the central-nervous-system. Can J Physiol Pharmacol 1986; 64: 369–375CrossRefGoogle Scholar
Lim, A.Kumar, V.Hari Dass, S.A.Vyas, A.Toxoplasma gondii infection enhances testicular steroidogenesis in rats. Mol Ecol 2013; 22: 102–110CrossRefGoogle ScholarPubMed
Flegr, J.Lindová, J.Kodym, P.Sex-dependent toxoplasmosis-associated differences in testosterone concentration in humans. Parasitology 2008; 135: 427–431CrossRefGoogle ScholarPubMed
Holub, D.Flegr, J.Dragomirecka, E.Rodriguez, M.Preiss, M.Novak, T.et al.Differences in onset of disease and severity of psychopathology between toxoplasmosis-related and toxoplasmosis-unrelated schizophrenia. Acta Psychiatr Scand 2013; 127: 227–238CrossRefGoogle ScholarPubMed
Celik, T.Kartalci, S.Aytas, O.Akarsu, G.A.Gozukara, H.Unal, S.Association between latent toxoplasmosis and clinical course of schizophrenia – continuous course of the disease is characteristic for Toxoplasma gondii-infected patients. Folia Parasitol 62 2015CrossRefGoogle ScholarPubMed
Horacek, J.Flegr, J.Tintera, J.Verebova, K.Spaniel, F.Novak, T.et al.Latent toxoplasmosis reduces gray matter density in schizophrenia but not in controls: voxel-based-morphometry (VBM) study. World J Biol Psychiatry 2012; 13: 501–509CrossRefGoogle Scholar
Menzies, L.Chamberlain, S.R.Laird, A.R.Thelen, S.M.Sahakian, B.J.Bullmore, E.T.Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: the orbitofronto-striatal model revisited. Neurosci Biobehav Rev 2008; 32: 525–549CrossRefGoogle ScholarPubMed
Koprivova, J.Horacek, J.Tintera, J.Prasko, J.Raszka, M.Ibrahim, I.et al.Medial frontal and dorsal cortical morphometric abnormalities are related to obsessive-compulsive disorder. Neurosci Lett 2009; 464: 62–66CrossRefGoogle ScholarPubMed
Koprivova, J.Congedo, M.Horacek, J.Prasko, J.Raszka, M.Brunovsky, M.et al.EEG source analysis in obsessive-compulsive disorder. Clin Neurophysiol 2011; 122: 1735–1743CrossRefGoogle ScholarPubMed
Koprivova, J.Horacek, J.Raszka, M.Brunovsky, M.Prasko, J.Standardized low-resolution electromagnetic tomography in obsessive-compulsive disorder – a replication study. Neurosci Lett 2013; 548: 185–189CrossRefGoogle ScholarPubMed
Kodym, P.Machala, L.Roháčová, H.Širocká, B.Malý, M.Evaluation of a commercial IgE ELISA in comparison with IgA and IgM ELISAs, IgG avidity assay and complement fixation for the diagnosis of acute toxoplasmosis. Clin Microbiol Infect 2007; 13: 40–47CrossRefGoogle Scholar
Kolbeková, P.Kourbatova, E.Novotná, M.Kodym, P.Flegr, J.New and old risk-factors for Toxoplasma gondii infection: prospective cross-sectional study among military personnel in the Czech Republic. Clin Microbiol Infect 2007; 13: 1012–1017CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.