Toxoplasma gondiiInfection and Mixed Anxiety and Depressive Disorder: A Case-Control Seroprevalence Study in Durango, Mexico

Abstract

BackgroundThe parasite Toxoplasma gondii (T. gondii) may invade the brain and might induce behavioral changes. We sought to determine the association of T. gondii infection and mixed anxiety and depressive disorder.MethodsThrough an age- and gender-matched case-control seroprevalence study, we examined 65 patients suffering from mixed anxiety and depressive disorder (WHO ICD-10 code: F41.2) attending in a public hospital of mental health and 260 control subjects without this disorder from the general population. Sera of participants were analyzed for anti-Toxoplasma IgG and IgM antibodies using enzyme-linked immunoassays.ResultsFifteen (23.1%) of the 65 patients and 18 (6.9%) of the 260 controls had anti-T. gondii IgG antibodies (odds ratio (OR): 4.03; 95% confidence interval (CI): 1.90 - 8.53; P < 0.001). The frequency of high (> 150 IU/mL) anti-T. gondii IgG levels was similar in cases and controls (OR: 0.25; 95% CI: 0.05 - 1.06; P = 0.05). Seroprevalence was similar in male cases and controls (P = 1.0); however, seroprevalence was significantly higher in female cases than in female controls (OR: 7.08; 95% CI: 2.83 - 17.67; P < 0.00001). Patients aged 31 - 50 years old had a significantly higher seroprevalence of T. gondii infection than controls of the same age group (OR: 21.04; 95% CI: 5.22 - 84.80; P < 0.00001). Anti-T. gondii IgM antibodies were found in four (26.7%) of the 15 anti-T. gondii IgG seropositive cases and in 10 (55.6%) of the 18 anti-T. gondii IgG seropositive controls (P = 0.15).ConclusionsResults support for the first time an association between seropositivity to T. gondii and mixed anxiety and depressive disorder. Further research to confirm this association and to determine the seroepidemiology of T. gondii infection in patients with this disorder is needed.

Toxoplasma gondii—A Gastrointestinal Pathogen Associated with Human Brain Diseases

“…Psychiatric conditions which have been associated either with increased prevalence of Toxoplasma infection or increased levels of antibodies include bipolar disorder (Pearce et al, 2012), general anxiety disorder (Markovitz et al, 2015), mixed anxiety and depressive disorder (Alvarado-Esquivel et al, 2016), aggressive behavior (Cook et al, 2015), and acute convulsive epilepsy (Ae-Ngibise et al, 2015). Exposure to Toxoplasma has also been associated with increased rates of suicidality as measured by the number of actual suicide attempts (Alvarado-Esquivel et al, 2013) or episodes of self-directed violence (Zhang et al, 2012).…”

Toxoplasma gondii infection and common mental disorders in the Finnish general population

“…A recent meta-analysis investigated its association with schizophrenia, bipolar disorder, major depressive disorder (MDD) and addiction (mainly opioid dependence), and found significant association with schizophrenia, bipolar disorder and addiction but not with MDD (Sutterland et al, 2015). In addition, previous reports have associated T. gondii seropositivity with depressive and anxiety symptoms (Groër et al, 2011; Duffy et al, 2015), generalized anxiety disorder (GAD) (Markovitz et al, 2015), obsessive-compulsive disorder (OCD) (Miman et al, 2010), suicidality (Zhang et al, 2012), mixed anxiety and depressive disorder (Alvarado-Esquivel et al, 2016) and aggression and impulsivity (Cook et al 2015). However, negative findings have also been published (Gale et al 2014, Sudgen et al 2016).…”

The association between suicide attempts and Toxoplasma gondii infection

“…In other studies, Dalimi and Abdoli 15) and Fekadu et al 16) suggested that latent T. gondii infection is associated with depression. Although Coccaro et al 10) reported no significant difference in depressive symptoms between the seropositive and seronegative groups, a case-control study performed by Alvarado-Esquivel et al 17) reported a higher seroprevalence in depressive patients. Our result also supports the relationship between depression and T. gondii infection.…”

“…Alvarado-Esquivel et al 17) also reported about the association between T. gondii infection and mixed anxiety and depressive disorder. Markovitz et al 19) reported that the T. gondii seropositive group has a greater risk of generalized anxiety disorder.…”