Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis -

Objective

To perform a meta-analysis on studies reporting prevalence of Toxoplasma 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 (ORs) with IgG 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 IgM 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.

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