Large-scale study of Toxoplasma and Cytomegalovirus shows an association between infection and serious psychiatric disorders

Research output: Contribution to journalJournal articleResearchpeer-review

  • Kristoffer Sølvsten Burgdorf
  • Betina Trabjerg
  • Marianne Giørtz Pedersen
  • Janna Nissen
  • Ole Birger Pedersen
  • Erik Sørensen
  • Kaspar René Nielsen
  • Margit Hørup Larsen
  • Christian Erikstrup
  • Peter Bruun-Rasmussen
  • David Westergaard
  • Lise Wegner Thørner
  • Henrik Hjalgrim
  • Helene Martina Paarup
  • Carsten B. Pedersen
  • E Fuller Torrey
  • Preben Bo Mortensen
  • Robert Yolken
  • Henrik Ullum

BACKGROUND: Common infectious pathogens have been associated with psychiatric disorders, self-violence and risk-taking behavior.

METHODS: This case-control study reviews register data on 81,912 individuals from the Danish Blood Donor Study to identify individuals who have a psychiatric diagnosis (N=2,591), have attempted or committed suicide (N=655), or have had traffic accidents (N=2,724). For all cases, controls were frequency matched by age and sex, resulting in 11,546 participants. Plasma samples were analyzed for immunoglobulin G (IgG) antibodies against Toxoplasma gondii and cytomegalovirus (CMV).

RESULTS: T. gondii was detected in 25·9% of the population and was associated with schizophrenia (odds ratio [OR], 1·47; 95% confidence interval [CI], 1·03-2·09). Accounting for temporality, with pathogen exposure preceding outcome, the association was even stronger (IRR, 2·78; 95% CI, 1·27-6·09). A very weak association between traffic accident and toxoplasmosis (OR, 1·11; 95% CI, 1·00-1·23, p = 0.054) was found. CMV was detected in 60·8% of the studied population and was associated with any psychiatric disorder (OR, 1·17; 95% CI, 1·06-1·29), but also with a smaller group of neurotic, stress-related, and somatoform disorders (OR, 1·27; 95% CI, 1·12-1·44), and with attempting or committing suicide (OR, 1·31; 95% CI, 1·10-1·56). Accounting for temporality, any psychiatric disorder (IRR, 1·37; 95% CI, 1·08-1·74) and mood disorders (IRR, 1·43; 95% CI, 1·01-2·04) were associated with exposure to CMV. No association between traffic accident and CMV (OR, 1·06; 95% CI, 0·97-1·17) was found.

CONCLUSIONS: This large-scale serological study is the first study to examine temporality of pathogen exposure and to provide evidence of a causal relationship between T. gondii and schizophrenia, and between CMV and any psychiatric disorder.

Original languageEnglish
JournalBrain, Behavior, and Immunity
Pages (from-to)152-158
Publication statusPublished - 2019

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