Elsevier

Biological Psychiatry

Volume 72, Issue 4, 15 August 2012, Pages 290-295
Biological Psychiatry

Archival Report
The Relationship Between Toxoplasma Gondii Infection and Mood Disorders in the Third National Health and Nutrition Survey

https://doi.org/10.1016/j.biopsych.2012.01.003Get rights and content

Background

Toxoplasma gondii (T. gondii) is a neurotropic protozoan parasite that causes persistent infection in humans. A substantial literature suggests that schizophrenia is associated with increased seroprevalence of T. gondii, but a possible link of the parasite with mood disorders has not been as thoroughly investigated.

Methods

We examined the association of Toxoplasma-specific immunoglobulin G results with mood disorder outcomes in 7440 respondents from the third National Health and Nutrition Survey, which is a nationally representative sample of the United States noninstitutionalized civilian population. Regression models were adjusted for numerous potential confounders, including tobacco smoking and C-reactive protein levels.

Results

No statistically significant associations were found between T. gondii seroprevalence and a history of major depression (n = 574; adjusted odds ratio [OR]: .8; 95% confidence interval [CI]: .5–1.2), severe major depression (n = 515; adjusted OR: .8; 95% CI: .6–1.2), dysthymia (n = 548; adjusted OR: 1.1; 95% CI: .7–1.8), or dysthymia with comorbid major depression (n = 242, adjusted OR: 1.2; 95% CI: .6–2.4), all p values were > .05, including analysis stratified by gender. However, there was a significant relationship between T. gondii seroprevalence and bipolar disorder type I for respondents in which both manic and major depression symptoms were reported (n = 41; adjusted OR: 2.4; 95% CI: 1.2–4.8; p < .05).

Conclusions

In a population-based sample, T. gondii seroprevalence is not elevated in unipolar mood disorders but is higher in a subset of respondents with a history of bipolar disorder type 1.

Section snippets

Methods and Materials

To examine the relationship between prevalence of immunoglobulin G (IgG) antibodies to T. gondii and the diagnosis of selected mood disorders we used data from NHANES III, a cross-sectional survey conducted between 1988 and 1994 by the National Center for Health Statistics, Centers for Disease Control and Prevention. The NHANES III was designed to obtain nationally representative statistics on health measures and conditions through household interviews, standardized physical examinations, and

Results

Characteristics of the study population are shown in Table 1. All percentages reported are weighted; the actual number of respondents is reported only to indicate sample size in each subgroup. Of the 7440 respondents included in this study, 1211 were seropositive for T. gondii with a weighted percent of 14.5 (95% confidence interval [CI]: 13.0–16.0).

As shown in Table 2, there was no statistically significant association between T. gondii seroprevalence and severe major depression (unadjusted

Discussion

The main finding in the group studied is that T. gondii antibody is not associated with major depression but is associated with bipolar disorder type I in which both manic and depressive features were reported. Strengths of the study include a large sample size with clearly defined racial and ethnic composition and appropriate adjustment for confounding demographic and other variables, including tobacco smoking. Moreover, the sample is community-based and not biased by selection of only

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