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

Cosme Alvarado-Esquivel, Luis Francisco Sanchez-Anguiano, Jesus Hernandez-Tinoco, Luis Omar Berumen-Segovia, Yazmin Elizabeth Torres-Prieto, Sergio Estrada-Martinez, Alma Rosa Perez-Alamos, Maria Nalleli Ortiz-Jurado, Gabriel Molotla-de-Leon, Isabel Beristain Garcia, Elizabeth Rabago-Sanchez, Oliver Liesenfeld


Background: The parasiteToxoplasma gondii (T. gondii) may invade the brain and might induce behavioral changes. We sought to determine the association ofT. gondii infection and mixed anxiety and depressive disorder.

Methods: Through 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.

Results: Fifteen (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 ofT. 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).

Conclusions: Results support for the first time an association between seropositivity toT. gondii and mixed anxiety and depressive disorder. Further research to confirm this association and to determine the seroepidemiology ofT. gondii infection in patients with this disorder is needed.

J Clin Med Res. 2016;8(7):519-523


Toxoplasma gondii; Seroprevalence; Mixed anxiety and depressive; Psychiatric patients; Case-control

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