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The correlation between Toxoplasma gondii infection and prenatal depression in pregnant women

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Abstract

Previous studies have demonstrated that latent toxoplasmosis is associated with neuropsychiatric disorders. We evaluated the correlation between Toxoplasma gondii infection and prenatal depression. In this case–control study, we enrolled 116 depressed pregnant women and 244 healthy controls. The Edinburgh Postpartum Depression Scale (EPDS) was used to evaluate the depression symptom severity in study participants. All participants were screened for the anti-Toxoplasma IgG by enzyme-linked immunosorbent assay. Seroprevalence of T. gondii did not significantly differ between the depressed pregnant women and healthy controls (OR = 1.4; 95 % CI = 0.9–2.19; P = 0.142). T. gondii IgG titer was significantly higher in depressed women (18.6 ± 10.9 IUs) than those in the control group (13.6 ± 8.1 IUs) (z = −5.36, P < 0.001). The T. gondii–positive depressed women showed a positive correlation of T. gondii IgG titer with the EPDS scores (r = 0.52; P < 0.01). The mean EPDS score was also significantly higher in the T. gondii–positive depressed women (20.7 ± 2.7) compared with the controls (18.36 ± 2.7) (P < 0.001). The results obtained from the current study revealed that T. gondii infection might affect susceptibility to depression and severity of depressive symptoms in pregnant women, particularly in those patients who have high antibody titers. Further study is required to fully elucidate the characteristics and mechanisms of this association.

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References

  1. Montoya J, Liesenfeld O (2004) Toxoplasmosis. Lancet 363:1965–1976

    Article  CAS  PubMed  Google Scholar 

  2. Flegr J, Prandota J, Sovičková M, Israili ZH (2014) Toxoplasmosis—a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countries. PLoS One 9:e90203

    Article  PubMed  PubMed Central  Google Scholar 

  3. Nourollahpour Shiadeh M, Niyyati M, Fallahi S, Rostami A (2016) Human parasitic protozoan infection to infertility:a systematic review. Parasitol Res 115:469–477

    Article  Google Scholar 

  4. Rostami A, Keshavarz H, Shojaee S, Mohebali M, Meamar AR (2014) Frequency of Toxoplasma gondii in HIV positive patients from West of Iran by ELISA and PCR. Iran J Parasitol 9:474–481

    PubMed  PubMed Central  Google Scholar 

  5. McConkey GA, Martin HL, Bristow GC, Webster JP (2013) Toxoplasma gondii infection and behaviour—location, location, location? J Exp Biol 216:113–119

    Article  PubMed  PubMed Central  Google Scholar 

  6. Webster JP, McConkey GA (2010) Toxoplasma gondii-altered host behaviour: clues as to mechanism of action. Folia Parasitol 57:95–104

    Article  PubMed  Google Scholar 

  7. Flegr J (2013) Influence of latent Toxoplasma infection on human personality, physiology and morphology: pros and cons of the Toxoplasma–human model in studying the manipulation hypothesis. J Exp Biol 216:127–133

    Article  PubMed  Google Scholar 

  8. Arias I, Sorlozano A, Villegas E et al (2012) Infectious agents associated with schizophrenia: a meta-analysis. Schizophr Res 136:128–136

    Article  PubMed  Google Scholar 

  9. Sutterland A, Fond G, Kuin A et al (2015) Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis. Acta Psychiatr Scand 132(3):161–179. doi:10.1111/acps.12423

    Article  CAS  PubMed  Google Scholar 

  10. Ling VJ, Lester D, Mortensen PB, Langenberg PW, Postolache TT (2011) Toxoplasma gondii seropositivity and suicide rates in women. J Nerv Ment Dis 199:440–444

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hinze-Selch D, Däubener W, Erdag S, Wilms S (2010) The diagnosis of a personality disorder increases the likelihood for seropositivity to Toxoplasma gondii in psychiatric patients. Folia Parasitol 57:129–135

    Article  CAS  PubMed  Google Scholar 

  12. Pearce BD, Kruszon-Moran D, Jones JL (2012) The relationship between Toxoplasma gondii infection and mood disorders in the third National Health and Nutrition Survey. Biol Psychiatry 72:290–295

    Article  PubMed  PubMed Central  Google Scholar 

  13. Miman O, Kusbeci OY, Aktepe OC, Cetinkaya Z (2010) The probable relation between Toxoplasma gondii and Parkinson’s disease. Neurosci Lett 475:129–131

    Article  CAS  PubMed  Google Scholar 

  14. Miman O, Mutlu EA, Ozcan O, Atambay M, Karlidag R, Unal S (2010) Is there any role of Toxoplasma gondii in the etiology of obsessive–compulsive disorder? Psychiatry Res 177:263–265

    Article  PubMed  Google Scholar 

  15. Torrey EF, Bartko JJ, Yolken RH (2012) Toxoplasma gondii and other risk factors for schizophrenia: an update. Schizophr Bull 38:642–647

    Article  PubMed  PubMed Central  Google Scholar 

  16. Groer MW, Yolken RH, Xiao J-C et al (2011) Prenatal depression and anxiety in Toxoplasma gondii-positive women. Am J Obstet Gynecol 204(433):e1–e7

    PubMed  Google Scholar 

  17. Markovitz AA, Simanek AM, Yolken RH et al (2015) Toxoplasma gondii and anxiety disorders in a community-based sample. Brain Behav Immun 43:192–197

    Article  PubMed  Google Scholar 

  18. Hamdani N, Daban-Huard C, Lajnef M et al (2013) Relationship between Toxoplasma gondii infection and bipolar disorder in a French sample. J Affect Dis 148:444–448

    Article  CAS  PubMed  Google Scholar 

  19. Pedersen MG, Mortensen PB, Norgaard-Pedersen B, Postolache TT (2012) Toxoplasma gondii infection and self-directed violence in mothers. Arch Gen Psychiatry 69:1123–1130

    Article  PubMed  Google Scholar 

  20. Mazhari S, Nakhaee N (2007) Validation of the Edinburgh postnatal depression scale in an Iranian sample. Arch Womens Ment Health 10:293–297

    Article  CAS  PubMed  Google Scholar 

  21. Montazeri A, Torkan B, Omidvari S (2007) The Edinburgh Postnatal Depression Scale (EPDS): translation and validation study of the Iranian version. BMC Psychiatry 7:11

    Article  PubMed  PubMed Central  Google Scholar 

  22. Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786

    Article  CAS  PubMed  Google Scholar 

  23. Murray D, Cox JL (1990) Screening for depression during pregnancy with the Edinburgh Depression Scale (EDDS). J Reprod Infant Psychol 8:99–107

    Article  Google Scholar 

  24. Sadock BJ, Sadock VA (2008) Kaplan & Sadock’s concise textbook of clinical psychiatry, vol 2008, 3rd edn. Lippincott Williams & Wilkins, Philadelphia, p 201

    Google Scholar 

  25. Gaynes BN, Gavin N, Meltzer-Brody S, et al (2005) Perinatal depression: prevalence, screening accuracy, and screening outcomes. Online at http://www.ahrq.gov/clinic/epcsums/peridepsum.htm

  26. Wang X, Zhang L, Lei Y et al (2014) Meta-analysis of infectious agents and depression. Sci Rep 4:4530

    PubMed  Google Scholar 

  27. Benros ME, Waltoft BL, Nordentoft M et al (2013) Autoimmune diseases and severe infections as risk factors for mood disorders: a nationwide study. JAMA Psychiatry 70:812–820

    Article  PubMed  Google Scholar 

  28. Hinze-Selch D, Däubener W, Eggert L, Erdag S, Stoltenberg R, Wilms S (2007) A controlled prospective study of Toxoplasma gondii infection in individuals with schizophrenia: beyond seroprevalence. Schizophr Bull 33:782–788

    Article  PubMed  PubMed Central  Google Scholar 

  29. Arling TA, Yolken RH, Lapidus M et al (2009) Toxoplasma gondii antibody titers and history of suicide attempts in patients with recurrent mood disorders. J Nerv Ment Dis 3:905–908

    Article  Google Scholar 

  30. Cetinkaya Z, Yazar S, Gecici O, Namli MN (2007) Anti-Toxoplasma gondii antibodies in patients with schizophrenia—preliminary findings in a Turkish sample. Schizophr Bull 33:789–791

    Article  PubMed  PubMed Central  Google Scholar 

  31. Hamidinejat H, Ghorbanpoor M, Hosseini H et al (2010) Toxoplasma gondii infection in first-episode and inpatient individuals with schizophrenia. Int J Infect Dis 14:e978–e981

    Article  PubMed  Google Scholar 

  32. Kar N, Misra B (2004) Toxoplasma seropositivity and depression: a case report. BMC Psychiatry 4:1

    Article  PubMed  PubMed Central  Google Scholar 

  33. Berenreiterova M, Flegr J, Kubena AA, Nemec P (2011) The distribution of Toxoplasma gondii cysts in the brain of a mouse with latent toxoplasmosis: implications for the behavioral manipulation hypothesis. PLoS One 6:e28925

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Haroon F, Händel U, Angenstein F et al (2012) Toxoplasma gondii actively inhibits neuronal function in chronically infected mice. PLoS One 7:e35516

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Hsu PC, Groer M, Beckie T (2014) New findings: depression, suicide, and Toxoplasma gondii infection. J Am Assoc Nurse Pract 26:629–637

    PubMed  Google Scholar 

  36. Kohl C, Walch T, Huber R et al (2005) Measurement of tryptophan, kynurenine and neopterin in women with and without postpartum blues. J Affect Disord 86:135–142

    Article  CAS  PubMed  Google Scholar 

  37. Stowe ZN, Hostetter A, Newport DJ (2005) The onset of postpartum depression: implications for identification in obstetrical and primary care. Am J Obstet Gynecol 192:522–526

    Article  PubMed  Google Scholar 

  38. Wasserman EE, Nelson K, Rose NR et al (2009) Infection and thyroid autoimmunity: a seroepidemiologic study of TPOaAb. Autoimmunity 42:439–446

    Article  PubMed  Google Scholar 

  39. Lazarus J, Hall R, Othman S et al (1996) The clinical spectrum of postpartum thyroid disease. Q J Med 89:429–435

    Article  CAS  Google Scholar 

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Acknowledgments

The authors are very thankful to the staff of the prenatal health care centers of Shahid Beheshti University of Medical Sciences, especially Miss Khademi, for their kind assistance in sample collection. Most importantly, the authors would like to thank all the participants in this study. We are thankful for the collaboration of the Protozoology unit of the Shahid Beheshti University of Medical Sciences.

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Authors and Affiliations

  1. Department of Midwifery and Reproductive Health, Nursing and Midwifery School, Mazandaran University of Medical Sciences, Sari, Iran

    M. Nourollahpour Shiadeh & M. Danesh

  2. Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    A. Rostami & S. J. Seyyedtabaei

  3. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    B. D. Pearce

  4. Department of Tissue Engineering and Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Science, Tehran, Iran

    M. Gholipourmalekabadi

  5. Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran

    M. Gholipourmalekabadi

  6. Departments of Psychiatry & Behavioral Sciences and Obstetrics & Gynecology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA

    D. J. Newport

  7. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Science, Tehran, Iran

    S. Mehravar

Authors
  1. M. Nourollahpour Shiadeh
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  2. A. Rostami
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  3. B. D. Pearce
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  4. M. Gholipourmalekabadi
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  5. D. J. Newport
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  6. M. Danesh
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  7. S. Mehravar
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Correspondence to A. Rostami.

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All procedures performed in studies were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards

Conflict of interest

Dr. Newport has received research support from Eli Lilly, Glaxo SmithKline (GSK), Janssen, the National Alliance for Research on Schizophrenia and Depression (NARSAD), the National Institutes of Health (NIH), and Wyeth. He has served on speakers’ bureaus and/or received honoraria from Astra–Zeneca, Eli Lilly, GSK, Pfizer, and Wyeth. He has served on advisory boards for GSK. He has never served as a consultant to any biomedical or pharmaceutical corporations. Neither he nor family members have ever held equity positions in biomedical or pharmaceutical corporations. None of the other authors have any conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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Nourollahpour Shiadeh, M., Rostami, A., Pearce, B.D. et al. The correlation between Toxoplasma gondii infection and prenatal depression in pregnant women. Eur J Clin Microbiol Infect Dis 35, 1829–1835 (2016). https://doi.org/10.1007/s10096-016-2734-5

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  • DOI: https://doi.org/10.1007/s10096-016-2734-5

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