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Toxoplasmosis in Treatment-Resistant Obsessive–Compulsive Disorder Patients

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Abstract

Background and Objectives

The current study was done to evaluate the relationship between T. gondii and obsessive–compulsive disorder (OCD) as well as prevalence rate of toxoplasmosis in treatment-resistant patients with OCD in comparison with treatment-sensitive patients with OCD.

Methods

A total of 180 subjects were selected, including 90 patients with OCD and 90 control participants. Immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies against T. gondii were measured by the enzyme-linked immunosorbent assay (ELISA) technique. Detection of acute and chronic toxoplasmosis was carried out using the ELISA IgG avidity. In addition, the presence of this parasite in blood was detected using the nested-polymerase chain reaction (PCR) method.

Results

Regarding T. gondii IgG antibodies 42 (46.7%) and 17 (18.9%) cases were detected in the patients and controls, respectively (P = 0.000). Also, 16 (17.8%) and 5 (5.6%) cases were positive for B1 gene in patients and controls, respectively (P = 0.018). The antibodies were found to be related to risk of OCD [OR (95% CI) = 3.71 (1.88–7.30); P < 0.001]. Moreover, out of 90 patients, 35 and 55 cases were resistant and sensitive to treatment, respectively, so that 24 (68.6%) out of 35 and 18 (32.7%) out of 55 were positive for the antibodies (P = 0.01) as well as 11 (31.4%) out of 35 and 5 (9.1%) out of 55 were positive for B1 gene (P = 0.010). The antibodies were also associated with risk of resistance to treatment in patients with OCD [OR (95% CI) = 3.81 (1.42–10.17); P = 0.008].

Conclusion

Our findings showed that toxoplasmosis was more frequent in patients with OCD than the control group. In addition, prevalence rate of toxoplasmosis in treatment-resistant patients with OCD was significantly more than that in treatment-sensitive patients with OCD.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Chegeni TN, Sarvi S, Amouei A, Moosazadeh M, Hosseininejad Z, Aghayan SA et al (2019) Relationship between toxoplasmosis and obsessive compulsive disorder: a systematic review and meta-analysis. PLoS Neglected Tropical Dis 13(4):e0007306. https://doi.org/10.1371/journal.pntd.0007306

    Article  Google Scholar 

  2. Alvarado-Esquivel C, Sanchez-Anguiano LF, Hernandez-Tinoco J, Berumen-Segovia LO, Torres-Prieto YE, Estrada-Martinez S, et al (2016). Toxoplasma gondii infection and mixed anxiety and depressive disorder: a case-control seroprevalence study in Durango, Mexico. J Clin Med Res 8(7):519. https://doi.org/10.14740/jocmr2576w.

  3. de Barros JLVM, Barbosa IG, Salem H, Rocha NP, Kummer A, Okusaga OO et al (2017) Is there any association between Toxoplasma gondii infection and bipolar disorder? A systematic review and meta-analysis. J Affective Dis 209:59–65. https://doi.org/10.1016/j.jad.2016.11.016

    Article  Google Scholar 

  4. Cetinkaya Z, Yazar S, Gecici O, Namli MN (2007) Anti-Toxoplasma gondii antibodies in patients with schizophrenia—preliminary findings in a Turkish sample. Schizophrenia Bull 33(3):789–791. https://doi.org/10.1093/schbul/sbm021

    Article  Google Scholar 

  5. Ene L, Marcotte T, Umlauf A, Grancea C, Temereanca A, Bharti A et al (2016) Latent toxoplasmosis is associated with neurocognitive impairment in young adults with and without chronic HIV infection. J Neuroimmunol 299:1–7. https://doi.org/10.1016/j.jneuroim.2016.08.003

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Sutterland A, Fond G, Kuin A, Koeter M, Lutter R, Van Gool T et al (2015) Beyond the association. T oxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis. Acta Psychiatr Scand 132(3):161–179. https://doi.org/10.1111/acps.12423

    Article  CAS  PubMed  Google Scholar 

  7. Wang X, Zhang L, Lei Y, Liu X, Zhou X, Liu Y et al (2014) Meta-analysis of infectious agents and depression. Sci Rep 4:4530. https://doi.org/10.1038/srep04530

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Ngoungou EB, Bhalla D, Nzoghe A, Dardé M-L, Preux P-M (2015) Toxoplasmosis and epilepsy—systematic review and meta analysis. PLoS Negl Trop Dis 9(2):e0003525. https://doi.org/10.1371/journal.pntd.0003525

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Arias I, Sorlozano A, Villegas E, de Dios LJ, McKenney K, Cervilla J et al (2012) Infectious agents associated with schizophrenia: a meta-analysis. Schizophrenia Res 136(1–3):128–136. https://doi.org/10.1016/j.schres.2011.10.026

    Article  Google Scholar 

  10. Organization WH (1999). The “newly defined” burden of mental problems. Fact sheets. 217.

  11. Flegr J, Horáček J (2017) Toxoplasma-infected subjects report an obsessive-compulsive disorder diagnosis more often and score higher in obsessive-compulsive inventory. Euro Psychiatry 40:82–87. https://doi.org/10.1016/j.eurpsy.2016.09.001

    Article  CAS  Google Scholar 

  12. 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(1–2):263–265. https://doi.org/10.1016/j.psychres.2009.12.013

    Article  PubMed  Google Scholar 

  13. Memik NÇ, Tamer GS, Ünver H, Gündoğdu ÖY (2015) The relationship between pediatric obsessive compulsive disorder and Toxoplasma gondii. J Obsessive-Compulsive Related Dis 7:24–28. https://doi.org/10.1016/j.jocrd.2015.08.004

    Article  Google Scholar 

  14. Henriquez S, Brett R, Alexander J, Pratt J, Roberts C (2009) Neuropsychiatric disease and Toxoplasma gondii infection. NeuroImmunoModulation 16(2):122–133. https://doi.org/10.1159/000180267

    Article  CAS  PubMed  Google Scholar 

  15. Westenberg HG, Fineberg NA, Denys D (2007) Neurobiology of obsessive-compulsive disorder: serotonin and beyond. CNS Spectr 12(S3):14–27. https://doi.org/10.1017/S1092852900002479

    Article  Google Scholar 

  16. Kar N, Misra B (2004) Toxoplasma seropositivity and depression: a case report. BMC Psychiatry 4(1):1–2. https://doi.org/10.1186/1471-244X-4-1

    Article  PubMed Central  PubMed  Google Scholar 

  17. Smadja D, Cabre P, Prat C, Vernant J (1995) Loss of psychic auto-activation. Obsessive-compulsive behaviour. Toxoplasmic abscess of the basal ganglia. Revue neurologique. 151(4):271

    CAS  PubMed  Google Scholar 

  18. Saki J, Mowla K, Arjmand R, Kazemi F, Fallahizadeh S (2019) Prevalence of Toxoplasma gondii and Toxocara canis among Myositis Patients in Southwest of Iran. Infect Disord Drug Targets. https://doi.org/10.2174/1871526520666191231123159

    Article  Google Scholar 

  19. Fallahi S, Kazemi B, Bandehpour M, Lasjerdi Z, Taghipour N, Zebardast N et al (2014) Comparison of the RE and B1 gene for detection of Toxoplasma gondii infection in children with cancer. Parasitol Int 63(1):37–41. https://doi.org/10.1016/j.parint.2013.08.005

    Article  CAS  PubMed  Google Scholar 

  20. Arling TA, Yolken RH, Lapidus M, Langenberg P, Dickerson FB, Zimmerman SA et al (2009) Toxoplasma gondii antibody titers and history of suicide attempts in patients with recurrent mood disorders. J Nervous Mental Dis 197(12):905–908. https://doi.org/10.1097/NMD.0b013e3181c29a23

    Article  Google Scholar 

  21. Akaltun İ, Kara SS, Kara T (2018) The relationship between Toxoplasma gondii IgG antibodies and generalized anxiety disorder and obsessive-compulsive disorder in children and adolescents: a new approach. Nordic J Psychiatry 72(1):57–62. https://doi.org/10.1080/08039488.2017.1385850

    Article  Google Scholar 

  22. Brynska A, Tomaszewicz-Libudzic E, Wolanczyk T (2001) Obsessive-compulsive disorder and acquired toxoplasmosis in two children. Euro Child Adolescent Psychiatry. 10(3):200–204. https://doi.org/10.1007/s007870170027

    Article  CAS  Google Scholar 

  23. Miman Ö, Özcan Ö, Ünal S, Atambay M (2018) Toxoplasma gondii–obsessive–compulsive disorder elationship: is it different in children? Nordic J Psychiatry 72(7):501–505. https://doi.org/10.1080/08039488.2018.1514421

    Article  Google Scholar 

  24. Flegr J (2013) How and why Toxoplasma makes us crazy. Trends Parasitol 29(4):156–163. https://doi.org/10.1016/j.pt.2013.01.007

    Article  Google Scholar 

  25. Webster JP, McConkey GA (2010). Toxoplasma gondii-altered host behaviour: clues as to mechanism of action. Folia Parasitologica. 57(2):95. https://doi.org/10.14411/fp.2010.012.

  26. Niebuhr DW, Millikan AM, Cowan DN, Yolken R, Li Y, Weber NS (2008) Selected infectious agents and risk of schizophrenia among US military personnel. Am J Psychiatry 165(1):99–106. https://doi.org/10.1176/appi.ajp.2007.06081254

    Article  Google Scholar 

  27. Havlíček J, Gašová Z, Smith AP, Zvára K, Flegr J (2001) Decrease of psychomotor performance in subjects with latent ‘asymptomatic’toxoplasmosis. Parasitology 122(5):515–520. https://doi.org/10.1017/s0031182001007624

    Article  Google Scholar 

  28. Abdoli A, Dalimi A, Arbabi M, Ghaffarifar F (2014). Neuropsychiatric manifestations of latent toxoplasmosis on mothers and their offspring. J Maternal-Fetal Neonatal Med 27(13):1368–74 https://doi.org/10.3109/14767058.2013.858685.

  29. Kessler M, Terramani T, Lynch G, Baudry M (1989) a glycine site associated with N-methyl-D-aspartic acid receptors: characterization and identification of a new class of antagonists. J Neurochem 52(4):1319–1328

    Article  CAS  Google Scholar 

  30. Alvarado-Esquivel C, Alanis-Quiñones O-P, Arreola-Valenzuela M-Á, Rodríguez-Briones A, Piedra-Nevarez L-J, Duran-Morales E, et al (2006). Seroepidemiology of Toxoplasma gondii infection in psychiatric inpatients in a northern Mexican city. BMC Infectious Dis. 6(1):1–7. org/https://doi.org/10.1186/1471-2334-6-178.

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Acknowledgements

The present data are extracted from a research project. Therefore, we would like to acknowledge the Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, for financial support.

Funding

This study was funded by Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

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Authors and Affiliations

  1. Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Forough Kazemi

  2. Department of Parasitology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Forough Kazemi, Mehdi Tavalla & Reza Arjmand

  3. Education Development Center (EDC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Mehdi Sayyah

  4. Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Mehdi Tavalla & Reza Arjmand

Authors
  1. Forough Kazemi
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  4. Reza Arjmand
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Corresponding author

Correspondence to Reza Arjmand.

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Conflict of Interest

The authors declare no conflict of interests.

Ethical Considerations

The present study was confirmed by the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (Approval number: IR.AJUMS.REC.1399.858) and written informed consent was obtained from all subjects.

Human and Animal Rights

No animals were used in this study. All human research procedures were in accordance with the standards set forth in the Declaration of Helsinki https://www.wma.net/policiespost/wmadeclarationof-helsinki-ethical principles for medical research-involving animals subjects/ principles of 1975, as revised in 2008 (http://www.wma.net/en/20activities/10ethics/10helsinki/).

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Kazemi, F., Sayyah, M., Tavalla, M. et al. Toxoplasmosis in Treatment-Resistant Obsessive–Compulsive Disorder Patients. Acta Parasit. 67, 356–361 (2022). https://doi.org/10.1007/s11686-021-00471-8

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  • DOI: https://doi.org/10.1007/s11686-021-00471-8

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