Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore 21201, USA.
J Clin Psychiatry. 2012 Aug;73(8):1069-76. doi: 10.4088/JCP.11m07532. Epub 2012 Jul 10.
The primary aim was to relate Toxoplasma gondii seropositivity and serointensity to scores on the self-rated Suicide Assessment Scale (SUAS-S). Another aim was to reevaluate the previously reported positive association between T gondii serointensity and a history of nonfatal suicidal self-directed violence.
This cross-sectional, observational study compared T gondii serointensity and seropositivity in plasma from 54 adult suicide attempters (inpatients at Lund University Hospital, Lund, Sweden) and 30 adult control subjects (randomly selected from the municipal population register in Lund, Sweden) recruited between 2006 and 2010. The potential of patients and controls for self-directed violence was evaluated with the SUAS-S. Psychiatric diagnoses were made according to DSM-IV criteria. Plasma samples were tested for immunoglobulin G antibodies to T gondii, cytomegalovirus, and herpes simplex virus type 1. Data were analyzed using multivariable logistic regression to investigate the association between T gondii serointensity or seropositivity and a history of nonfatal suicidal self-directed violence; multivariable linear regression was used to explore the relationship between T gondii serointensity or seropositivity and the SUAS-S. Both regression models included sex, age, and body mass index as covariates.
Seropositivity of T gondii (adjusted odds ratio [OR] = 7.12; 95% CI, 1.66-30.6; P = .008) and serointensity of T gondii (adjusted OR = 2.01; 95% CI, 1.09-3.71; P = .03) were positively associated with a history of nonfatal suicidal self-directed violence. Seropositivity of T gondii was associated with higher SUAS-S scores, a relationship significant for the whole sample (P = .026), but not for suicide attempters only. No significant associations with other pathogens were identified.
These results are consistent with previous reports on the association between T gondii infection and nonfatal suicidal self-directed violence. Confirming these results in future large longitudinal studies and including suicide as an outcome may lead to novel individualized approaches in suicide prevention.
本研究的主要目的是探讨弓形体血清阳性率和血清抗体强度与自我评估自杀量表（SUAS-S）评分之间的关系。另一个目的是重新评估先前报道的弓形体血清抗体强度与非致命性自杀性自伤暴力史之间的正相关关系。
本横断面观察性研究比较了 2006 年至 2010 年间在瑞典隆德大学医院住院的 54 例自杀未遂患者（患者组）和在瑞典隆德市居民登记处随机选择的 30 例成人对照（对照组）血浆中的弓形体血清抗体强度和血清阳性率。采用 SUAS-S 评估患者和对照发生自伤性暴力的可能性。根据 DSM-IV 标准进行精神科诊断。检测血浆样本中针对弓形体、巨细胞病毒和单纯疱疹病毒 1 型的免疫球蛋白 G 抗体。采用多变量 logistic 回归分析调查弓形体血清抗体强度或血清阳性率与非致命性自杀性自伤暴力史之间的关系；采用多变量线性回归分析调查弓形体血清抗体强度或血清阳性率与 SUAS-S 之间的关系。这两个回归模型均包含性别、年龄和体重指数作为协变量。
弓形体血清阳性率（调整后的比值比 [OR] = 7.12；95%CI，1.66-30.6；P =.008）和弓形体血清抗体强度（调整后的 OR = 2.01；95%CI，1.09-3.71；P =.03）与非致命性自杀性自伤暴力史呈正相关。弓形体血清阳性率与 SUAS-S 评分较高相关，这种关系在整个样本中具有统计学意义（P =.026），但仅在自杀未遂者中无统计学意义。未发现与其他病原体的显著关联。
这些结果与先前报道的弓形体感染与非致命性自杀性自伤暴力之间的关联一致。在未来的大型纵向研究中确认这些结果并将自杀作为结局，可能会为自杀预防带来新的个体化方法。
