Akaltun İsmail, Kara Soner Sertan, Kara Tayfun
a Department of Child and Adolescent Psychiatry , Gaziantep Dr. Ersin Arslan Training and Research Hospital , Gaziantep , Turkey.
b Department of Pediatric Infectious Diseases , Erzurum Regional Training and Research Hospital , Erzurum , Turkey.
Nord J Psychiatry. 2018 Jan;72(1):57-62. doi: 10.1080/08039488.2017.1385850. Epub 2017 Oct 9.
Toxoplasma gondii may play a role in the development of psychiatric diseases by affecting the brain. The purpose of this study was to examine the relation between serum toxoplasma IgG positivity and obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD) in children and adolescents.
Sixty patients diagnosed with OCD and 60 patients with GAD presenting to the pediatric psychiatry clinic, together with 60 control group subjects with no psychiatric diagnosis, were included in the study. The patients were administered the State-Trait Anxiety Inventory for Children and the Children's Yale-Brown Obsessive Compulsive Scale. Serum toxoplasma IgG levels were determined from blood specimens collected from the study and control groups. The results were then compared using statistical methods.
State and trait anxiety levels were significantly higher in the OCD and GAD patients than in the control group (p = .0001/.0001). Serum toxoplasma IgG levels were positive in 21 (35%) of the OCD patients, 19 (31.7%) of the GAD patients and 6 (10%) of the control group. A significant relation was determined between IgG positivity and GAD (p = .003). IgG-positive individuals were determined to have a 4.171-fold greater risk of GAD compared to those without positivity (4.171[1.529-11.378]) (p = .005). A significant relation was also determined between IgG positivity and OCD (p = .001). IgG-positive individuals were determined to have a 4.846-fold greater risk of OCD compared to those without positivity (4.846[1.789-13.126]) (p = .002).
This study shows that serum toxoplasma IgG positivity indicating previous toxoplasma infection increased the risk of GAD 4.171-fold and the risk of OCD 4.846-fold in children and adolescents. Further studies are now needed to investigate the relation between T. gondii infection and GAD/OCD and to determine the pathophysiology involved.
弓形虫可能通过影响大脑在精神疾病的发展中发挥作用。本研究的目的是探讨儿童和青少年血清弓形虫IgG阳性与强迫症（OCD）和广泛性焦虑症（GAD）之间的关系。
本研究纳入了60例诊断为强迫症的患者、60例广泛性焦虑症患者以及60例无精神疾病诊断的对照组受试者，这些患者均来自儿童精神病诊所。对患者进行了儿童状态-特质焦虑量表和儿童耶鲁-布朗强迫症量表测试。从研究组和对照组采集的血液标本中测定血清弓形虫IgG水平。然后使用统计方法对结果进行比较。
强迫症和广泛性焦虑症患者的状态和特质焦虑水平显著高于对照组（p = .0001/.0001）。强迫症患者中有21例（35%）血清弓形虫IgG水平呈阳性，广泛性焦虑症患者中有19例（31.7%）呈阳性，对照组中有6例（10%）呈阳性。IgG阳性与广泛性焦虑症之间存在显著相关性（p = .003）。与IgG阴性个体相比，IgG阳性个体患广泛性焦虑症的风险高4.171倍（4.171[1.529 - 缉.378]）（p = .005）。IgG阳性与强迫症之间也存在显著相关性（p = .001）。与IgG阴性个体相比，IgG阳性个体患强迫症的风险高4.846倍（4.846[1.789 - 13.126]）（p = .002）。
本研究表明，血清弓形虫IgG阳性表明既往有弓形虫感染，在儿童和青少年中，其使广泛性焦虑症风险增加4.171倍，使强迫症风险增加4.846倍。现在需要进一步研究来调查弓形虫感染与广泛性焦虑症/强迫症之间的关系，并确定其中涉及的病理生理学机制。
