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一组意大利双相情感障碍和精神障碍患者中的弓形虫病:感染如何影响临床特征?

Toxoplasmosis in a Cohort of Italian Patients With Bipolar and Psychotic Disorders: How Infection May Affect Clinical Features?

作者信息

Del Grande Claudia, Schiavi Elisa, Masci Isabella, Barbuti Margherita, Maccariello Giuseppe, Massimetti Gabriele, Bruschi Fabrizio, Dell'Osso Liliana

机构信息

Section of Psychiatry, Department of Clinical and Experimental Medicine.

Department of Translational Research, N.T.M.S., School of Medicine, University of Pisa, Pisa, Italy.

出版信息

J Nerv Ment Dis. 2020 Feb;208(2):118-126. doi: 10.1097/NMD.0000000000001102.

Abstract

This study investigated the seroprevalence of Toxoplasma gondii in a cohort of 101 Italian inpatients affected by mood or schizophrenia-spectrum disorders and compared clinical features between seronegative and seropositive subjects. Patients diagnosed according to DSM-5 criteria underwent clinical assessments and blood collection to test parasite-specific IgG/IgM serum levels. Twenty-eight patients (27.7%) had IgG anti-T. gondii, and none had IgM antibodies. We found higher prevalence rate in patients aged 40 years or older, as compared with younger. No significant association was detected between T. gondii and a specific diagnostic category; however, bipolar disorder (BD)-II showed the highest positivity rate (40.9%). The seropositive status was significantly associated with a lower presence of psychotic symptoms, higher number of total episodes of predominant excitatory polarity, longer illness duration, and lower severity of current episode, particularly anxiety, depressive, and withdrawal/retardation symptoms. These preliminary results seem to point out an association between chronic toxoplasmosis and a specific subtype of BD.

摘要

本研究调查了101名患有情绪障碍或精神分裂症谱系障碍的意大利住院患者队列中弓形虫的血清阳性率,并比较了血清阴性和血清阳性受试者之间的临床特征。根据《精神疾病诊断与统计手册》第五版(DSM-5)标准诊断的患者接受了临床评估和血液采集,以检测寄生虫特异性IgG/IgM血清水平。28名患者(27.7%)有抗弓形虫IgG,无一例有IgM抗体。我们发现40岁及以上患者的患病率高于年轻患者。未检测到弓形虫与特定诊断类别之间存在显著关联;然而,双相情感障碍(BD)II型的阳性率最高(40.9%)。血清阳性状态与精神病性症状较少、主要为兴奋性极性的总发作次数较多、病程较长以及当前发作的严重程度较低显著相关,尤其是焦虑、抑郁和退缩/迟缓症状。这些初步结果似乎指出了慢性弓形虫病与BD的一种特定亚型之间的关联。

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