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Infection with Toxoplasma gondii increases the risk of psychiatric disorders in Taiwan: a nationwide population-based cohort study

Published online by Cambridge University Press:  30 July 2020

Hsin-An Lin ,
Wu-Chien Chien ,
Kuo-Yang Huang ,
Chi-Hsiang Chung ,
Lih-Chyang Chen ,
Hsin-Chung Lin  and
Jong-Long Guo Open the ORCID record for Jong-Long Guo [Opens in a new window]
Hsin-An Lin
Affiliation:
Division of Infection, Department of Medicine, Tri-Service General Hospital SongShan Branch, National Defense Medical Center, No. 131, Jiankang Rd., Songshan District, Taipei City10581, Taiwan Department of Health Promotion and Health Education, National Taiwan Normal University, No. 162, Section 1, Heping E. Rd., Taipei City106, Taiwan
Wu-Chien Chien
Affiliation:
School of Public Health, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City11490, Taiwan Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, No. 131, Jiankang Rd., Songshan District, Taipei City10581, Taiwan Graduate Institute of Life Sciences, National Defense Medical Center, No. 161, Sec. 6, 1 Minquan E. Rd., Neihu Dist., Taipei City11490, Taiwan
Kuo-Yang Huang
Affiliation:
Graduate Institute of Pathology and Parasitology, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City11490, Taiwan
Chi-Hsiang Chung
Affiliation:
School of Public Health, National Defense Medical Center, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City11490, Taiwan Taiwanese Injury Prevention and Safety Promotion Association, Rm. 4112, No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City114, Taiwan
Lih-Chyang Chen
Affiliation:
Department of Medicine, Mackay Medical College, No. 46, Sec. 3, Zhongzheng Rd., Sanzhi Dist., New Taipei City252, Taiwan
Hsin-Chung Lin*
Affiliation:
Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu District, Taipei City11490, Taiwan
Jong-Long Guo*
Affiliation:
Department of Health Promotion and Health Education, National Taiwan Normal University, No. 162, Section 1, Heping E. Rd., Taipei City106, Taiwan
*
Authors for correspondence: Hsin-Chung Lin, E-mail: [email protected] and Jong-Long Guo, E-mail: [email protected]
Authors for correspondence: Hsin-Chung Lin, E-mail: [email protected] and Jong-Long Guo, E-mail: [email protected]
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Abstract

This study aimed to evaluate associations between toxoplasmosis and psychiatric disorders in Taiwan based on the National Health Insurance Research Database, Taiwan (1997–2013). Patients newly diagnosed with toxoplasmosis formed the case group (n = 259), and the control group included propensity-score matched patients without toxoplasmosis (n = 1036). The primary outcome was incidence of psychiatric disorders. Cox proportional hazards regression and stratified analyses were performed to examine risk of developing specific psychiatric disorders between patients with and without toxoplasmosis. Patients with toxoplasmosis had significantly higher incidence of psychiatric disorders than those without toxoplasmosis (P = 0.016). A significant difference was found in numbers of psychiatric disorders between the two groups during 14 years of follow-up (log-rank P < 0.001). Those with toxoplasmosis had significantly higher risk of bipolar disorder [adjusted hazard ratio (aHR = 3.60, 95% confidence interval (CI) = 2.07, 7.26), depression (aHR = 4.94, 95% CI = 2.15, 11.80) and anxiety (aHR = 5.36, 95% CI = 2.98, 25.88), but no significant between-group differences were found for schizophrenia and other psychiatric disorders. In conclusion, the present nationwide population-based analysis revealed that Toxoplasma gondii infection in Taiwan significantly increases the risk for developing bipolar disorder, depression and anxiety, but not for schizophrenia and other psychiatric disorders.

Keywords

Anxietybipolar disorderdepressionschizophreniaToxoplasma gondii
Type
Research Article
Information
Parasitology , Volume 147 , Issue 13 , November 2020 , pp. 1577 - 1586
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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