Differences in onset of disease and severity of psychopathology between toxoplasmosis-related and toxoplasmosis-unrelated schizophrenia.

Holub D, Flegr J, Dragomirecka´E, Rodriguez M, Preiss M, Nova´kT,Cˇerma´k J, Hora´cˇek J, Kodym P, Libiger J, Ho¨schl C, Motlova´LB.Differences in onset of disease and severity of psychopathology betweentoxoplasmosis-related and toxoplasmosis-unrelated schizophrenia.Objective: Toxoplasmosis is a lifelong parasitic disease that appears tobe associated to schizophrenia. However, no distinguishing attributes inToxoplasma-infected schizophrenia patients have been described as yet.Method: We searched for differences in symptom profile, cognitiveperformance and treatment response between 194 Toxoplasma-free and57 (22.7%) Toxoplasma-infected schizophrenia patients treated inPrague Psychiatric Centre between 2000 and 2010.Results: Infected and non-infected patients differed in severity ofsymptoms (P = 0.032) measured with the Positive and NegativeSymptom Scale (PANSS). Infected patients scored higher in positivesubscale of PANSS, but not in the general and negative subscales.Infected men scored higher also in Total PANSS score, and negative,reality distortion, disorganisation and cognitive scores. Higher PANSSscores of positive, negative and disorganised psychopathology wereassociated with the lower titres of anti-Toxoplasma antibodiessuggesting that psychopathology deteriorates with duration of parasiticinfection. Infected patients remained about 33 days longer in hospitalduring their last admission than uninfected ones (P = 0.003).Schizophrenia started approximately 1 year earlier in infected men andabout 3 years later in infected women, no such difference was observedin uninfected subjects.Conclusion: Latent toxoplasmosis in schizophrenia may lead to moresevere positive psychopathology and perhaps less favourable course ofschizophrenia.