10/9/2018 Stanley Medical Research Institute | Toxoplasmosis–Schizophrenia Research

Toxoplasmosis–Schizophrenia Research
(Last updated July 2017)

Welcome to the Toxoplasmosis–Schizophrenia Research section. This site is maintained by the Stanley Medical
Research Institute (SMRI) and the Stanley Division of Developmental Neurovirology for researchers and others
interested in the possible etiological relationship between Toxoplasma gondii (and related organisms) and
schizophrenia (and related psychoses). The purpose of the webpage is to make information on this line of research,
including background data and current research, easily available.

This section will be updated periodically. Comments, suggestions, additions, and corrections are welcomed. They
can be sent to either E. Fuller Torrey, MD, or Robert H. Yolken, MD.

Related sites:
ToxoDB: provides detailed information on the genome of Toxoplasma gondii
Schizophrenia Research Forum: a useful online forum to keep updated on schizophrenia research

Introduction
SMRI has undertaken extensive research on infectious agents as one of the possible causes of schizophrenia.
Among the infectious agents that appear most promising is Toxoplasma gondii, a protozoan parasite that causes
toxoplasmosis and is carried by cats and other felines. Until recently, toxoplasmosis was thought to be a problem
only for pregnant women who, if they became infected with T. gondii during their pregnancy, risked having the
organism cause damage to the growing fetus. This is why pregnant women are advised to not change the litter in
the cat litter box. Infection with T. gondii in other adults and children was thought to be either asymptomatic or to
cause an influenza-like or mononucleosis-like syndrome. It now seems possible that T. gondii may be associated
with some cases of schizophrenia and perhaps other psychiatric syndromes.

Schizophrenia is a brain disease that begins in young adults, typically between the ages of 16 and 30, and is
characterized by some combination of auditory hallucinations (hearing voices), delusions, flattened affect,
disordered thought patterns, bizarre behavior, and social withdrawal. Schizophrenia affects approximately 1 percent
of the adult population and in most cases is a lifelong disease with remissions and exacerbations. It is also a very
expensive disease. Conservative estimates place the cost of schizophrenia in the United States at more than $40
billion a year.

For additional information on schizophrenia, see Torrey EF, Surviving Schizophrenia, 6th edition (New York,
HarperCollins, 2013).

Summary: What links T. gondii to schizophrenia and related psychoses?

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More than 80 studies have reported increased antibody levels to T. gondii in individuals with schizophrenia and
related psychoses.
Four studies have reported that individuals with schizophrenia, compared to controls, have had more contact with
cats during childhood.
T. gondii has been shown to make dopamine, thought to be elevated in individuals with schizophrenia.
Epidemiologically there are many similarities between schizophrenia and toxoplasmosis.
Some antipsychotics have been shown to suppress T. gondii.
A study in China reported that having antibodies to T. gondii at the time students entered college made it
significantly more likely that the student would be diagnosed with psychosis during the next four years.

Topics of Interest
I. All About Cats

Origin, domestication and early history

Modern history
Distribution and number of cats
Cat feces and T. gondii oocyst distribution

II. Transmission of T. gondii

Ingestion of tissue cysts

Ingestion or inhalation of oocysts
Vertical transmission from infected mother to offspring
Sexual transmission of T. gondii
Timing of infection by T. gondii
Do people with close cat contact have a greater chance of being infected with T. gondii?
Do children with close cat contact have a greater chance of developing schizophrenia?

III. Epidemiological Similarities and Differences Between Toxoplasmosis and Schizophrenia

Familial and genetic aspects

Age of onset
Males get sick at a younger age than females
Socioeconomic status and household crowding
Seasonal variation
Association with stillbirths
Geographic low-prevalence toxoplasmosis regions
Historical trends
Urban-rural differences
Geographic high-prevalence toxoplasmosis regions
Historical trends

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IV. Effects of T. gondii on Behavior and Psychiatric Symptoms

Early Research
Behavioral manipulation by T. gondii in animals
Effects of T. gondii on personality traits of humans
Effects of T. gondii on cognition in humans
Effects of T. gondii on reaction time and vehicular accidents
Psychiatric manifestations of congenital T. gondii infections
Psychiatric manifestations of adult T. gondii infections
The effects of different strains of T. gondii

V. Studies of T. gondii Antibodies in Schizophrenia

Studies of antibodies in individuals who have schizophrenia

Studies of antibodies in individuals prior to the onset of schizophrenia
Studies of T. gondii antibodies in the mothers of children who are later diagnosed with schizophrenia
Do antibodies to T. gondii remain detectable over many years?

VI. Neurotransmitters and T. gondii

Origin of interest in dopamine and T. gondii

Toxoplasma gondii has the ability to make dopamine
Effects of changing levels of dopamine on behavior induced by T. gondii infection
Effects of T. gondii infection on GABA
Strain differences in effects on neurotransmitters

VII. Neuropathology of T. gondii

Neuropath studies of T. gondii in schizophrenia

Other means of identifying T. gondii in brain tissue
T. gondii and the intestine

VIII. Treatment Approaches to Toxoplasmosis and Schizophrenia

Background: Protozoa
In vitro studies
Trials of drugs known to be effective against T. gondii on patients with schizophrenia

IX. Toxoplasmosis and Other Diseases

Bipolar Disorder
Obsessive-Compulsive Disorder

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Depression and Anxiety Disorder

Suicidal Behavior
Substance Abuse
Intermittent Explosive Disorder
Multiple Sclerosis
Parkinson’s Disease
Migraines
Epilepsy
Alzheimer’s Disease
Brain Cancer
Obesity
Rheumatoid Arthritis

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