title: Differences in onset of disease and severity of psychopathology between toxoplasmosis-related and toxoplasmosis-unrelated schizophrenia.
abstract: OBJECTIVE
  Toxoplasmosis is a lifelong parasitic disease that appears to be associated to schizophrenia. However, no distinguishing attributes in Toxoplasma-infected schizophrenia patients have been described as yet.
  
  
  METHODS
  We searched for differences in symptom profile, cognitive performance and treatment response between 194 Toxoplasma-free and 57 (22.7%) Toxoplasma-infected schizophrenia patients treated in Prague Psychiatric Centre between 2000 and 2010.
  
  
  RESULTS
  Infected and non-infected patients differed in severity of symptoms (P = 0.032) measured with the Positive and Negative Symptom Scale (PANSS). Infected patients scored higher in positive subscale 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 PANSS scores of positive, negative and disorganised psychopathology were associated with the lower titres of anti-Toxoplasma antibodies suggesting that psychopathology deteriorates with duration of parasitic infection. Infected patients remained about 33 days longer in hospital during their last admission than uninfected ones (P = 0.003). Schizophrenia started approximately 1 year earlier in infected men and about 3 years later in infected women, no such difference was observed in uninfected subjects.
  
  
  CONCLUSIONS
  Latent toxoplasmosis in schizophrenia may lead to more severe positive psychopathology and perhaps less favourable course of schizophrenia.
authors.affiliation: Medical Faculty Charles University, Hradec Králové, Czech Republic.
authors.forename: D
authors.initials: D
authors.lastname: Holub
authors.forename: J
authors.initials: J
authors.lastname: Flegr
authors.forename: E
authors.initials: E
authors.lastname: Dragomirecká
authors.forename: M
authors.initials: M
authors.lastname: Rodriguez
authors.forename: M
authors.initials: M
authors.lastname: Preiss
authors.forename: T
authors.initials: T
authors.lastname: Novák
authors.forename: J
authors.initials: J
authors.lastname: Čermák
authors.forename: J
authors.initials: J
authors.lastname: Horáček
authors.forename: P
authors.initials: P
authors.lastname: Kodym
authors.forename: J
authors.initials: J
authors.lastname: Libiger
authors.forename: C
authors.initials: C
authors.lastname: Höschl
authors.forename: L B
authors.initials: LB
authors.lastname: Motlová
mesh_terms: D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000453:epidemiology / Q000469:parasitology / Q000523:psychology; D018153:Czech Republic; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000453:epidemiology* / Q000469:parasitology*; D012565:Schizophrenic Psychology; D012720:Severity of Illness Index; D017678:Sex Distribution; D016781:Toxoplasmosis, Cerebral / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult