title: Treatment with anti-toxoplasmic activity (TATA) for toxoplasma positive patients with bipolar disorders or schizophrenia: a cross-sectional study.
abstract: OBJECTIVE
  The association between Toxoplasma gondii seropositivity and respectively Bipolar Disorder (BD) and Schizophrenia/Schizoaffective disorder (SZ) is one of the most studied link between one pathogen and psychiatric disorders. The aim of the present study was thus to retrospectively determine if the administration of an antipsychotic and/or a mood stabilizer having known in vitro Anti-Toxoplasmic Activity (TATA+) was associated with a better clinical outcome in a population of 152 BD or 114 SZ patients and seropositive for T. gondii infection compared to patients receiving a treatment without anti-toxoplasmic activity (TATA-).
  
  
  METHODS
  This multicenter study was conducted in an academic public hospital during a 3-years period between 2009 and 2011. All consecutive inpatients and outpatients with SZ or BD diagnosis with a stable treatment for more than 4 weeks were recruited. socio-demographic and clinical characteristics measured with validated scales as well as a serological status for toxoplasmic infection were included. Treatments were classified according to their in vitro antitoxoplasmic activity. A multivariate model was used to determine the clinical characteristics that were significantly different between patients receiving a treatment with no antitoxoplasmic activity compared to others.
  
  
  RESULTS
  BD patients with positive serum antibodies against T. gondii presented more lifetime depressive episodes (p = 0.048) after adjustment for age, sex and sociodemographic characteristics when treated by drug having no anti-toxo activity, compared to patients having received drugs with anti-toxo activity. A significant difference was not found in BD toxonegative patients and in SZ toxopositive or toxonegative patients.
  
  
  CONCLUSIONS
  It seems to be of importance to consider prescribing a drug with a clear anti-toxoplasmic activity (TATA+) for BD patients seropositive to T. gondii, in particular valproate that was found as the mood stabilizer with the highest antitoxoplasmic activity. Prospective randomized controlled trials are warranted to confirm this preliminary data.
authors.affiliation: INSERM U955, Équipe de Psychiatrie Translationnelle, Université Paris-Est Créteil, DHU Pe-psy, Pôle de psychiatrie des hôpitaux universitaire H Mondor, Créteil, France; Fondation FondaMental Fondation de coopération scientifique en santé mentale, France. Electronic address: guillaume.fond@gmail.com.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Fond
authors.affiliation: Fondation FondaMental Fondation de coopération scientifique en santé mentale, France; Pôle psychiatrie universitaire, CHU Sainte-Marguerite, F-13274 Marseille cedex 09, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Boyer
authors.affiliation: Fondation FondaMental Fondation de coopération scientifique en santé mentale, France.
authors.forename: Alexandru
authors.initials: A
authors.lastname: Gaman
authors.affiliation: Fondation FondaMental Fondation de coopération scientifique en santé mentale, France.
authors.forename: Hakim
authors.initials: H
authors.lastname: Laouamri
authors.affiliation: Fondation FondaMental Fondation de coopération scientifique en santé mentale, France.
authors.forename: Dodji
authors.initials: D
authors.lastname: Attiba
authors.affiliation: INSERM U955, Équipe de Psychiatrie Translationnelle, Université Paris-Est Créteil, DHU Pe-psy, Pôle de psychiatrie des hôpitaux universitaire H Mondor, Créteil, France; Fondation FondaMental Fondation de coopération scientifique en santé mentale, France.
authors.forename: Jean-Romain
authors.initials: JR
authors.lastname: Richard
authors.affiliation: Fondation FondaMental Fondation de coopération scientifique en santé mentale, France; AP-HP, Université Paris Diderot, Service de Psychiatrie, Hôpital Lariboisiere Fernand Widal, Paris, F-75010, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Delavest
authors.affiliation: INSERM U955, Équipe de Psychiatrie Translationnelle, Université Paris-Est Créteil, DHU Pe-psy, Pôle de psychiatrie des hôpitaux universitaire H Mondor, Créteil, France; Fondation FondaMental Fondation de coopération scientifique en santé mentale, France; CEA Saclay, Neurospin, Gif-Sur-Yvette, France.
authors.forename: Josselin
authors.initials: J
authors.lastname: Houenou
authors.affiliation: Jean Dausset Laboratory & INSERM, UMRS 940, Hôpital Saint Louis, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Le Corvoisier
authors.affiliation: CIC 006 Henri Mondor INSERM & Plateforme de Ressources Biologiques, Université Paris Est Créteil, AP-HP, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Charron
authors.affiliation: INSERM, UMRS 665, INTS, Paris, France.
authors.forename: Rajagopal
authors.initials: R
authors.lastname: Krishnamoorthy
authors.affiliation: Fondation FondaMental Fondation de coopération scientifique en santé mentale, France; Jean Dausset Laboratory & INSERM, UMRS 940, Hôpital Saint Louis, Paris, France.
authors.forename: José
authors.initials: J
authors.lastname: Oliveira
authors.affiliation: Jean Dausset Laboratory & INSERM, UMRS 940, Hôpital Saint Louis, Paris, France.
authors.forename: Ryad
authors.initials: R
authors.lastname: Tamouza
authors.affiliation: Stanley Laboratory of Developmental Neurovirology, Johns Hopkins University Medical Center, Baltimore, MD, USA; Stanley Research Program, Sheppard Pratt, Baltimore, MD, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Yolken
authors.affiliation: Stanley Research Program, Sheppard Pratt, Baltimore, MD, USA.
authors.forename: Faith
authors.initials: F
authors.lastname: Dickerson
authors.affiliation: INSERM U955, Équipe de Psychiatrie Translationnelle, Université Paris-Est Créteil, DHU Pe-psy, Pôle de psychiatrie des hôpitaux universitaire H Mondor, Créteil, France; Fondation FondaMental Fondation de coopération scientifique en santé mentale, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Leboyer
authors.affiliation: INSERM U955, Équipe de Psychiatrie Translationnelle, Université Paris-Est Créteil, DHU Pe-psy, Pôle de psychiatrie des hôpitaux universitaire H Mondor, Créteil, France; Fondation FondaMental Fondation de coopération scientifique en santé mentale, France.
authors.forename: Nora
authors.initials: N
authors.lastname: Hamdani
mesh_terms: D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood; D000977:Antiparasitic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy; D014122:Toxoplasma / Q000276:immunology; D014123:Toxoplasmosis / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D000977:Antiparasitic Agents; D011619:Psychotropic Drugs
keywords: Antipsychotic drugs; Bipolar disorder; Mood stabilizer; Schizophrenia; Toxoplasma gondii; Valproate