title: Toxoplasma gondii Infection and Premenstrual Dysphoric Disorder: A Cross-Sectional Study.
abstract: BACKGROUND
  Premenstrual dysphoric disorder is a severe form of premenstrual syndrome. The influence of Toxoplasma gondii (T. gondii) infection on clinical features in women with this disorder has not been studied. Therefore, we determined the association of T. gondii infection with symptoms and signs in women suffering from premenstrual dysphoric disorder.
  
  
  METHODS
  We performed a cross-sectional study of 151 women suffering from premenstrual dysphoric disorder. Anti-Toxoplasma IgG and IgM antibodies were detected in sera of the participants using enzyme-linked immunoassays (EIAs). In addition, T. gondii DNA was detected in whole blood of IgG seropositive participants using polymerase chain reaction. We obtained the clinical data of women with the aid of a questionnaire. The association of T. gondii infection with clinical characteristics of women was assessed by bivariate and multivariate analyses.
  
  
  RESULTS
  Anti-T. gondii IgG antibodies were found in 10 (6.6%) of the 151 women studied. Of the 10 IgG seropositive women, four (40.0%) were positive for anti-T. gondii IgM antibodies, and one (10.0%) for T. gondii DNA. Mean number (25.8 ± 7.58) of premenstrual clinical characteristics in seropositive women was similar to that (29.22 ± 9.13) found in seronegative women (P = 0.25). Logistic regression showed that seropositivity to T. gondii was negatively associated with difficulty concentrating (OR: 0.18; 95% CI: 0.03 - 0.91; P = 0.03), and positively associated with out of control feeling or overwhelmed (OR: 9.00; 95% CI: 1.32 - 62.00; P = 0.02).
  
  
  CONCLUSIONS
  Results of this first study on the association of T. gondii infection and clinical characteristics of premenstrual dysphoric disorder suggest that this infection might be linked to some symptoms of this disorder. We report for the first time the association of T. gondii infection and out of control feeling or overwhelmed. Results warrant for further research on the role of T. gondii in premenstrual dysphoric disorder.
authors.affiliation: Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Dgo, Mexico.
authors.forename: Cosme
authors.initials: C
authors.lastname: Alvarado-Esquivel
authors.affiliation: Institute for Scientific Research "Dr. Roberto Rivera Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Durango, Mexico.
authors.forename: Luis Francisco
authors.initials: LF
authors.lastname: Sanchez-Anguiano
authors.affiliation: Institute for Scientific Research "Dr. Roberto Rivera Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Durango, Mexico.
authors.forename: Jesus
authors.initials: J
authors.lastname: Hernandez-Tinoco
authors.affiliation: Institute for Scientific Research "Dr. Roberto Rivera Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Durango, Mexico.
authors.forename: Alma Rosa
authors.initials: AR
authors.lastname: Perez-Alamos
authors.affiliation: Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Dgo, Mexico.
authors.forename: Yazmin Del Rosario
authors.initials: Ydel R
authors.lastname: Rico-Almochantaf
authors.affiliation: Institute for Scientific Research "Dr. Roberto Rivera Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Durango, Mexico.
authors.forename: Sergio
authors.initials: S
authors.lastname: Estrada-Martinez
authors.affiliation: Health Center No. 2 "Dr. Carlos Santamaria", Servicios de Salud de Durango, Talpa S/N, 34170 Durango, Mexico.
authors.forename: Raquel
authors.initials: R
authors.lastname: Vaquera-Enriquez
authors.affiliation: Health Center No. 2 "Dr. Carlos Santamaria", Servicios de Salud de Durango, Talpa S/N, 34170 Durango, Mexico.
authors.forename: Arturo
authors.initials: A
authors.lastname: Diaz-Herrera
authors.affiliation: Clinica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas S/N, 34079 Durango, Mexico.
authors.forename: Agar
authors.initials: A
authors.lastname: Ramos-Nevarez
authors.affiliation: Institute for Scientific Research "Dr. Roberto Rivera Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Durango, Mexico.
authors.forename: Ada Agustina
authors.initials: AA
authors.lastname: Sandoval-Carrillo
authors.affiliation: Institute for Scientific Research "Dr. Roberto Rivera Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Durango, Mexico.
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Salas-Pacheco
authors.affiliation: Clinica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas S/N, 34079 Durango, Mexico.
authors.forename: Sandra Margarita
authors.initials: SM
authors.lastname: Cerrillo-Soto
authors.affiliation: Institute for Scientific Research "Dr. Roberto Rivera Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Durango, Mexico.
authors.forename: Elizabeth Irasema
authors.initials: EI
authors.lastname: Antuna-Salcido
authors.affiliation: Institute for Microbiology and Hygiene, Campus Benjamin Franklin, Charite Medical School, Hindenburgdamm 27, D-12203 Berlin, Germany; Current address: Medical and Scientific Affairs, Roche Molecular Systems, Pleasanton, CA 94588, USA.
authors.forename: Oliver
authors.initials: O
authors.lastname: Liesenfeld
authors.affiliation: Clinica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas S/N, 34079 Durango, Mexico.
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Guido-Arreola
keywords: Cross-sectional study; Premenstrual dysphoric disorder; Seroprevalence; Toxoplasma gondii