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Candida albicans associated with mental disorders
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Recent study data showed that men with schizophrenia or bipolar disorder were more likely to have a history of Candida albicans yeast infections than men without the disorders. Moreover, women with schizophrenia or bipolar disorder who tested positive for C. albicans were more likely to have delayed memory than women with the disorders but no history of infection.
“It’s far too early to single out Candida infection as a cause of mental illness, or vice versa,” Emily G. Severance, PhD, assistant professor of pediatrics and member of the Stanley Division of Developmental Neurovirology at Johns Hopkins University School of Medicine, said in a press release. “However, most Candida infections can be treated in their early stages, and clinicians should make it a point to look out for these infections in their patients with mental illness.”
Figure 1. An oral Candida infection.
Source: James Heilman, MD
In the release, Severance reported that new evidence indicates schizophrenia may be associated with weakened immune systems. Since immunocompromised patients are more susceptible to fungal infections, Severance and colleagues launched an investigation to examine the possible association between C. albicans and mental illness.
The researchers evaluated the incidence of C. albicans among patients with schizophrenia (n = 261), bipolar disorder (n = 270) and control participants (n = 277) aged 18 to 65 years. They measured IgG antibody levels obtained from blood samples to determine whether the participants were infected with or had a prior history of yeast infections.
Link between yeast infections, mental disorders varies by gender
Initially, there were no significant differences in IgG levels among the participants. When divided by sex, the researchers found elevated C. albicans measures in men with schizophrenia and bipolar disorder vs. controls (P < .0043). Further analysis adjusted for age, homelessness, race and socioeconomic status yielded a significant association between schizophrenia and C. albicans positivity (OR = 3.32; 95%, 1.55-7.11); however, the researchers were able to attribute the relationship between men with bipolar disorder and C. albicans infection with homelessness (P < .0015).
Severance and colleagues then determined whether C. albicans exposure was associated with cognitive symptoms based on participants’ scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Form A. The results showed that women with schizophrenia who were positive for C. albicans performed worse on cognitive impairment tests than women with schizophrenia who had no history of the infection (OR = 1.12; 95% CI, 1.03-1.23). In addition, they found that delayed memory was more common among seropositive women with schizophrenia (P = .0007) or bipolar disorder (P = .01) than seronegative women with the conditions.
“Although we cannot demonstrate a direct link between Candida infection and physiological brain processes, our data show that some factor associated with Candida infection, and possibly the organism itself, plays a role in affecting the memory of women with schizophrenia and bipolar disorder, and this is an avenue that needs to be further explored,” Severance said in the release. “Because Candida is a natural component of the human body microbiome, yeast overgrowth or infection in the digestive tract, for example, may disrupt the gut-brain axis. This disruption in conjunction with an abnormally functioning immune system could collectively disturb those brain processes that are important for memory.”
Previous findings link T. gondii infections to aggression
Similarly, findings previously reported also are suggestive of a relationship between infections and psychiatric disorders. Research published in the Journal of Clinical Psychiatry linked Toxoplasma gondii — a parasite found in undercooked meat and cat feces — to aggression.
Emil F. Coccaro
“Our work suggests that latent infection with the Toxoplasma gondii parasite may change brain chemistry in a fashion that increases the risk of aggressive behavior,” study researcher Emil F. Coccaro, MD, of the Pritzker School of Medicine, University of Chicago, said in a press release. “However, we do not know if this relationship is causal, and not everyone that tests positive for toxoplasmosis will have aggression issues.”
An analysis of IgG antibodies to T. gondii from 358 adults with DSM-5 intermittent explosive disorder, psychiatric disorders other than intermittent explosive disorder and control participants demonstrated that T. gondii seropositive status was associated with higher aggression (P = .022) and impulsivity (P = .05). Further analysis controlling for aggression and impulsivity scores revealed that only aggression was more common in seropositive participants (P = .011).
“It will take experimental studies to see if treating a latent toxoplasmosis infection with medication reduces aggressiveness,” Coccaro said in the release. “If we can learn more, it could provide rationale to treat [intermittent explosive disorder] in toxoplasmosis-positive patients by first treating the latent infection.” – by Stephanie Viguers
Reference:
Coccaro EF, et al. J Clin Psychiatry. 2016;doi:10.4088/JCP.14m09621.
Disclosures: Severance reports no relevant financial disclosures. Coccaro reports being a consultant, serving on the scientific advisory board and having stock options at Azevan Pharmaceuticals. Please see the full studies for a list of all other authors’ relevant financial disclosures.
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