Schizophrenia Clinical Trial
Official title:
A German Multicenter Study on Toxoplasma Gondii in First-episode Schizophrenia
Environmental risk factors for the development of schizophrenia include infections during
the perinatal period or later in life with Toxoplasma gondii (TG) being one of the candidate
agents. A recent review (Torrey and Yolken, 2003) on TG in schizophrenia and other serious
mental disorder reported higher antibodies to TG in patients compared to controls in 18 of
19 studies, one having been conducted by the investigators group. In a second, independent
study on first-episode schizophrenia (n=56) and control subjects (n=32), sera were sampled
and standard instruments used to assess diagnoses and psychopathology, respectively to
screening controls.
For the total sample, contacts with animals during pregnancy and age emerged as a
non-significant predictors of TG IgG titers. Means of patients' and controls' TG IgG titers
did not differ significantly but variances did; a subgroup of patients' titers reached much
higher levels than those of controls. Patients in the high TG IgG subgroup were older
(p=0.001), also they were older when psychiatric symptoms appeared, more individuals had
regular animal contacts during pregnancy, or rural upbringing including regular animal
contact, more consumption of raw meat, and a higher absolute treatment response (all trend
levels). Regarding the short term course of patients, the investigators detected decreasing
IgG titers in several individuals A power analysis demonstrated that results fell short of
significance due to lack of statistical power. Based on the power analysis, the
investigators propose an opel label, multicenter study at three regionally different sites
within Germany (Halle, Hamm, Heidelberg). The investigators intent to study 173
first-episode patients with schizophrenia, schizoaffective, and schizophreniform disorder
and 173 matched controls.
The investigators hypothesize that - according to the heterogeneity of the illness - a
subgroup of patients will exhibit higher TG IgG titers compared to the remaining patients
and to controls; that this subgroup will have had regular contact with animals during
pregnancy and early life as well as developmental delays; and that clinical improvement,
response to treatment, and subjective well-being will run parallel with TG IgG decrease.
Patients shall be assessed on admission to hospital, at discharge and at 6- and
12-month-follow-up with respect to TG antibody titers, symptomatology, neuropsychology,
predictors of outcome, quality of life, and neurological soft signs. In controls two
assessments shall be performed, 12 months apart. All foreseen assessments will be performed
using standard measurement instruments with sound reliability and validity such as the SCID
and the PANSS. Exposure to cats, other warm-blooded life-stock, and raw meat will be
assessed using a special questionnaire.
n/a
Observational Model: Case Control, Time Perspective: Prospective
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