A Longitudinal Study of the Association Between Persistent Pathogens and Incident Depression Among Older U.S. Latinos

Simanek, Amanda M.; Zheng, Cheng; Yolken, Robert H.; Haan, Mary N.; Aiello, Allison E.

doi:10.1093/gerona/gly172

Cited by 20 publications

(20 citation statements)

References 49 publications

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“…We have previously reported an association between T. gondii and depressive symptoms in this sample, even when adjusting for age, gender, region of residence, education, marital status, cat ownership, 12-month diagnoses, CRP, and antidepressant use [1]. Some previous studies have found CMV but not HSV-1 to be linked with depression [11,14,50], but the association between exposure to herpes infections and depressive symptoms has not been extensively studied.…”

Section: Discussionmentioning

confidence: 59%

Exposure to common infections and risk of suicide and self-harm: a longitudinal general population study

Lindgren

Holm

Markkula

et al. 2020

Eur Arch Psychiatry Clin Neurosci

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Common infectious agents, such as Toxoplasma gondii (T. gondii) and several human herpes viruses, have been linked to increased risk of self-harm. The aim of this study was to investigate the associations between self-harm and seropositivity to T. gondii, Epstein-Barr virus (EBV), Herpes Simplex virus Type 1 (HSV-1), and Cytomegalovirus (CMV). IgM and IgG antibodies to these infections were measured in the Health 2000 project nationally representative of the whole Finnish adult population, and 6250 participants, age 30 and over, were followed for 15 years via registers. In addition, lifetime suicidal ideation and suicide attempts based on medical records and interview were assessed within a subsample of 694 participants screened to a substudy for possible psychotic symptoms or as controls. Among the 6250 participants, 14 individuals died of suicide and an additional 4 individuals had a diagnosis of intentional self-harm during follow-up. Serological evidence of lifetime or acute infections was not found to be associated with these suicidal outcomes. However, in the subsample, those seropositive for CMV had fewer suicide attempts compared to those seronegative, adjusting for gender, age, educational level, childhood family size, regional residence, CRP, and screen status (OR for multiple attempts = 0.40, 95% confidence interval 0.20-0.83, p = 0.014). To conclude, common infections were not associated with risk of death by suicide or with self-harm diagnoses at a 15-year follow-up in the general population sample. Our finding of an increased number of suicide attempts among persons seronegative for CMV calls for further research.

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Section: Discussionmentioning

confidence: 59%

Exposure to common infections and risk of suicide and self-harm: a longitudinal general population study

Lindgren

Holm

Markkula

et al. 2020

Eur Arch Psychiatry Clin Neurosci

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“…Considering the earlier cross-sectional associations of T. gondii with depressive symptoms, GAD and comorbid disorders in this study population (Suvisaari et al, 2017), and abundant literature documenting such associations in other populations (Pearce et al, 2012;Rector et al, 2014;Simanek et al, 2018b), the lack of association in this longitudinal setting was unexpected. However, our results are in line with a recent systematic review, which did not find an association between depressive disorders and T. gondii infection (Sutterland et al, 2015).…”

Section: Discussionmentioning

confidence: 68%

“…One of the few other longitudinal studies on the topic assessed infections and the risk of new-onset depressive symptoms, and found that CMV, but not HSV-1, varicella zoster, T. gondii or Helicobacter pylori predicted incident depression over a nine-year follow-up (OR 1.4), and the association was not mediated by CRP or IL-6 levels (Simanek et al, 2018b). In another population with a one-year follow-up, there was also an association between higher CMV, but not HSV-1, IgG antibody level and incident depressive symptoms (Simanek et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…One study pointed to a modification effect of gender, whereby cytomegalovirus seropositivity was associated with a lower risk of mood disorders in men, but a higher risk in women (Simanek et al, 2018a). In few prospective studies, CMV has been associated with incident depressive symptoms (Burgdorf et al, 2019;Simanek et al, 2014;Simanek et al, 2018b). CMV has also been associated with cognitive decline in the elderly (Barnes et al, 2014), although a recent Finnish study failed to find an association with cognitive decline in the adult population (Torniainen-Holm et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Association of exposure to Toxoplasma gondii, Epstein-Barr Virus, Herpes Simplex virus Type 1 and Cytomegalovirus with new-onset depressive and anxiety disorders: An 11-year follow-up study

Markkula

Lindgren

Yolken

et al. 2020

Brain, Behavior, and Immunity

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Background: Some prevalent infections have been associated with common mental disorders, but there are few longitudinal studies, and results are inconsistent. We aimed to assess whether serological evidence of exposure to Toxoplasma gondii (T. gondii), Epstein-Barr Virus (EBV), Herpes Simplex virus Type 1 (HSV-1) and Cytomegalovirus (CMV) predict development of new-onset depressive and anxiety disorders. Methods: In a nationally representative sample of the Finnish adult population aged 30 and over (BRIF8901, n = 8028), IgG antibodies for T. gondii, EBV, HSV-1 and CMV were measured in plasma samples. The population was followed up for 11 years and new-onset depressive and anxiety disorders were diagnosed with the Composite International Diagnostic Interview. Associations were analysed controlling for sex, age, educational level, region of residence and marital status, and in separate analyses also for C-reactive protein level. Results: Seropositivity and serointensity of the four infectious agents were not associated with an increased risk of new-onset depressive or anxiety disorders. Seropositivity for CMV at baseline was associated with a lower risk of new-onset generalized anxiety disorder (adjusted OR 0.43, 95% CI 0.22-0.86 for CMV positive persons). Conclusion:The results of this large, nationally representative longitudinal study suggest that common viral infections are not significant risk factors for common mental disorders. The association of CMV with a lower risk of generalized anxiety disorder warrants further investigation.

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“…Given the well-established association between MDD, stress, and inflammation [1,2], it is conceivable that HCMV may be more prone to reactivation in MDD populations. Indeed, HCMV has been associated with depression in at least 13 studies [40][41][42][43][44][45][46][47][48][49][50][51][52][53]. In our recent work, we found that HCMV infection was associated with reduced gray matter volume in participants with MDD but not healthy controls [54].…”

Section: Introductionmentioning

confidence: 67%

Replicable association between human cytomegalovirus infection and reduced white matter fractional anisotropy in major depressive disorder

Zheng

Bergamino

Ford

et al. 2021

Neuropsychopharmacol.

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Major depressive disorder (MDD) is associated with reductions in white matter microstructural integrity as measured by fractional anisotropy (FA), an index derived from diffusion tensor imaging (DTI). The neurotropic herpesvirus, human cytomegalovirus (HCMV), is a major cause of white matter pathology in immunosuppressed populations but its relationship with FA has never been tested in MDD despite the presence of inflammation and weakened antiviral immunity in a subset of depressed patients. We tested the relationship between FA and HCMV infection in two independent samples consisting of 176 individuals with MDD and 44 healthy controls (HC) (Discovery sample) and 88 participants with MDD and 48 HCs (Replication sample). Equal numbers of HCMV positive (HCMV+) and HCMV negative (HCMV−) groups within each sample were balanced on ten different clinical/demographic variables using propensity score matching. Anti-HCMV IgG antibodies were measured using a solid-phase ELISA. In the Discovery sample, significantly lower FA was observed in the right inferior fronto-occipital fasciculus (IFOF) in HCMV+ participants with MDD compared to HCMV− participants with MDD (cluster size 1316 mm3; pFWE < 0.05, d = −0.58). This association was confirmed in the replication sample by extracting the mean FA from this exact cluster and applying the identical statistical model (p < 0.05, d = −0.45). There was no significant effect of diagnosis or interaction between diagnosis and HCMV in either sample. The effect of chronic HCMV infection on white matter integrity may—in at-risk individuals—contribute to the psychopathology of depression. These findings may provide a novel target of intervention for a subgroup of patients with MDD.

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A Longitudinal Study of the Association Between Persistent Pathogens and Incident Depression Among Older U.S. Latinos

Cited by 20 publications

References 49 publications

Exposure to common infections and risk of suicide and self-harm: a longitudinal general population study

Exposure to common infections and risk of suicide and self-harm: a longitudinal general population study

Association of exposure to Toxoplasma gondii, Epstein-Barr Virus, Herpes Simplex virus Type 1 and Cytomegalovirus with new-onset depressive and anxiety disorders: An 11-year follow-up study

Replicable association between human cytomegalovirus infection and reduced white matter fractional anisotropy in major depressive disorder

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