Is there any association between Toxoplasma gondii infection and bipolar disorder? A systematic review and meta-analysis

João Luís Vieira Monteiro de Barros, Izabela Guimarães Barbosa, Haitham Salem, Natalia Pessoa Rocha, Arthur Kummer, Olaoluwa O. Okusaga, Jair C. Soares, Antonio Lucio Teixeira

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Background The relationship between Toxoplasma gondii infection and the development of bipolar disorder (BD) has long been investigated, yet to date it is still poorly understood and documented. The aim of this review is to derive a summary estimate of the strength of the association between infection with T. gondii and BD from the available published studies. Methods A systematic review was performed using PubMed, LILACS, PsycINFO, and Embase databases. Studies which included a proportion of seropositive BD patients and controls were further examined in a meta-analysis. Results One hundred eighteen citations were initially retrieved. Thirteen studies were included in our systematic review. Eight out of these thirteen studies were included in our meta-analysis. Statistical analyses showed that T. gondii infection is associated with with BD (OR=1.26). Limitations Small sample size was the major limitation among the studies that carried out serological analyses. In addition, the available studies did not have enough information on disease status/severity or type of bipolar disorder. Also, it was not possible to analyze pregnancy status or perinatal infection. Future studies addressing the aforementioned topics are clearly needed. Conclusions Despite heterogeneous results, patients with BD are more likely to be infected by T. gondii than controls. Early T. gondii infection might predispose the development of BD. T.gondii infection is becoming clinically relevant in psychiatric disorders and future mechanistic studies are required to elucidate the underlying pathophysiological mechanisms.

Original languageEnglish (US)
Pages (from-to)59-65
Number of pages7
JournalJournal of Affective Disorders
StatePublished - Feb 1 2017
Externally publishedYes


  • Bipolar disorder
  • Immunology
  • Inflammation
  • Toxoplasma gondii

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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