A German Multicenter Study on Toxoplasma Gondii in First-episode Schizophrenia

NCT ID: NCT00686400

Last Updated: 2010-01-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

360 participants

Study Classification

OBSERVATIONAL

Study Start Date

2008-05-31

Study Completion Date

2011-05-31

Brief Summary

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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.

Detailed Description

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Conditions

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Schizophrenia Schizophreniform Disorder Schizoaffective Disorder

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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1: FE

FE = first episode schizophrenia

TAU = treatment as usual

Intervention Type OTHER

medication and psychosocial interventions to be chosen by treating psychiatrist

2: CO

CO = age and gender-matched control subjects

No interventions assigned to this group

Interventions

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TAU = treatment as usual

medication and psychosocial interventions to be chosen by treating psychiatrist

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Inclusion Criteria:

* Key inclusion criteria will be a first episode of schizophrenia, schizoaffective or schizophreniform disorder.

Exclusion Criteria:

* Exclusion criteria will be major organic and substance induced disorders, refusal or withdrawal of IC.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Heidelberg University

OTHER

Sponsor Role collaborator

Martin-Luther-Universität Halle-Wittenberg

OTHER

Sponsor Role lead

Responsible Party

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Dept. of Psychiatry, Psychotherapy and Psychosomatics, University of Halle

Principal Investigators

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Silke Bachmann, MD, assistant prof. psychiatry

Role: PRINCIPAL_INVESTIGATOR

Dept. of Psychiatry, Psychotherapy and Psychosomatics, University of Halle (Saale), Germany

Locations

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Dpt. of Psychiatry, University of Frankfurt

Frankfurt am Main, , Germany

Site Status RECRUITING

Dept. of Psychiatry, University of Halle (Saale)

Halle, , Germany

Site Status RECRUITING

Dept. of Psychiatry, University of Heidelberg

Heidelberg, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Silke Bachmann, MD, assistant prof. psychiatry

Role: CONTACT

49-345-557 ext. 3624

Johannes Schroeder, MD, professor of psychiatry

Role: CONTACT

49-6221-56 ext. 4403

Facility Contacts

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Johannes Pantel, Professor

Role: primary

+49-69-6301 ext. 7094

Daniela Hainz, MA

Role: backup

+49-69-6301 ext. 7094

Silke Bachmann, Deputy Director

Role: primary

+49-345-557 ext. 3624

Johannes Schroeder, Professor

Role: primary

+49-6221-56 ext. 4403

Kira Krapf, MA

Role: backup

+49-6221-56 ext. 4403

References

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Torrey EF, Yolken RH. Toxoplasma gondii and schizophrenia. Emerg Infect Dis. 2003 Nov;9(11):1375-80. doi: 10.3201/eid0911.030143.

Reference Type BACKGROUND
PMID: 14725265 (View on PubMed)

Yolken RH, Bachmann S, Ruslanova I, Lillehoj E, Ford G, Torrey EF, Schroeder J. Antibodies to Toxoplasma gondii in individuals with first-episode schizophrenia. Clin Infect Dis. 2001 Mar 1;32(5):842-4. doi: 10.1086/319221. Epub 2001 Feb 28.

Reference Type BACKGROUND
PMID: 11229859 (View on PubMed)

Bachmann S, Schroder J, Bottmer C, Torrey EF, Yolken RH. Psychopathology in first-episode schizophrenia and antibodies to Toxoplasma gondii. Psychopathology. 2005 Mar-Apr;38(2):87-90. doi: 10.1159/000085349. Epub 2005 Apr 22.

Reference Type BACKGROUND
PMID: 15855832 (View on PubMed)

Related Links

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http://www.stanleyresearch.org

The SMRI funds this study, sample analyses wil be made at the Stanley Laboratory of Developmental Neurovirology at the Johns Hopkins University, Baltimore, MD, USA

Other Identifiers

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07R-1815, SMRI

Identifier Type: -

Identifier Source: org_study_id

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