Are infectious agents involved in the pathogenesis of postpartum psychosis?
de Witte, L.D., Snijders, G., Litjens, M., Kamperman, A.M., Kushner, S.A., Kahn, R.S., Bergink, V.
Journal of Affective Disorders 2018; 229: 141-144
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Background: Since postpartum psychosis has been linked to activation of the immune system, it has been hypothesized that infectious agents may be involved in the pathogenesis of this disorder. We therefore investigated whether exposure to pathogens that can infect the central nervous system is increased in patients with postpartum psychosis. Methods: We measured the prevalence and titers of immunoglobulin G (IgG) and M (IgM) to herpes simplex virus type 1 (HSV-1) and 2 (HSV-2), Epstein-Barr virus (EBV), cytomegalovirus (CMV) and Toxoplasma Gondii (TG) in a cohort of patients with postpartum psychosis (n = 81) and compared these to matched postpartum controls. Results: We did not find significant differences in seroprevalence or antibody titers for any of these pathogens. Limitations: Limitations of this study include the indirect measurement of infectious disease and the cross-sectional design. Conclusion: Our results do not support the hypothesis that exposure to these neurotropic pathogens is involved in postpartum psychosis.