Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2012 Aug;139(1-3):161-8.
doi: 10.1016/j.schres.2012.05.023. Epub 2012 Jun 15.

Childhood infection and adult schizophrenia: a meta-analysis of population-based studies

Golam M Khandaker  1 , Jorge Zimbron, Christina Dalman, Glyn Lewis, Peter B Jones
Affiliations
Meta-Analysis

Childhood infection and adult schizophrenia: a meta-analysis of population-based studies

Golam M Khandaker et al. Schizophr Res. 2012 Aug.

Abstract

Objective: To determine whether exposures to infectious illness during childhood involving the CNS or elsewhere is associated with adult schizophrenia or other psychoses.

Method: Systematic review and meta-analysis of published literature identified by electronic and manual search meeting three inclusion criteria: population-base, objective assessment of childhood infection at the individual level, standard definition of adult psychotic outcomes. We calculated risk ratio for all CNS infection, and separately for viral and bacterial infection in relation to non-affective psychosis and schizophrenia, which was combined in meta-analysis.

Results: Seven studies were included. Meta-analysis involving 2424 cases and over 1.2 million controls showed CNS viral infection was associated with nearly two-fold increased risk of adult non-affective psychosis (risk ratio 1.70; 95% CI 1.13-2.55; p=0.01). There was no significant heterogeneity between studies (p=0.26; I(2)=20%). Separate meta-analysis involving 1035 cases and over 1.2 million controls suggested all childhood CNS infections, particularly viral infections, may be associated with nearly two-fold risk of adult schizophrenia. However, there was evidence of some heterogeneity between these studies (p=0.07; I(2)=70%). CNS bacterial infections were not associated with risk of psychosis. Data on childhood infections with no obvious involvement of the CNS is insufficient.

Conclusions: These findings indicate childhood CNS viral infections increase the risk of adult psychotic illness. Possible mechanisms may include both direct effects of pathogens, and the effects of inflammatory response on the developing brain.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Selection of studies for the review of early life infection and schizophrenia.
Fig. 2
Fig. 2
Meta-analysis of childhood CNS infection and adult non-affective psychosis including schizophrenia.
Fig. 3
Fig. 3
Meta-analysis of childhood CNS infection and adult schizophrenia.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Abrahao A.L., Focaccia R., Gattaz W.F. Childhood meningitis increases the risk for adult schizophrenia. World J. Biol. Psychiatry. 2005;6(Suppl. 2):44–48. - PubMed
    1. Bayer T.A., Falkai P., Maier W. Genetic and non-genetic vulnerability factors in schizophrenia: the basis of the “two hit hypothesis”. J. Psychiatr. Res. 1999;33(6):543–548. - PubMed
    1. Brown A.S., Derkits E.J. Prenatal infection and schizophrenia: a review of epidemiologic and translational studies. Am. J. Psychiatry. 2010;167(3):261–280. - PMC - PubMed
    1. Brown A.S., Cohen P., Harkavy-Friedman J., Babulas V., Malaspina D., Gorman J.M., Susser E.S. A.E. Bennett Research Award. Prenatal rubella, premorbid abnormalities, and adult schizophrenia. Biol. Psychiatry. 2001;49(6):473–486. - PubMed
    1. Brown A.S., Hooton J., Schaefer C.A., Zhang H., Petkova E., Babulas V., Perrin M., Gorman J.M., Susser E.S. Elevated maternal interleukin-8 levels and risk of schizophrenia in adult offspring. Am. J. Psychiatry. 2004;161(5):889–895. - PubMed

Publication types

MeSH terms