Exposure to common infections and risk of suicide and self-harm: a longitudinal general population study
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ORIGINAL PAPER
Exposure to common infections and risk of suicide and self‑harm: a longitudinal general population study Maija Lindgren1 · Minna Holm1 · Niina Markkula2 · Tommi Härkänen3 · Faith Dickerson4 · Robert H. Yolken5 · Jaana Suvisaari1 Received: 22 October 2019 / Accepted: 11 March 2020 © The Author(s) 2020
Abstract 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. Keywords Toxoplasma gondii · Herpes · Cytomegalovirus (CMV) · Epstein–Barr virus (EBV) · Herpes simplex virus 1 (HSV-1) · Suicide attempt
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00406-020-01120-3) contains supplementary material, which is available to authorized users. * Maija Lindgren [email protected] 1
Mental Health Unit, Finnish Institute for Health and Welfare (THL), PO Box 30, 00271 Helsinki, Finland
2
Department of Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland
3
Health Monitoring Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
4
Sheppard Pratt Health System, Stanley Research Program, Baltimore, MD, USA
5
Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
The association between mental health and common infection agents has been an increasing area of investigation. The specific infections of interest particularly includ
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