Home' Trinidad and Tobago Guardian : October 31st 2015 Contents A24
body & soul
Guardian www.guardian.co.tt Saturday, October 31, 2015
Sometime around 1907, American psychiatrist
Henry Cotton began removing decaying teeth from
his patients in hopes of curing their mental disor-
ders. If that didn t work, he moved on to more inva-
sive excisions: tonsils, testicles, ovaries and, in
some cases, colons.
Cotton was the newly appointed director of the
New Jersey State Hospital for the Insane and was
acting on a theory proposed by influential Johns
Hopkins psychiatrist Adolf Meyer, under whom Cotton
had studied, that psychiatric illness is the result of
chronic infection. Meyer s idea was based on obser-
vations that patients with high fevers sometimes
experience delusions and hallucinations.
Cotton ran with the idea, scalpel in hand. Eventually
he opened a hugely successful private practice, catering
to the infected molars of Trenton, NJ high society.
Following his death in 1933, interest in Cotton s
cures waned. His mortality rates hovered at a troubling
45 per cent, and in all likelihood his treatments didn t
work. But though his rogue surgeries were dreadfully
misguided and disfiguring, growing research suggests
there might be something to his belief that infec-
tion---and with it inflammation---is involved in some
forms of mental illness.
Late last year, Turhan Canli, an associate professor
of psychology and radiology at Stony Brook University,
published a paper in the journal Biology of Mood
and Anxiety Disorders asserting that depression
should be thought of as an infectious disease.
"Depressed patients act physically sick," says Canli.
"They re tired, they lose their appetite, they don t
want to get out of bed."
"The idea that depression is caused simply by
changes in serotonin is not panning out. We need
to think about other possible causes and treatments
for psychiatric disorders," says Canli.
His assertion might seem far-fetched, but some
data bolster his claim. Canli notes how certain infec-
tions of the brain can result in emotional disturbances
that mimic psychiatric conditions. He also notes that
many pathogens have been associated with mental
illnesses, including Borna disease virus, Epstein-Barr
and certain strains of herpes, including varicella
zoster, the virus that causes chickenpox and shingles.
A Danish study published in JAMA Psychiatry in
2013 looked at the medical records of over three
million people and found that any history of hos-
pitalisation for infection was associated with a 62
per cent increased risk of later developing a mood
disorder, including depression and bipolar disorder.
Canli believes that pathogens acting directly on
the brain may result in psychiatric symptoms, but
also that autoimmune activity---or the body s immune
system attacking itself---triggered by infection may
also contribute. The Danish study also reported that
a past history of an autoimmune disorder increases
the risk of a future mood disorder by 45 per cent.
The idea there may be a relationship between the
immune system and brain disease isn t new. Autoan-
tibodies were reported in schizophrenia patients in
the 1930s. Subsequent work has detected antibodies
to various neurotransmitter receptors in the brains
of psychiatric patients, while a number of brain dis-
orders, including multiple sclerosis, are known to
involve abnormal immune system activity.
Researchers at the University of Virginia recently
identified a previously undiscovered network of vessels
directly connecting the brain with the immune system;
the authors concluded that an interplay between the
two could significantly contribute to certain neuro-
logical and psychiatric conditions. Both infection and
autoimmune activity result in inflammation, our
body s response to harmful stimuli, which in part
involves a surge in immune system activity. And it s
Could depression be
caused by an infection?
thought by many in the psychiatric research com-
munity that inflammation is somehow involved in
depression and perhaps other mental illnesses.
Multiple studies have linked depression with ele-
vated markers of inflammation, including two analyses
from 2010 and 2012 that collectively reviewed data
from 53 studies, as well as several postmortem studies.
A large body of related research confirms that autoim-
mune and inflammatory activity in the brain is linked
with psychiatric symptoms. (Bret Stetka/NPR)
YOUR DAILY HEALTH
News and Advice
Are there links between infection and some forms of depression?
PHOTO: KATHERINE STREETER
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