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Schizophrenia Research
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Article history: Two previous studies suggested that childhood cat ownership is a possible risk factor for later developing
Received 29 January 2015 schizophrenia or other serious mental illness. We therefore used an earlier, large NAMI questionnaire to try
Received in revised form 26 February 2015 and replicate this finding. The results were the same, suggesting that cat ownership in childhood is significantly
Accepted 2 March 2015
more common in families in which the child later becomes seriously mentally ill. If true, an explanatory
Available online 17 April 2015
mechanism may be Toxoplasma gondii. We urge our colleagues to try and replicate these findings to clarify
Keywords:
whether childhood cat ownership is truly a risk factor for later schizophrenia.
Schizophrenia © 2015 Elsevier B.V. All rights reserved.
Bipolar disorder
Cat contact
Toxoplasmosis
Toxoplasma gondii
1. Introduction list; the refusal rate was 9%. Two controls for each case from families
without any serious mental illness were selected from the same
In 1995 a study suggested that cat ownership during childhood telephone exchange as the subjects and matched for age, sex and socio-
might be a risk factor for later developing schizophrenia (Torrey and economic status; the refusal rate was 28%. The interview focused on the
Yolken, 1995). The data came from a 1992 questionnaire filled out by perinatal and preadolescent childhood periods and included 19 major
165 members of the National Alliance for the Mentally Ill (NAMI). At variables, many of which included subsets, asking about the mother's
that time, NAMI had approximately 170,000 members and consisted pregnancy, miscarriages/stillbirths, delivery, breast-feeding, develop-
almost exclusively of families in which a family member had been diag- mental milestones and place of residence as well as exposure to dogs,
nosed with schizophrenia or schizoaffective disorder (approximately cats, other pets, and farm animals. Regarding family ownership of a
two-thirds) or bipolar disorder or severe depression, usually with psy- cat between the affected person's birth and age 13, 136/262 (51.9%) of
chotic features (approximately one-third) (Steinwachs et al., 1992). cases and 220/522 (42.1%) of controls responded ‘yes’ [chi square =
The question asked whether at any time between the affected family 6.7, p ≤ .01; OR = 1.48 (1.09–2.02)]. Dog ownership was more common
member's birth and age 10 there was a cat living in the house; 84/165 among the controls (78.8%) than among the cases (73.1%) although the
(50.9%) of the cases and 65/165 (39.4%) of the controls responded yes. difference was not statistically significant (p = .09).
The controls were obtained by having a family friend, whose child had Based on these two studies, we decided to analyze cat ownership
not developed any mental illness, fill out an identical questionnaire. from a large unpublished NAMI survey carried out in 1982, 10 years be-
The cat question was part of two pages of questions covering fore any data on cat ownership and mental illness had been published.
breastfeeding, developmental milestones, coordination, rheumatoid ar- The issue is potentially important since cats are carriers, and the
thritis, and multiple sclerosis. Although the cat question was statistically definitive hosts, of Toxoplasma gondii. This parasite has been linked to
significant by itself [chi square = 4.4, p ≤ .036; odds ratio (OR) = 1.60 schizophrenia in a meta-analysis of 38 studies of T. gondii antibodies
(1.00–2.53), mean (95% confidence interval)], it was not significant (pooled OR = 2.71) (Torrey et al. 2012). In addition, T. gondii has been
following the application of the Bonferroni correction for the number shown to produce dopamine, thought to be increased in schizophrenia
of questions asked. (Gaskell, et al., 2009). There are also other reasons to suspect that
Based on these initial findings, a 1997 follow-up survey was under- T. gondii may play a role in some cases of schizophrenia (Torrey and
taken (Torrey, et al., 2000). Trained interviewers at the Survey Research Yolken, 2003; Yolken et al., 2009).
Center, University of Maryland, carried out a 20 minute telephone
interview with subjects randomly selected from the NAMI membership 2. Materials and methods
⁎ Corresponding author. Tel.: +1 301 571 2078. At the NAMI annual convention in 1982, participants whose family
E-mail address: torreyf@stanleyresearch.org (E. Fuller Torrey). member was diagnosed with schizophrenia or schizoaffective disorder
http://dx.doi.org/10.1016/j.schres.2015.03.036
0920-9964/© 2015 Elsevier B.V. All rights reserved.
2 E. Fuller Torrey et al. / Schizophrenia Research 165 (2015) 1–2
Table 1
Cat ownership in NAMI families and controls.
Cases Controls
1992 questionnaire Cat in house, birth to age 10 84/165 (50.9%) 65/165 (39.4%) p = .03; OR = 1.60 (1.00–2.53)
1997 survey Cat ownership, birth to age 13 136/262 (51.9%) 220/522 (42.1%) p = .01; OR = 1.48 (1.09–2.02)
1982 questionnaire Cat ownership, birth to age 13 1075/2125 (50.6%) 2065/4847 (42.6%) p ≤ .0001; OR = 1.38 (1.25–1.53)
p values are derived from chi square, 2 tailed; ORs shown as mean (95% CI).
were asked to fill out a two-page questionnaire. Questions included Even if this mode of transmission explains the findings presented
conditions of pregnancy, birth weight, childhood illnesses, smallpox here, it is somewhat surprising that this can be demonstrated by surveys
vaccination, seizures, age of first referral, illnesses immediately preced- of cat ownership. Children could theoretically become infected by
ing onset, family history of mental illness and rheumatoid arthritis, and playing in any infected public play area even if their family did not
cat and dog ownership up to age 17. The question on pets included ages own a cat. Alternately, neighborhood cats could infect the child's
of pet exposure, so it was possible to identify those exposed between home outside play area. It is also possible that exposure to cats provides
birth and age 13, thus making the data comparable to the 1997 risk in terms of other infectious agents shed by cats or by allergic
telephone questionnaire. The 1982 questionnaire did not include con- exposures, since increased levels of childhood allergic reactions
trols. However, a 1991 survey of 55,143 households by the American have been associated with increased risk of schizophrenia in later life
Veterinary Medical Association reported cat ownership among 10 differ- (Khandaker et al., 2014; Zhang et al., 2014).
ent groups such as young singles, young couples, retired older couples, It is important to ascertain whether or not cat ownership in child-
etc. The group which was most similar to our study group was the hood is a risk factor for later schizophrenia since it is a risk factor
group of “middle parents”, defined as having multiple members, the which could be minimized. We therefore urge our colleagues in other
household head being younger than 45 years, and the youngest child countries to collect data on cat and other pet ownership, and a major
being 6 or over (American Veterinary Medical Association, 1991). goal of this paper is to encourage such research.