 Psychiatry

FROM THE JOU RNALS

Cat ownership in childhood

linked ‘conditionally’ to
psychosis in adult males
Publish date: March 9, 2022

By Kelli Whitlock Burton

CEMEDYT
ABRIR
Aptos Físicos para Deportistas

FROM THE JOURNAL OF PSYCHIATRIC RESEARCH

Owning an outdoor cat as a child is

associated with an increased risk of
psychotic experiences in adulthood –
but only in males, new research
suggests.

Investigators found male children who

owned cats that went outside had a
small, but significantly increased, risk
of psychotic experiences in adulthood,
compared with their counterparts who
had no cat during childhood or who
had an indoor cat.

Courtesy McGill University

Dr. Vincent Paquin

The suspected culprit is not the cat

itself but rather exposure to
Toxoplasma gondii, a common
parasite carried by rodents and
sometimes found in cat feces. The
study adds to a growing evidence
showing exposure to T. gondii may be
a risk factor for schizophrenia and
other psychotic disorders.

“These are small pieces of evidence

but it’s interesting to consider that
there might be combinations of risk
factors at play,” lead author Vincent
Paquin, MD, psychiatry resident at
McGill University, Montreal, said in an
interview.

“And even if the magnitude of the risk

is small at the individual level,” he
added, “cats and Toxoplasma gondii
are so present in our society that if we
add up all these small potential effects
then it becomes a potential public
health question.”

The study was published online Jan.

30, 2022, in the Journal of Psychiatric
Research.

Inconsistent evidence
T. gondii infects about 30% of the
human population and is usually
transmitted by cats. Most infections
are asymptomatic, but T. gondii can
cause toxoplasmosis in humans, which
has been linked to increased risk of
schizophrenia, suicide attempts, and
more recently, mild cognitive
impairment.

Although some studies show an

association between cat ownership
and increased risk of mental illness,
the research findings have been
inconsistent.

“The evidence has been mixed about

the association between cat
ownership and psychosis expression,
so our approach was to consider
whether specific factors or
combinations of factors could explain
this mixed evidence,” Dr. Paquin said.

For the study, 2206 individuals aged

18-40 years completed the Community
Assessment of Psychic Experiences
(CAPE-42) and a questionnaire to
gather information about cat
ownership at any time between birth
and age 13 and if the cats lived
exclusively indoors (nonhunting) or if
they were allowed outside (rodent
hunting).

Participants were also asked about

the number of residential moves
between birth and age 15, date and
place of birth, lifetime history of head
trauma, and tobacco smoking history.

Rodent-hunting cat ownership was

associated with higher risk of
psychosis in male participants,
compared with owning no cat or a
nonhunting cat. When the
investigators added head trauma and
residential moves to rodent-hunting
cat ownership, psychosis risk was
elevated in both men and women.

Independent of cat ownership,

younger age, moving more than three
times as a child, a history of head
trauma, and being a smoker were all
associated with higher psychosis risk.

Courtesy McGill University

Dr. Suzanne King

The study wasn’t designed to explore

potential biological mechanisms to
explain the sex differences in
psychosis risk seen among rodent-
hunting cat owners, but “one possible
explanation based on the animal
model literature is that the
neurobiological effects of parasitic
exposure may be greater with male
sex,” senior author Suzanne King,
PhD, professor of psychiatry at McGill,
said in an interview.

The new study is part of a larger, long-

term project called EnviroGen, led by
Dr. King, examining the environmental
and genetic risk factors for
schizophrenia.

Need for replication

Commenting on the findings, E. Fuller
Torrey, MD, who was among the first
researchers to identify a link between
cat ownership, T. gondii infection, and
schizophrenia, said the study is “an
interesting addition to the studies of
cat ownership in childhood as a risk
factor for psychosis.”

Of the approximately 10 published

studies on the topic, about half
suggest a link between cat ownership
and psychosis later in life, said Dr.
Torrey, associate director for research
at the Stanley Medical Research
Institute in Rockville, Md.

“The Canadian study is interesting in

that it is the first study that separates
exposure to permanently indoor cats
from cats that are allowed to go
outdoors, and the results were
positive only for outdoor cats,” Dr.
Torrey said.

The study has limitations, Dr. Torrey

added, including its retrospective
design and the use of a self-report
questionnaire to assess psychotic
experiences in adulthood.

Also commenting on findings, James

Kirkbride, PhD, professor of
psychiatric and social epidemiology,
University College London, noted the
same limitations.

Dr. Kirkbride is the lead author of a

2017 study that showed no link
between cat ownership and serious
mental illness that included nearly
5,000 people born in 1991 or 1992 and
followed until age 18. In this study,
there was no link between psychosis
and cat ownership during pregnancy
or at ages 4 or 10 years.

“Researchers have long been

fascinated with the idea that cat
ownership may affect mental health.
This paper may have them chasing
their own tail,” Dr. Kirkbride said.

“Evidence of any association is limited

to certain subgroups without a strong
theoretical basis for why this may be
the case,” he added. “The
retrospective and cross-sectional
nature of the survey also raise the
possibility that the results are
impacted by differential recall bias, as
well as the broader issues of chance
and unobserved confounding.”

Dr. King noted that recall bias is a

limitation the researchers highlighted
in their study, but “considering the
exposures are relatively objective and
factual, we do not believe the
potential for recall bias is substantial.”

“Nonetheless, we strongly believe that

replication of our results in
prospective, population-
representative cohorts will be crucial
to making firmer conclusions,” he
added.

The study was funded by grants from

the Quebec Health Research Fund.
The study authors and Dr. Kirkbride
disclosed no relevant financial
relationships.

A version of this article first appeared

on Medscape.com.

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