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Abstract
Objectives: Schizophrenia is a severe psychiatric illness that has been purported to be causally related to in utero infection of neurotropic organisms. For obvious ethical reasons, this hypothesis has never been tested prospectively in humans. However, with the recent introduction of Zika virus into the New World offers the opportunity to test the hypothesis of infection in schizophrenia.
Methods: This is a directed review examining the hypothesis. The literature relevant to Zika virus transmission in the New World, its biology and neurotropy is reviewed.
Results: Zika virus has been associated with a wide variety of neural tube and neuroanatomical abnormalities. In its original range, Zika is only infrequently associated with congenital anomalies, but in the New World, where the majority of the population has not developed immunity, infections are associated with a wide range of neurologic abnormalities.
Conclusions: The current outbreak of Zika virus in the Western Hemisphere, offers the opportunity to prospectively examine the congenital infection hypothesis of the pathogenesis of schizophrenia.
Acknowledgements
A poster summarising this paper has been presented at the 2017 meeting of the American Psychiatric Association
Conflicts of interest
Dr. El-Mallakh is funded by the National Institute of Mental Health, the State of Kentucky, Janssen and Alexza. He is a speaker for Allergan, Lundbeck, Merck Otsuka, and Takeda. Mr. Pierson and Dr. Yeruva do not have any conflicts of interest.
Individual contributions
Mr. Pierson did most of the literature research and writing. Dr. Yeruva performed some of the early literature research and a small fraction of the writing. Dr. El-Mallakh originated the idea, supervised, edited and finalised the paper.