427
CORRESPONDENCE
emphasising the financial savings it allows. Out patient ECT was chosenin our casebecausegiven that the physical examination, routine blood tests, chest X-ray and electrocardiogram were normal, it wasfelt beneficialfor the patient to bespendingmost
reinfection receives support from the epidemiologi
of his day among those he knew, particularly as hospital admission had contributed to his present
cal findings of Hare & Walter (1978)on the seasonal variations in the admissions of schizophrenic and manicpatientswith peaksin July and August, corres ponding roughly to the peaksin the incidenceof all three enterovirus infections. The somewhat earlier peaksin psychiatric admissionsmay be due to pre
mental state.
existing sensitisation of these patients, with most
GOLDSTEIN, M. Z. & JEN5v0LD,M. F. (1989) ECT treatment of the elderly mentally retarded man. Psychosomatics. 30, 104—106. KEARNS,A. (1987) Cotard's
syndrome
in a mentally handicapped
man. BritishJournalof Psychiatry, 150, 112—114. LAZARUS,A., JAFFE,R. L. & DuBIN, W. R. (1990) Electroconvulsive
therapyand major depressionin Down'ssyndrome.Journalof Clinical Psychiatry. 51,422—425.
non-sensitised individuals presenting with other symptoms of viral infection 1 to 3 months later. The peaks of enterovirus infections are followed, approximately six months later, by peaks in excess births of individuals who will, 25 to 30 years later, develop schizophrenia or mania. These findings suggestthat infected mothers may passa psychoto
SPYROSKARVOUNIS GERALDINE HOLT ANDREW HODGKISS
genic enterovirus to their foetuses during the first or
et a!, 1975), and can be passed from mother to foetus
HARa, E. H. & WALTER, S. D. (1978) Seasonal variation in admissions of psychiatric patients and its relation to seasonal variation in their births. Journal of Epidemiology and Community
secondtrimesterofpregnancywhenthe foetal brain is mostsensitiveto infectivedamage,asDr Eaglespoints out. Suchearly viral infection may result in selective Mental Handicap Unit destructionofexcitatory glutamatergicand choliner Goldie Leigh LodgeHill gic neuronsin the foetal brain (Squires& Saederup, 1991)aswell ascausingthe foetus'immunesystem Abbey Wood London SE2 OA V to treat the invading viral antigen as non-foreign, leadingto permanentsensitivity to the virus. The hypothesisofin uterosensitisationand immu Are polioviruses a causeof schizophrenia? nocompromise by an enterovirus predicts greatly SIR:The thought-provoking commentary by Eagles lowered levelsof antibodies to this virus in schizo on a possiblerole of poliovirusesin the development phrenic adults and can be easily tested by deter of schizophrenia(Journal, May 1992,160,598—600) mining the relative abilities of blood samples,taken from schizophrenicand non-schizophrenicadults, to raises the possibility that two other closely related neutralizevarious enterovirusesin vitro. groups of picorna enteroviruses (Coxsackie and Perhapsrepeatedreinfectionsof sensitisedindivid ECHO) may also be involved in the genesisof some instances of schizophrenia. Like polioviruses, the uals,over a lifetime, may beacauseof theprogressive deterioration seenin schizophrenia. incidences of Coxsackie and ECHO virus infections peakduring the summer,both are neurotropic (Sells (Modlin et a!, 1981).Poliovirus sensitivity genesmay encode several subunits of the membrane-bound picornavirus-receptor
complexes that are members
of the immunoglobulin super family, some of which may be identical to intercellular adhesion molecules
(seeSelinka et a!, 1991).The picornavirus receptor subunits might becombinedin various waysto yield multimeric receptor complexes that are more or less specific for certain viruses, but with some overlap.
Health, 32,47—52. MODLIN,
J. F., POLK,
F., HORTON,
P. et al(l98l)
Perinatalechovirus
infection: risk of transmission during a community outbreak. New EnglandJournalof Medicine. 305,368—371. SELINKA, H-C., ZIBERT, A. & WIMMER, E. (1991) Poliovirus can enter and infect mammalian cells by way of an intercellular adhe
sion molecule I pathway. Proceedingsof the NationalAcademyof Scienceof the United States of America, 88,3598—3602. SELLS,J. J., CARPENTER,R. L. & RAY, C. G. (1975) Sequelae of
central-nervous-system enterovirus infections. New England For example, Siddique et al (1988,cited by Eagles) Journal of Medicine. 293, 1—4. found that severalrodent—human hybrid cell lines, SQurnEs, R. E. & SAEDERUP,E. (1991) A review of evidence of infected with appropriate fragments of human GABAergic predominance/glutamatergic deficit as a common etiological factor in both schizophrenia and affective psychoses: chromosome 19, could subsequently be infected more support for a continuum hypothesis of “¿functional― by both poliovirus 1 and ECHO virus 11. If later psychosis. Neurochemical Research. 16, 1099—1111. reinfection is required for the full development of schizophrenia,asDr Eaglessuggests,the reinfection RICHARD F. SQUIRES might therefore also be by one of the Coxsackieor TheNathanKlineinstitutefor PsychiatricResearch ECHO viruses,in previously sensitisedand immuno Orangeburg compromised individuals. The idea of required NV 10962,USA
Are polioviruses a cause of schizophrenia? R F Squires BJP 1992, 161:427. Access the most recent version at DOI: 10.1192/bjp.161.3.427
References Reprints/ permissions You can respond to this article at Downloaded from
This article cites 0 articles, 0 of which you can access for free at: http://bjp.rcpsych.org/content/161/3/427.citation#BIBL To obtain reprints or permission to reproduce material from this paper, please write to [email protected] /letters/submit/bjprcpsych;161/3/427 http://bjp.rcpsych.org/ on May 28, 2017 Published by The Royal College of Psychiatrists
To subscribe to The British Journal of Psychiatry go to: http://bjp.rcpsych.org/site/subscriptions/
CORRESPONDENCE
emphasising the financial savings it allows. Out patient ECT was chosenin our casebecausegiven that the physical examination, routine blood tests, chest X-ray and electrocardiogram were normal, it wasfelt beneficialfor the patient to bespendingmost
reinfection receives support from the epidemiologi
of his day among those he knew, particularly as hospital admission had contributed to his present
cal findings of Hare & Walter (1978)on the seasonal variations in the admissions of schizophrenic and manicpatientswith peaksin July and August, corres ponding roughly to the peaksin the incidenceof all three enterovirus infections. The somewhat earlier peaksin psychiatric admissionsmay be due to pre
mental state.
existing sensitisation of these patients, with most
GOLDSTEIN, M. Z. & JEN5v0LD,M. F. (1989) ECT treatment of the elderly mentally retarded man. Psychosomatics. 30, 104—106. KEARNS,A. (1987) Cotard's
syndrome
in a mentally handicapped
man. BritishJournalof Psychiatry, 150, 112—114. LAZARUS,A., JAFFE,R. L. & DuBIN, W. R. (1990) Electroconvulsive
therapyand major depressionin Down'ssyndrome.Journalof Clinical Psychiatry. 51,422—425.
non-sensitised individuals presenting with other symptoms of viral infection 1 to 3 months later. The peaks of enterovirus infections are followed, approximately six months later, by peaks in excess births of individuals who will, 25 to 30 years later, develop schizophrenia or mania. These findings suggestthat infected mothers may passa psychoto
SPYROSKARVOUNIS GERALDINE HOLT ANDREW HODGKISS
genic enterovirus to their foetuses during the first or
et a!, 1975), and can be passed from mother to foetus
HARa, E. H. & WALTER, S. D. (1978) Seasonal variation in admissions of psychiatric patients and its relation to seasonal variation in their births. Journal of Epidemiology and Community
secondtrimesterofpregnancywhenthe foetal brain is mostsensitiveto infectivedamage,asDr Eaglespoints out. Suchearly viral infection may result in selective Mental Handicap Unit destructionofexcitatory glutamatergicand choliner Goldie Leigh LodgeHill gic neuronsin the foetal brain (Squires& Saederup, 1991)aswell ascausingthe foetus'immunesystem Abbey Wood London SE2 OA V to treat the invading viral antigen as non-foreign, leadingto permanentsensitivity to the virus. The hypothesisofin uterosensitisationand immu Are polioviruses a causeof schizophrenia? nocompromise by an enterovirus predicts greatly SIR:The thought-provoking commentary by Eagles lowered levelsof antibodies to this virus in schizo on a possiblerole of poliovirusesin the development phrenic adults and can be easily tested by deter of schizophrenia(Journal, May 1992,160,598—600) mining the relative abilities of blood samples,taken from schizophrenicand non-schizophrenicadults, to raises the possibility that two other closely related neutralizevarious enterovirusesin vitro. groups of picorna enteroviruses (Coxsackie and Perhapsrepeatedreinfectionsof sensitisedindivid ECHO) may also be involved in the genesisof some instances of schizophrenia. Like polioviruses, the uals,over a lifetime, may beacauseof theprogressive deterioration seenin schizophrenia. incidences of Coxsackie and ECHO virus infections peakduring the summer,both are neurotropic (Sells (Modlin et a!, 1981).Poliovirus sensitivity genesmay encode several subunits of the membrane-bound picornavirus-receptor
complexes that are members
of the immunoglobulin super family, some of which may be identical to intercellular adhesion molecules
(seeSelinka et a!, 1991).The picornavirus receptor subunits might becombinedin various waysto yield multimeric receptor complexes that are more or less specific for certain viruses, but with some overlap.
Health, 32,47—52. MODLIN,
J. F., POLK,
F., HORTON,
P. et al(l98l)
Perinatalechovirus
infection: risk of transmission during a community outbreak. New EnglandJournalof Medicine. 305,368—371. SELINKA, H-C., ZIBERT, A. & WIMMER, E. (1991) Poliovirus can enter and infect mammalian cells by way of an intercellular adhe
sion molecule I pathway. Proceedingsof the NationalAcademyof Scienceof the United States of America, 88,3598—3602. SELLS,J. J., CARPENTER,R. L. & RAY, C. G. (1975) Sequelae of
central-nervous-system enterovirus infections. New England For example, Siddique et al (1988,cited by Eagles) Journal of Medicine. 293, 1—4. found that severalrodent—human hybrid cell lines, SQurnEs, R. E. & SAEDERUP,E. (1991) A review of evidence of infected with appropriate fragments of human GABAergic predominance/glutamatergic deficit as a common etiological factor in both schizophrenia and affective psychoses: chromosome 19, could subsequently be infected more support for a continuum hypothesis of “¿functional― by both poliovirus 1 and ECHO virus 11. If later psychosis. Neurochemical Research. 16, 1099—1111. reinfection is required for the full development of schizophrenia,asDr Eaglessuggests,the reinfection RICHARD F. SQUIRES might therefore also be by one of the Coxsackieor TheNathanKlineinstitutefor PsychiatricResearch ECHO viruses,in previously sensitisedand immuno Orangeburg compromised individuals. The idea of required NV 10962,USA
Are polioviruses a cause of schizophrenia? R F Squires BJP 1992, 161:427. Access the most recent version at DOI: 10.1192/bjp.161.3.427
References Reprints/ permissions You can respond to this article at Downloaded from
This article cites 0 articles, 0 of which you can access for free at: http://bjp.rcpsych.org/content/161/3/427.citation#BIBL To obtain reprints or permission to reproduce material from this paper, please write to [email protected] /letters/submit/bjprcpsych;161/3/427 http://bjp.rcpsych.org/ on May 28, 2017 Published by The Royal College of Psychiatrists
To subscribe to The British Journal of Psychiatry go to: http://bjp.rcpsych.org/site/subscriptions/
