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Influenza and schizophrenia: How can we shed a light in the new virus from an old association?

Published online by Cambridge University Press:  13 August 2021

D. Magalhães ,
F. Ferreira ,
T. Ferreira ,
I. Figueiredo ,
F. Martinho ,
R. Felício  and
N. Santos
D. Magalhães*
Affiliation:
Psychiatry, Hospital Professor Doutor Fernando Fonseca, Lisboa (Amadora), Portugal
F. Ferreira
Affiliation:
Psychiatry, Hospital Professor Doutor Fernando Fonseca, Lisboa (Amadora), Portugal
T. Ferreira
Affiliation:
Psychiatry, Hospital Professor Doutor Fernando Fonseca, Lisboa (Amadora), Portugal
I. Figueiredo
Affiliation:
Mental Health Department, Hospital Professor Doutor Fernando Fonseca, Lisboa (Amadora), Portugal
F. Martinho
Affiliation:
Psychiatry, Hospital Professor Doutor Fernando Fonseca, Lisboa (Amadora), Portugal
R. Felício
Affiliation:
Mental Health Department, Hospital Professor Doutor Fernando Fonseca, Lisboa (Amadora), Portugal
N. Santos
Affiliation:
Psychiatry, Hospital Professor Doutor Fernando Fonseca, Lisboa (Amadora), Portugal
*
*Corresponding author.

Abstract

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Introduction

COVID-19 raises serious concerns regarding its unknown consequences for health, including psychiatric long term outcomes. Historically, influenza virus has been responsible for pandemics associated with schizophrenia. Epidemiological studies showed increased risk for schizophrenia in children of mothers exposed to the 1957 influenza A2 pandemic. Controversy remains concerning the mechanisms of pathogenesis underlying this risk.

Objectives

We aim to review the evidence for the association between influenza infection and schizophrenia risk, the possible pathogenic mechanisms underlying and correlate these findings with the schizophrenia hypothesis of neurodevelopment.

Methods

We reviewed literature regarding evidence from epidemiological, translational animal models and serological studies using medline database.

Results

The biological mechanisms likely to be relevant account to the effects of infection-induced maternal immune activation, microglial activation, infection-induced neuronal autoimmunity, molecular mimicry of the influenza virus, neuronal surface autoantibodies and psychosis with potential infectious antecedents. Influenza infection may fit into the theory of the neurodevelopment of schizophrenia as a factor that alters the normal maturation processes of the brain (possible second or third hit).

Conclusions

Influenza infection has multiple pathogenic pathways in both pre and post natal processes that might increase the risk of schizophrenia or psychosis. The existing evidence regarding the relationship between influenza virus and psychosis might help us draw similar long-term concerns of COVID-19.

Disclosure

No significant relationships.

Keywords

schizophréniainfluenzaviralinfection
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S168
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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