Viral antibodies in recent onset, nonorganic psychoses: correspondence with symptomatic severity

A parallel of generalized viral infection with psychiatric symptoms has been reported in nonorganic psychotic disorders. The patients concerned had been ill for long periods and some of them had been readmitted. In order to determine the presence of viral infection at the very onset of the psychosis, antibodies in blood and cerebrospinal fluid (CSF) to six viruses [cytomegalovirus (CMV), herpes simplex (HSV) Type 1, mumps, measles, varicella zoster virus (VZV), and Japanese encephalitis virus (JEV)] were assayed in 35 psychotic patients [14 schizophrenics; 13 manic patients; and 8 patients with psychosis not otherwise specified (NOS)] within 1 month of onset of illness. Ten (28.6%) patients had a diagnostic (fourfold) change in the antibody titer in the paired serum and/or CSF samples (drawn at 2-week intervals) and another 10 had high titers (above 2 SDs from the mean in 35 control subjects). The striking temporal correlation with the initial severity and resolution of psychopathology by 2 weeks on the Brief Psychiatric Rating Scale (BPRS) suggests a causally significant, currently active viral infection in these 20 cases.