image 26 - 2017-18Research/Psychiatry-Psychiatric_Presentation

Psychiatry/Psychiatric

Presentations Research

Autoimmune encephalitis as a differential diagnosis of schizophreniform psychosis: clinical symptomatology, pathophysiology, diagnostic approach, and therapeutic considerations

The awareness of the fact that psychotic syndromes may have autoimmune, Ab-associated causes opens up a new field in psychiatry for a small but probable relevant subgroup of patients. For clinicians, this raises the question as to how far the diagnostic workup and immunomodulating therapy attempts should be advanced in individual cases. This article investigates this question by illustrating constellations in which extended organic diagnostic procedures, especially Ab analyses, should be carried out.

Reviews Red Flags, the syndrome of possible autoimmune encephalitis, Diagnostic approach: Taking Extended history, Medical and neurological physical examination, Neuropsychological testing, Laboratory measurements, EEG, Imaging, tumor screening.

Screening for anti-NMDAR Encephalitis in Psychiatry

Anti-NMDAR encephalitis most commonly presents to psychiatric services, so early identification of this disorder is essential. We aim to validate the two screening criteria (Scott et al. and Herken and Pruss) which have been proposed to identify first episode psychosis patients who should have anti-NMDAR antibody testing.

 

Psychosis associated to CASPR2 autoantibodies and ovarian teratoma: A case report

 

First report of CASPR2 associated psychosis related to an ovarian teratoma. Prompt reduction of psychotic symptoms after excision of teratoma. The diagnosis of autoimmune psychosis can be made in the presence of autoantibodies in the serum while CSF is unremarkable.

Patients with depressive and psychotic symptoms non-responding to antidepressant and antipsychotic treatment should be screened for neuronal autoantibodies including CASPR2.

 

Autoimmune psychosis: an international consensus on an approach to the diagnosis and management of psychosis of suspected autoimmune origin

2 years in the making, top experts in the field make a valueable contribution in this work. They briefly review the background, discuss the existing evidence for a form of autoimmune psychosis, and propose a novel, conservative approach to the recognition of possible, probable, and definite autoimmune psychoses for use in psychiatric practice.  Investigations required and the appropriate therapeutic approaches, both psychiatric and immunological, for probable and definite cases of autoimmune psychoses are outlined, and discuss the ethical issues posed by this challenging diagnostic category.

Autoimmunity in psychotic disorders. Where we stand, challenges and opportunities

Take home message

  • To date, pathogenic autoantibodies targeting neuronal surface antigens are very rare in psychotic disorders without any form of neurological manifestation.
  • Awareness from psychiatrist of the existence of symptoms which overlap between autoimmune encephalitis and psychotic disorders is essential to prompt early diagnosis and intervention for cases with an atypical disease course.

An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: mechanisms and models

The Psychopathology of NMDAR-antibody encephalitis in adults: a systematic review and phenotypic analysis of individual patient data

Neuropsychiatric symptoms in autoimmune encephalopathies: a clinician’s guide

Psychotic and Non Psychotic Mood Disorders In Autoimmune Encephalitis: Diagnostic Issues and Research Implications

Autoantibodies to central nervous system neuronal surface antigens: psychiatric symptoms and psychopharmacological implications

Autoimmune encephalitis in psychiatric institutions: current perspectives

Autoimmune encephalitis with psychosis: Warning signs, step-by-step diagnostics and treatment

Antibody Mediated Psychosis

Neuropsychological And Psychopathological Profile Of Anti-Nmdar Encephalitis: A Possible Pathophysiological Model For Pediatric Neuropsychiatric Disorders

Dynamic disorganization of synaptic NMDA receptors triggered by autoantibodies from psychotic patients

Anti-NMDA receptor encephalitis presenting as postpartum psychosis—a clinical description and review

Anti-NMDA Receptor Encephalitis: Diagnostic Issues for Psychiatrists

Autoimmune Encephalitis: Not Rare and Increasing

Anti-NMDA receptor encephalitis: An emerging differential diagnosis in the psychiatric community

Psychiatric manifestations of anti-NMDA receptor encephalitis: neurobiological underpinnings and differential diagnostic implications

Ethical Implications of the Mild Encephalitis Hypothesis of Schizophrenia

A prospective three-year follow up on the clinical significance of anti-neuronal antibodies in acute psychiatric disorders

The clinical significance of anti-neuronal antibodies for psychiatric disorders is controversial. We investigated if a positive anti-neuronal antibody status at admission to acute psychiatric inpatient care was associated with a more severe neuropsychiatric phenotype and more frequent abnormalities during clinical work-up three years later.

Recognizing anti-NMDA receptor encephalitis psychosis on the psych ward

Anti-NMDA Receptor Encephalitis: A Need for Increased Awareness Among Psychiatrists

Autoimmune encephalitis masquerading as psychosis: Diagnostic and therapeutic challenge

A transdiagnostic pattern of psychiatric symptoms in autoimmune encephalitis

Red Flags: Clinical Signs for Identifying Autoimmune Encephalitis in Psychiatric Patients

Evaluation and Management of Autoimmune Encephalitis: A Clinical Overview for the Practicing Child Psychiatrist

The prevalence and treatment outcomes of antineuronal antibody-positive patients admitted with first episode of psychosis

RECOGNIZING PSYCHIATRIC PRESENTATIONS OF ANTI-NMDA RECEPTOR ENCEPHALITIS

Autoimmune Encephalitis in Postpartum Psychosis

Diagnostic and Therapeutic Approach to Autoimmune Neurologic Disorders

Abnormal brain metabolism on FDG-PET/CT is a common early finding in autoimmune encephalitis

The Clinical Challenge of Autoimmune Psychosis: Learning from Anti-NMDA Receptor Autoantibodies

Cell- and Single Molecule-Based Methods to Detect Anti-NMDAr Abs in Patient w/ psychosis

Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A New Challenging Entity for Consultation-Liaison Psychiatrist

In the Clinic-Autoimmune Encephalitis: Persistent Cognitive, Neuropsychological Deficits After Anti-NMDAR Encephalitis Require Therapy, Study Suggests

First-episode psychosis in a 15 year-old female with clinical presentation of anti-NMDAr

Chronic schizophrenia later diagnosed with anti-NMDA receptor encephalitis: Case report and review of the literature

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International Autoimmune Encephalitis Society is a charitable non-profit 501(c)(3) organization founded in 2013 by Tabitha Andrews Orth, Gene Desotell and Anji Hogan-Fesler. Tax ID# 81-3752344. Donations raised directly supports research, patients, families and caregivers impacted by autoimmune encephalitis and to educating healthcare communities around the world. Financial statement will be made available upon request.

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