Neural Antibodies in First-episode Psychosis Patients with Warning Signs for Autoimmune Encephalitis.

Objective: : Autoimmune encephalitis (AE) remains an essential differential diagnosis in patients with first-episode psychosis (FEP). In this study, we aimed to assess to prevalence of AE in a cohort of FEP patients. Methods: : We used a phenotype-driven algorithm to detect AE in patients with FEP. Initially, we screened patients for warning signs with a low or high pre-test probability for AE, defined as "yellow" and "red flags", respectively. In the next step, patients with red flags underwent cerebrospinal fluid analysis (including neural antibodies), while patients with yellow flags underwent tests for serum neural antibodies, electroencephalography, and brain magnetic resonance imaging. Results: : We screened 78 patients with FEP and found that eight (10.3%) had at least one warning sign for AE: four (5.13%) patients had at least one red flag, while four (5.13%) had only yellow flags. Among these, two patients (2.56%) had anti-N-methyl-D-aspartate receptor encephalitis, while the remaining six (7.69%) received a primary psychiatric disorder diagnosis. Conclusion: : Our study highlights the importance of considering AE in the differential diagnosis of FEP.

The relevance of anti-N-methyl-D-aspartate receptor encephalitis for psychiatrists.

Psychiatrists are often the first to be consulted in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. While this disease is rare, psychiatrists need to be aware of its relevant fundamental, clinical and therapeutic aspects. We begin by reviewing the connection between anti-NMDAR encephalitis and the glutamate hypothesis of schizophrenia. Next, we focus on the profile of the patient typically afflicted with this disease. Then, we tackle the limited utility of current diagnostic criteria during the early stage of the disease. After reviewing the psychiatric features, we debate the quest for finding specific psychiatric phenotypes that could facilitate early-stage diagnosis. We conclude by discussing the treatment of psychiatric symptoms and disease outcomes. As follows, this paper presents the relevance of anti-NMDAR encephalitis for psychiatrists.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an essential differential diagnosis in Psychiatry, particularly when dealing with first-episode psychosis.Psychiatrists are often the first to be consulted in patients with NMDAR encephalitis, so they need to be aware of the relevant fundamental, clinical and therapeutic aspects of this disease.