Anti-NMDAR Encephalitis: A Multidisciplinary Approach to Identification of the Disorder and Management of Psychiatric Symptoms.

BACKGROUND: The novelty of anti-NMDA receptor encephalitis, for which somatic treatments have only recently been developed, has led to a lack of information on assessment and treatment of its variable behavioral manifestations. METHOD: In this article, we discuss 4 challenging cases of anti-NMDAR encephalitis, focusing on the importance of a multidisciplinary approach to identification and management of the disorder and the necessity of close collaboration in the acute hospital setting for management of the behavioral symptoms. CONCLUSION: The cases we discuss highlight some of the medication and nonpharmacologic treatment strategies that may facilitate management of psychiatric symptoms, both while the medical workup is ongoing and after the diagnosis has been confirmed.

The Genetic and Neural Circuitry Predictors of Benefit From Manualized or Open-Ended Psychotherapy.

OBJECTIVE: New technologies incorporating genetics and neuroimaging into psychiatric care offer the possibility of illuminating associations among genetic alleles, neural functioning, and patients' response to various psychotherapeutic modalities. In this review, the authors survey the literature on the emerging field of genetic predictors of psychotherapy response, particularly in relation to the 5-HTTLPR polymorphism and individual response to manualized psychotherapy. METHODS: The extant literature was reviewed, with PubMed serving as the primary database. RESULTS: Several polymorphisms have been linked with response or resistance to treatment. Given the number of studies assessing the relevance of the 5-HTTLPR polymorphism to treatment response, this review focuses on this genetic variation. CONCLUSIONS: Because individual genetic endowments may predict nonresponse to manualized treatment modalities, it may become possible to identify individuals who would benefit from insight-oriented, open-ended psychotherapy tailored to their individual distress tolerance levels, rather than from shorter manualized treatment.