Clin Psychopharmacol Neurosci.
2024 Aug;22(3):520-530. 10.9758/cpn.24.1164.
Neural Antibodies in First-episode Psychosis Patients with Warning Signs for Autoimmune Encephalitis
- Affiliations
-
- 1Department of Psychiatry, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- 2Romanian Association for Autoimmune Encephalitis, Cluj-Napoca, Romania
- 3Department of Neurology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- 4Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- KMID: 2559172
- DOI: http://doi.org/10.9758/cpn.24.1164
Abstract
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.
