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  • The prevalence and treatment outcomes of antineuronal antibody-positive patients admitted with first episode of psychosis
  • James G. Scott, David Gillis, Alex E. Ryan, Hethal Hargovan, Nagaraj Gundarpi, Gemma McKeon, Sean Hatherill, Martin P. Newman, Peter Parry, Kerri Prain, Sue Patterson, Richard C. W. Wong, Robert J. Wilson, Stefan Blum
  • Journal: BJPsych Open / Volume 4 / Issue 2 / March 2018
  • Published online by Cambridge University Press: 16 March 2018, pp. 69-74
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  • View abstract
    Background

    Antineuronal antibodies are associated with psychosis, although their clinical significance in first episode of psychosis (FEP) is undetermined.

    Aims

    To examine all patients admitted for treatment of FEP for antineuronal antibodies and describe clinical presentations and treatment outcomes in those who were antibody positive.

    Method

    Individuals admitted for FEP to six mental health units in Queensland, Australia, were prospectively tested for serum antineuronal antibodies. Antibody-positive patients were referred for neurological and immunological assessment and therapy.

    Results

    Of 113 consenting participants, six had antineuronal antibodies (anti-N-methyl-D-aspartate receptor antibodies [n = 4], voltage-gated potassium channel antibodies [n = 1] and antibodies against uncharacterised antigen [n = 1]). Five received immunotherapy, which prompted resolution of psychosis in four.

    Conclusions

    A small subgroup of patients admitted to hospital with FEP have antineuronal antibodies detectable in serum and are responsive to immunotherapy. Early diagnosis and treatment is critical to optimise recovery.

    Declaration of interest

    None.