The Psychiatric Phenotype of Anti-NMDA Receptor Encephalitis.

The Psychiatric Phenotype of Anti-NMDA Receptor Encephalitis. J Neuropsychiatry Clin Neurosci. 2018 Oct 31;:appineuropsych17120343 Authors: Gibson LL, Pollak TA, Blackman G, Thornton M, Moran N, David AS Abstract In its early stages, anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is often characterized by prominent psychiatric manifestations that can lead to delays in diagnosis and treatment. The authors aimed to address this problem by providing a detailed description of the psychiatric phenotype and demographic features that may influence presentation. Eighty-six patients with positive serum NMDAR antibodies were identified, 22 of whom met diagnostic criteria for anti-NMDAR encephalitis. Medical notes were reviewed retrospectively to rate psychiatric symptoms using standardized scales. Clinical and demographic characteristics were compared for patients with and without psychosis. Patients with psychosis exhibited severe psychopathology with a characteristic phenotype: severe and disproportionate cognitive disturbance (p<0.005) with high negative symptom scores and excitability. Those presenting with psychotic symptoms were significantly younger than those without (p<0.005). Patients with anti-NMDAR encephalitis present with a somewhat distinct cluster of psychiatric symptoms not commonly seen in functional psychoses. When encountered, this atypical pattern should warrant further investigation and a high index of susp...
Source: Journal of Neuropsychiatry and Clinical Neurosciences - Category: Psychiatry Tags: J Neuropsychiatry Clin Neurosci Source Type: research