Looking for Autoimmune Psychosis: A Preliminary Report from Iran

Abstract

Background: There is increasing attention toward the recognition of psychotic disorders with autoimmune etiologies, especially among first-episode psychosis patients. These patients may be underdiagnosed before they develop a full range of neurological symptoms. Objectives: We aimed to characterize the rate and clinical presentations of first-episode autoimmune psychosis patients. Methods: All patients with first-episode psychosis (FEP) with the onset of symptoms over a maximum course of three months were recruited and underwent a comprehensive examination and serum and cerebrospinal fluid autoimmune tests. Results: Seven out of 15 patients with FEP were under 20 years, and four were Afghans. Twelve patients developed prodromal symptoms, all had at least one type of delusion, and 11 patients had experience of hallucinations. Formal thought disorders were detected in seven patients. Five patients had catatonic symptoms. Conclusions: Certain sample features made our cases unique, including young age, high rate of prodromal symptoms, catatonic features, and formal thought disorders. Lack of specific criteria to arrive at the diagnosis of autoimmune psychosis would be a major milestone to achieve in future studies.