Abstract
We investigated the feasibility of including plasma anti-NMDAR antibody screening in the assessment of first-episode psychosis patients in an early intervention programme in the Southern hemisphere. Anti-NMDAR IgG antibodies were assessed by ELISA in 166 patients (64.0% men), 166 matched population-based controls and 76 patients' siblings (30.3% men). Fisher's exact test and ANOVA were performed. Positive anti-NMDAR antibody patients were more often observed in bipolar disorder (10.0%) than schizophrenia (2.4%) or psychotic depression (3.1%), although no significant differences were observed. Our results are not conclusive regarding the inclusion of plasma anti-NMDAR IgG antibodies in differential diagnostic protocols for psychosis.
Highlights
MethodsMultiple factors may underlie the relationship between non-neurological autoimmune disorders and psychosis[1], with particular interest being given to autoantibodies against the N-methyl-d-aspartate receptor (NMDAR)
We investigated the feasibility of including plasma anti-NMDAR antibody screening in the assessment of first-episode psychosis patients in an early intervention programme in the Southern hemisphere
The sample was composed by 166 patients (64.0% males), 84 of whom were diagnosed on the schizophrenia spectrum, 50 with bipolar disorder, and 32 with psychotic depression
Summary
Multiple factors may underlie the relationship between non-neurological autoimmune disorders and psychosis[1], with particular interest being given to autoantibodies against the N-methyl-d-aspartate receptor (NMDAR) This receptor plays an important role in psychosis[2,3] and in a variety of neurological and non-neurological autoimmune diseases, including encephalitis[4], and systemic lupus erythematosus[5] and autoimmune thyroid disease[6]. The presence of anti-NMDAR autoantibodies has been reported among healthy individuals[14], resulting in uncertainty about their exact role in the neurobiology of psychosis. These discrepancies are being attributed to a variety of confounding factors, such as the duration of psychosis, substance misuse, psychotropic medication or the presence of other medical conditions[15]. Another unsolved question is related to the role that environmental factors may play in the immune response, given that the vast majority of studies have been carried out in the Northern hemisphere
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