BackgroundAntineuronal antibodies are associated with psychosis, although their clinical
significance in first episode of psychosis (FEP) is undetermined.AimsTo examine all patients admitted for treatment of FEP for antineuronal antibodies and
describe clinical presentations and treatment outcomes in those who were antibody
positive.MethodIndividuals 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.ResultsOf 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.ConclusionsA 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 interestNone.
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