TY  - JOUR
AU  - Al-Diwani, Adam
AU  - Theorell, Jakob
AU  - Zghoul, Tarek
AU  - Voruganti, Aniruddha
AU  - Townsend, Leigh
AU  - De Giorgi, Riccardo
AU  - Griffin, Benjamin
AU  - Bajorek, Tomasz
AU  - Okai, David
AU  - Lennox, Belinda
AU  - Leite, M Isabel
AU  - Kim, Carla Y
AU  - Coughlin, Arielle
AU  - Martin, Kelsey
AU  - Glassberg, Brittany
AU  - Lachner, Christian
AU  - Westerbeek, Nicola
AU  - Bergink, Veerle
AU  - Thakur, Kiran T
AU  - Yeshokumar, Anusha K
AU  - Prüss, Harald
AU  - Day, Gregory S
AU  - Finke, Carsten
AU  - Handel, Adam E
AU  - Manohar, Sanjay G
AU  - Joyce, Dan W
AU  - Irani, Sarosh R
TI  - The distinctive psychopathology of NMDAR-antibody encephalitis compared with primary psychoses: an international, multicentre, retrospective phenotypic analysis.
JO  - The lancet / Psychiatry
VL  - 13
IS  - 1
SN  - 2215-0366
CY  - Philadelphia, Pa.
PB  - Elsevier
M1  - DZNE-2025-01366
SP  - 47 - 61
PY  - 2026
AB  - N-methyl-D-aspartate receptor (NMDAR)-antibody encephalitis is a life-threatening neuropsychiatric disorder requiring prompt immunotherapy. The earliest features are mental-state changes, often mistaken for primary psychosis. Improved clinical differentiation could assist rational diagnostic investigation and expedite immunotherapy. Inspired by patients' and relatives' lived experience, we aimed to explore the psychiatric phenotype of NMDAR-antibody encephalitis and the features common to and distinct from real-world episodes of psychosis.In this international, multicentre, retrospective phenotypic analysis we collected data on episodes of NMDAR-antibody encephalitis from specialised neurology services in Europe (UK, Germany, and Sweden) and the USA. For comparison, we collected similar data from de-identified accepted referrals to a UK early intervention in psychosis service, including consecutively presenting cases (unselected psychosis) and a group defined by having been assessed and admitted to hospital under the Mental Health Act (selected psychosis). Additionally, we included episodes of postpartum psychosis from a mother and baby unit in the Netherlands. In our mental-state inventory we included core features from ICD-11, the Bush-Francis catatonia score, and the Neuropsychiatric Inventory encompassing anxiety, depression, mania, schizophrenia, catatonia, and also more granular transdiagnostic behavioural features including those common to neuropsychiatric and neurobehavioural syndromes, such as delirium and dementia. Ethnicity data were not available. We compared and visualised the neuropsychiatric phenotype of these cohorts.We collected data from 100 episodes of NMDAR-antibody encephalitis from 96 patients between 2010 and 2022 (median age 22 years, female:male ratio 3·80), 135 episodes of psychosis from 135 patients between 2018 and 2019 (median age 27 years, female:male ratio 0·75), and ten episodes of postpartum psychosis from ten patients between 2005 and 2012 (median age 30 years, all female sex). Psychopathology in NMDAR-antibody encephalitis was abundant (92 [92
KW  - Humans
KW  - Psychotic Disorders: diagnosis
KW  - Psychotic Disorders: psychology
KW  - Anti-N-Methyl-D-Aspartate Receptor Encephalitis: psychology
KW  - Anti-N-Methyl-D-Aspartate Receptor Encephalitis: diagnosis
KW  - Female
KW  - Retrospective Studies
KW  - Male
KW  - Adult
KW  - Phenotype
KW  - Young Adult
KW  - Middle Aged
KW  - Europe
KW  - Adolescent
LB  - PUB:(DE-HGF)16
C6  - pmid:41386901
DO  - DOI:10.1016/S2215-0366(25)00305-0
UR  - https://pub.dzne.de/record/282905
ER  -