Anti-bodies in brain 'can cause psychosis'

Patients with their first episode of psychosis, a sign of schizophrenia, should be tested for an alternative disorder, according to an expert.

A small number of patients admitted to hospital with schizophrenia-like symptoms actually have another condition which attacks the brain, a Brisbane study says.

The neuronal autoimmune disorder, revealed through a blood test, can be treated early giving patients the best chance of a very good outcome.

"If they get the treatment for schizophrenia, they won't recover, they will stay disabled all their lives," Associate Professor James Scott told AAP.

He presented his team's findings to the annual conference of the Australian and New Zealand College of Psychiatrists in Hong Kong.

The study involved 116 patients, aged between 12 and 50, admitted to hospital between July 2013 and May 2015 for their first presentation of psychosis, characterised by delusions and hallucinations.

They all were tested for the presence of autoimmune encephalitis which leads to inflammation of the brain.

"For some patients, the body is producing antibodies which attack the brain, just like rheumatoid arthritis antibodies attack the joints," Prof Scott said.

Four, "a small but not insignificant" number, were found to have an autoimmune encephalitis.

Instead of receiving psychiatric care, they were given immune-modulators therapy .

"If they get therapy that stops the production of the antibodies attacking the brain, they have a very good chance of recovery."

The condition affects the functioning of the brain, but "it's a mental illness for which we can understand what the cause is".

"Schizophrenia is going to be 100 disorders, many, many different illnesses and many, many different causes of it."

He recommended that the blood test, which costs the health system about $200, should be used for all patients presenting with first-episode psychosis.

"Early identification of these patients and referral for appropriate treatment is critical to optimise recovery."

* The writer travelled to Hong Kong courtesy of RANZCP.


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