In recent years some evidence has emerged that around 6% of people who have psychosis for the first time have antibodies in their body that attack the brain. The brain then becomes ‘inflamed’ and psychosis follows.
By eliminating these antibodies and treating the brain inflammation using anti-inflammatory drugs called corticosteroids some of these people went on to get better. You can listen to Professor Belinda Lennox speaking about this work here.
‘Antibody mediated psychosis’ is the working name for the condition from which these people suffer. It’s a broad term for people with psychosis and antibodies that are known to bind to structures called ‘receptors’ in the brain.
The most famous sufferer of antibody mediated psychosis is perhaps Susannah Cahalan. Cahalan went onto write a book in 2012 entitled ‘Brain on Fire’ about her experiences.
The symptoms of antibody mediated psychosis are almost identical to those found in mental health conditions such as schizophrenia. For this reason many people who might have antibody mediated psychosis may be mistakenly diagnosed with a condition such as schizophrenia and treated in mental health services.
It is not yet an accepted medical diagnosis. Indeed, some people disagree with the term and it might very well be changed.
Antibody mediated psychosis is very similar to a condition called encephalitis. The conditions are so similar that some believe that antibody mediated psychosis might be a specific type of encephalitis (the term ‘anti-NMDA encephalitis is sometimes used in place of ‘antibody mediated psychosis). Encephalitis is usually caused by some kind of infection (for example a virus).
You can found out more about encephalitis by visiting The Encephalitis Society website.
Antibody mediated psychosis is thought to be an ‘autoimmune’ condition. An autoimmune condition is one where the body’s immune system mistakenly attacks healthy body tissue. Arthritis is one well known autoimmune condition.
If antibody mediated psychosis is an autoimmune condition then it might respond to ways of treating other autoimmune conditions. So far a small number of people have been treated in this way and the results have been encouraging.
Much more work needs to be done in order to better understand and treat antibody mediated psychosis. For the time being most of this work will be done within the context of research studies. The SINAPPS-1 study funded by the Stanley Foundation is focused around looking at the practicalities of how you can identify people who might have antibody mediated psychosis in NHS settings. A further much larger study called SINAPPS-2 has been funded by the Medical Research Council. This study will focus on seeing if a therapy called IVIG together with antipsychotic and corticosteroid medication will help people get better.
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