UK Edition
Some cases of schizophrenia and bipolar disorder could be misdiagnosed immune disorders
Some patients sectioned with conditions such as schizophrenia or bipolar disorder could instead have a treatable immune disorder, Oxford University scientists have found.
Currently, people experiencing psychosis are often thought to be suffering from mental disorder and are treated as such with medication and psychotherapy.
But the research, published yesterday in the Lancet psychiatry journal, suggests that some of these patients could in fact be treated with immunosuppressant drugs.
Scientists studied 228 patients who had visited mental health service sites across England having experienced psychosis for the first time.
They took blood samples from each of the patients and found that three per cent of them had antibodies that attack the NMDA receptor, which allows brain cells to communicate with each other.
Encephalitis, as this inflammation of the brain is called, can usually be overcome by prompt recognition and treatment, whereas schizophrenia and bipolar disorder are conditions which require long-term management.
Calling for more blood testing, the report said: “Our study suggests that the only way to detect patients with these potentially pathogenic antibodies is to screen all patients with first-episode psychosis at first presentation.”
Professor Belinda Lennox, one of the report’s authors, described profound implications for the research.
Schizophrenia is a "devastating illness", she said, but "finding a potentially treatable cause for even a small proportion of people with this illness is very exciting."
In a British Social Attitudes survey about the illness, 46 per cent said they felt a schozophrenia diagnosis should affect someone's work promotion prospects, and only 27 per cent said they would be happy for a sufferer to marry into their family.
Professor Lennox said she hoped the research would challenge these attitudes. "By discovering that a proportion of schizophrenia is autoimmune, in the same way as diabetes or rheumatoid arthritis, I think this fundamentally challenges the stigma."
Another implication for the research, she said, is that a more joined-up approach across neurology and psychiatry may be needed to ensure patients get appropriate treatments.