Some patients who have been diagnosed with psychotic disorders, such as bipolar and even schizophrenia, may instead be suffering from a treatable autoimmune disease. The new study has looked at patients with psychosis from across the UKand found that a handful may actually have a condition where antibodies attack the brain.
Taking blood samples from 228 people when they were first diagnosed with psychotic illnesses, the researchers from the University of Oxford found evidence that around 3 percent of cases involved a particular antibody that was attacking a receptor in brain cells that help the cells communicate with each other, known as NMDA. This, the researchers suggest, means that potentially 1 in 11 people sectioned for psychotic illnesses could potentially be treated for the autoimmune disease instead.
The researchers suggest that those people diagnosed with psychotic disorders should also have their blood screened for the antibodies in question. If they turn up, then it could mean that treating these in addition to the psychosis could offer a new solution, and drive alternative therapies.
The implications of this are that there are patients in mental health services now who will have these antibodies and could potentially be treated in a very different way, Professor Belinda Lennox, who co-authored the study published in The Lancet, told the BBC. I think this is a really exciting advance for psychiatry as a whole, and every psychiatrist and patient with psychosis needs to be aware of this and to look for it and treat it assertively when we find it.
The findings described by Lennox and her team are not without controversy, however. Those with autoimmune diseases that do attack the brain often present to the doctor with a whole host of other symptoms such as seizures or abnormal movements. This implies that patients who may have been undergoing treatment for psychotic disorders for months or years without displaying these behaviors may only have low levels of the antibody in question, casting doubt on the suggestion that there are people who have been sectioned when all they have is the autoimmune aspect.
Clinical trials are now underway to expand the sample size, and test whether or not some patients could benefit from new treatments that tackle the immune system instead.