Subjective psychiatric symptoms in post-acute autoimmune encephalitis: findings from the Australian autoimmune encephalitis consortium.

IF 4.6 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Neurology Pub Date : 2025-09-29 DOI:10.1007/s00415-025-13353-0

Katherine Y Ko, Christina Kazzi, Nabil Seery, Sarah Griffith, Robb Wesselingh, Tiffany Rushen, Tracie H Tan, Hannah Ford, Catherine Meade, Marie F O'Shea, Laurie McLaughlin, Genevieve Skinner, Mirasol Forcadela, Amy Halliday, Andrew Duncan, Ernest G Butler, Anneke Van Der Walt, Tomas Kalincik, Wendyl D'Souza, Udaya Seneviratne, Katherine Buzzard, Richard Macdonell, Sudarshini Ramanathan, Stefan Blum, Jayashri Kulkarni, Stephen W Reddel, Todd A Hardy, Helmut Butzkueven, Terence J O'Brien, Rubina Alpitsis, Charles B Malpas, Mastura Monif

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引用次数: 0

Abstract

Background and objectives: This study examined self-reported psychopathology in patients with autoimmune encephalitis (AE), and explored their relationship with clinical outcomes as measured by the modified Rankin Scale (mRS) and Clinical Assessment Scale in Autoimmune Encephalitis (CASE) scores.

Methods: Eighty-seven AE patients (49.43% female, mean age = 54.47 years, SD = 17.84) from the Australian Autoimmune Encephalitis Consortium completed the SPECTRA-Indices of Psychopathology, time-matched with CASE and mRS scores within six months of the assessments.

Results: On average, assessments occurred 12 months post-onset. Median CASE and mRS scores were 2, with 84.13% of patients scoring mRS ≤ 2. Mean SPECTRA scores were significantly elevated across multiple domains, indicating greater psychopathology, particularly in depression, post-traumatic stress, suicidal ideation, and cognitive functioning. Patients with seronegative AE exhibited more severe psychopathology compared to those with anti-N-methyl-D-aspartate receptor (NMDAR) and anti-leucine-rich glioma-inactivated 1 (LGI1) subtypes. Psychiatric diagnoses prior to AE onset were associated with worse outcomes, compared to those with no pre-existing psychiatric conditions and those diagnosed post-onset. The mRS and CASE scores each explained only a small amount of variance (7-26%) across SPECTRA domains, and adding the other score to the model provided only little improvement.

Discussion: AE patients exhibit significant psychopathology across multiple domains, with significant internalising symptoms-including depression, post-traumatic stress, and suicidal ideation-as well as cognitive concerns, highlighting the considerable psychiatric burden in this population. Our findings highlight the need for systematic, timely assessments of psychological symptoms in AE, and the use of sensitive, comprehensive instruments to capture the full spectrum of their psychopathology.

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急性自身免疫性脑炎后的主观精神症状：来自澳大利亚自身免疫性脑炎协会的发现。

背景与目的：本研究考察自身免疫性脑炎（AE）患者自我报告的精神病理，并探讨其与自身免疫性脑炎临床评估量表（CASE）评分的临床结果的关系。方法：来自澳大利亚自身免疫性脑炎协会的87例AE患者（女性49.43%，平均年龄54.47岁，SD = 17.84）在评估后6个月内完成了精神病理学光谱指数，时间与CASE和mRS评分相匹配。结果：平均在发病后12个月进行评估。中位CASE和mRS评分为2分，其中84.13%的患者mRS评分≤2分。平均谱分数在多个领域显著升高，表明更大的精神病理，特别是在抑郁症、创伤后应激、自杀意念和认知功能方面。与抗n -甲基- d -天冬氨酸受体（NMDAR）和抗富亮氨酸胶质瘤失活1 （LGI1）亚型患者相比，血清阴性AE患者表现出更严重的精神病理。与无精神疾病和发病后诊断的患者相比，AE发病前的精神疾病诊断与更差的结果相关。mRS和CASE分数各自只解释了光谱域的少量方差（7-26%），并且将其他分数添加到模型中只提供了很少的改进。讨论：AE患者在多个领域表现出明显的精神病理，具有显著的内化症状，包括抑郁、创伤后应激和自杀意念，以及认知问题，突出了这一人群中相当大的精神负担。我们的研究结果强调，需要系统、及时地评估AE的心理症状，并使用敏感、全面的仪器来捕捉其精神病理的全谱。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neurology 医学-临床神经学

CiteScore

10.00

自引率

5.00%

发文量

558

审稿时长

1 months

期刊介绍： The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.