Individuals with anti-NMDA encephalitis manifest significant psychiatric symptoms like psychosis early in the disease timeline. Evidence with this disease correlates with the glutamatergic model of schizophrenia, and contributes to the research on schizophrenic neural circuit dysfunction. Psychotic symptoms in anti-NMDAR encephalitis has been a topic of interest, as it questions whether it is an identifiable, treatable subtype of psychosis. There is a distinct relation between schizophrenia and autoimmunity disturbances. There is a lack of evidence for autoantibodies that may result in psychosis, however autoimmunity involving IgG GluN1 antibodies causes a state similar to schizophrenia. 

Psychosis, Autoimmunity and their relation to Anti-NMDA Receptor Encephalitis

Patients with anti-NMDAR encephalitis show signs alongside acute psychosis (which is similar to psychotic episodes cause by a primary psychiatric disease). These patients tend to show resistance/intolerance to antipsychotic medication. Patients with cycloid psychosis experience an acute psychotic episode with the following symptoms: confusion, delusions, hallucinatory experiences, anxiety, and happiness/ecstacy.  

Psychotic symptomatology with anti-NMDA encephalitis: Similarities to cycloid psychosis

University of Illinois at Chicago

A neurological disease (and an autoimmune disease) where the body forms antibodies against the brain's NMDA receptors. The antibodies produced disrupt normal brain activity, causing swelling in the brain (encephalitis). Some patients also have a tumor that is correlated with this disease; most commonly an ovarian teratoma. Symptoms of anti-NMDA receptor encephalitis are as follows: behavior (hallucinations, paranoia), cognition, speech disorder, memory deficit, movement disorder (abnormal movements), seizures, autonomic dysfunction, and loss of consciousness. It is not known exactly what causes this disease, but it is likely environmental and genetic factors that can cause individuals to be more susceptible to this disease. 

anti-NMDA Receptor Encephalitis

Kayser, M. S., Dalmau, J., Matthew S. KayserView all articles by this author, & Josep DalmauView all articles by this author. (n.d.). Anti-NMDA receptor encephalitis, autoimmunity, and psychosis. Focus. https://psychiatryonline.org/doi/10.1176/appi.focus.140405#:~:text=Anti%2DNMDAR%20encephalitis%20demonstrates%20clearly,and%20other%20symptoms%20of%20schizophrenia. 

Anti-NMDA receptor encephalitis, autoimmunity, and psychosis

Anti-NMDAR Encephalitis. Anti-NMDAR Encephalitis | Center for Autoimmune Neurology | Perelman School of Medicine at the University of Pennsylvania. (n.d.). https://www.med.upenn.edu/autoimmuneneurology/nmdar-encephalitis.html 

Anti-NMDAR Encephalitis

Is anti-NMDA receptor encephalitis considered as one of the main cause of schizophrenia/schizoaffective disorders?

The hypothesis of this article states that NMDAR hypofunction (NRHypo) may be a model for a disease mechanism that may explain the course and conditions of schizophrenia. This hypothesis questions whether the disease mechanism involves downstream effects/dysfunction of the NMDA receptor (can be modeled by preventing the activation of NMDA receptors). 

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