Recent Advances in Psychiatry from Psycho-Neuro-Immunology Research: Autoimmunencephalitis, Autoimmune-Encephalopathy, Mild Encephalitis

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About this Research Topic

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Background

The causation of severe mental illness, especially the major psychiatric disorders of the affective and schizophrenic spectrum remain to be better understood in the light of an increasing number of risk factors being identified. Beyond genetic and developmental factors, previously considered the leading risk factors, nationwide analyses from Denmark and also from other regions, clearly demonstrate life time infections and autoimmune disorders represent a new important risk factor. Interestingly these disorders have a rather broad impact on the spectrum of severe mental illness. Further, these data suggest that the long established genetic contribution to risks, beyond neuronal factors, which have been traditionally favored, strongly influence immune-inflammatory and repair aspects of the CNS, perhaps contributing to chronicity of disease. The emerging data matches well with a neuro-inflammatory/ immune-model of pathology predicted by pioneers in the neuro-psycho-immunology field.

The contributions from the neuro-psycho-immunology field were aggregated and intensely discussed at the 13th PIE meeting in March 2016 and have broad interest to the wider psychiatric community, representing a ‘hot topic’ in psychiatric research, currently in its infancy. Several themes will be presented to outline the state of knowledge in this area as a Research Topic at Frontiers. They will include the status of knowledge and open questions regarding the neuroinflammatory contribution to psychiatric disease, presented as a selection of reviews and original work as discussed at the 13th PIE meeting.

These will focus on the important themes relevant to the patients’ perspective and assess how frequently autoimmune encephalitis is diagnosed and treated according to newly established diagnostic and therapeutic possibilities, which might lead to full recovery. Pioneers of these aspects will guide this section, including Dr. Najjar and others. Included will be novel data from a nationwide survey in Denmark, critically assessing the present practice guidelines, which will also address the apparent diagnostic gap. The prevalence of misdiagnosis and attitudes to diagnostic procedures, as well as propose up-to-date approaches will also be examined. A discussion of the present diagnostic options and needed further improvements including imaging, CSF analysis, and neurophysiological methods will be presented. Further reviews of therapeutic options will be presented and potential therapeutic pathways proposed, discussing emerging PIE research in an interdisciplinary framework from basic sciences to clinic. These reviews will also address ethical issues of extraordinary importance in the context of psychiatric illness and potential biological causation. In context with the 13th PIE meeting and in preparation of the next meeting ( idea is getting funded for the 14th PIE meeting by hopefully winning the grant from Frontiers with this Research Topic ) we encourage all participants of the 13th PIE meeting to submit papers of any type (see guidelines).

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Keywords: Psycho-Neuro-Immunology, Autoimmunencephalitis, Autoimmune-Encephalopathy, Mild Encephalitis, Etiopathology, Schizophrenia, Bipolar disorder, Affective disorder

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