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Secondary forms are based on a clearly identifiable organic cause, in terms of either an etiological or a relevant pathogenetic factor. The secondary or \u201csymptomatic\u201d forms of psychosis have reentered the focus stimulated by the discovery of autoantibody (Ab)-associated autoimmune encephalitides (AEs), such as anti-NMDA-R encephalitis, which can at least initially mimic variants of primary psychosis. These newly described secondary, immune-mediated schizophreniform psychoses typically present with the acute onset of polymorphic psychotic symptoms. Over the course of the disease, other neurological phenomena, such as epileptic seizures, movement disorders, or reduced levels of consciousness, usually arise. Typical clinical signs for AEs are the acute onset of paranoid hallucinatory symptoms, atypical polymorphic presentation, psychotic episodes in the context of previous AE, and additional neurological and medical symptoms such as catatonia, seizure, dyskinesia, and autonomic instability. Predominant psychotic courses of AEs have also been described casuistically. The term autoimmune psychosis (AP) was recently suggested for these patients. Paraclinical alterations that can be observed in patients with AE\/AP are inflammatory cerebrospinal fluid (CSF) pathologies, focal or generalized electroencephalographic slowing or epileptic activity, and\/or suspicious \u201cencephalitic\u201d imaging findings. The antibody analyses in these patients include the testing of the most frequently found Abs against cell surface antigens (NMDA-R, CASPR2, LGI1, AMPA-R, GABA<jats:sub>B<\/jats:sub>-R), intracellular antigens (Hu, Ri, Yo, CV2\/CRMP5, Ma2 [Ta], amphiphysin, GAD65), thyroid antigens (TG, TPO), and antinuclear Abs (ANA). Less frequent antineuronal Abs (e.g., against DPPX, GABA<jats:sub>A<\/jats:sub>-R, glycine-R, IgLON5) can be investigated in the second step when first step screening is negative and\/or some specific clinical factors prevail. Beyond, tissue-based assays on brain slices of rodents may detect previously unknown antineuronal Abs in some cases. The detection of clinical and\/or paraclinical pathologies (e.g., pleocytosis in CSF) in combination with antineuronal Abs and the exclusion of alternative causes may lead to the diagnosis of AE\/AP and enable more causal therapeutic immunomodulatory opportunities.<\/jats:p>","DOI":"10.1007\/s00406-020-01113-2","type":"journal-article","created":{"date-parts":[[2020,3,12]],"date-time":"2020-03-12T20:02:32Z","timestamp":1584043352000},"page":"803-818","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":109,"title":["Autoimmune encephalitis as a differential diagnosis of schizophreniform psychosis: clinical symptomatology, pathophysiology, diagnostic approach, and therapeutic considerations"],"prefix":"10.1007","volume":"270","author":[{"given":"Dominique","family":"Endres","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Leypoldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Bechter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkomiet","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Steiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Domschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus-Peter","family":"Wandinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Falkai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Arolt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Stich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Rauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Pr\u00fcss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludger Tebartz","family":"van Elst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,12]]},"reference":[{"issue":"3","key":"1113_CR1","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/S2215-0366(19)30001-X","volume":"6","author":"A Al-Diwani","year":"2019","unstructured":"Al-Diwani A, Handel A, Townsend L, Pollak T, Leite MI, Harrison PJ, Lennox BR, Okai D, Manohar SG, Irani SR (2019) The psychopathology of NMDAR-antibody encephalitis in adults: a systematic review and phenotypic analysis of individual patient data. 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FL: Consulting\/speech fees from Biogen, Grifols, Teva, Roche, Merck, Fresenius. KB: None. AH: Fees for consulting and lectures by Lundbeck, Otsuka, Janssen-Cilag, Roche and Pfizer. He is editor of the WFSBP Schizophrenia Guidelines and coordinator and member of the control group of the S3 Schizophrenia Guidelines. JS: Fees for consulting and lectures within the last 3\u00a0years from Janssen-Cilag. KD: Steering Committee Neurosciences, Janssen. KPW: He worked for Euroimmun up to December 2012. He has received payment for a lecture from the laboratory Dr. Fenner and colleagues. PF: Consulting for the past 3\u00a0years: Abbott, Janssen, Lundbeck, Otsuka, Recordati, Richter, Servier, Takeda. VA: He has been working as an advisor and gave lectures for the following pharmaceutical companies: Allergan, Astra-Zeneca, Janssen, Neuraxpharm, Otsuka, Organon, Sanofi, Servier, and Tromsdorff. OS: None. SR: Receiving consulting and lecture fees, grant and research support from Bayer Vital, Biogen, Merck Serono, Novartis, Sanofi-Aventis, Genzyme, Roche and Teva. Furthermore, SR indicates that he is a founding executive board member of ravo Diagnostika GmbH Freiburg. HP: None. LTvE: Advisory boards, lectures, or travel grants within the last three years: Roche, Eli Lilly, Janssen-Cilag, Novartis, Shire, UCB, GSK, Servier, Janssen and Cyberonics. Book publications on schizophrenic disorders, autism and \u201cepilepsy and mind\u201d.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}