{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:02:23Z","timestamp":1790298143489,"version":"4.1.0"},"reference-count":153,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Mol Psychiatry"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Psychiatric syndromes can be caused by underlying autoimmune encephalitis (AE). This represents a diagnostic challenge at the interface of psychiatry and neurology. While AE mostly manifests with a combined, complex neuropsychiatric syndrome, some patients with AE may (initially) present with predominant or isolated psychiatric symptoms. These cases can be difficult to classify, and diagnostic approaches vary considerably across clinical settings. This paper from the\n                    <jats:italic>GErman NEtwork for Research on AuToimmune Encephalitis<\/jats:italic>\n                    (GENERATE) provides interdisciplinary expert recommendations from psychiatry and neurology for the diagnostic evaluation of patients with suspected AE as the cause of psychiatric syndromes for psychiatric care settings. It integrates current scientific evidence with practical, empirical considerations from routine clinical care in different healthcare settings. The proposed diagnostic approach to detect psychiatric manifestations of AE emphasizes a rational, stepwise evaluation incorporating clinical assessment, magnetic resonance imaging, electroencephalography, blood testing, cerebrospinal fluid (CSF) analysis, and neuronal\/glial antibody testing in serum and CSF. In diagnostically ambiguous individuals, [\u00b9\u2078F]fluorodeoxyglucose positron-emission-tomography and advanced antibody testing (e.g., live-cell-based assays) or neuroimaging techniques (e.g., volumetric analysis) may provide additional supportive information. Typical findings and limitations of diagnostic modalities are discussed to facilitate appropriate interpretation and to avoid under-recognition or overdiagnosis. Importantly, these recommendations do not aim to define new disease entities or diagnostic criteria, but rather to support a harmonized and pragmatic diagnostic approach to patients presenting with psychiatric syndromes suspected to be caused by underlying AE. Finally, key unresolved issues in this evolving field of immunopsychiatry are outlined, and promising research strategies are described.\n                  <\/jats:p>","DOI":"10.1038\/s41380-026-03871-2","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:36:08Z","timestamp":1790296568000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosing autoimmune encephalitis in psychiatry: clinical recommendations and unresolved challenges from the GENERATE network"],"prefix":"10.1038","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7322-1195","authenticated-orcid":false,"given":"Dominique","family":"Endres","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"von Zedtwitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2274-5447","authenticated-orcid":false,"given":"Ludger","family":"Tebartz van Elst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2550-9132","authenticated-orcid":false,"given":"Katharina","family":"Domschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Weiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8816-3415","authenticated-orcid":false,"given":"Arnim J.","family":"Gaebler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8113-6959","authenticated-orcid":false,"given":"Thomas","family":"Frodl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7147-6167","authenticated-orcid":false,"given":"Elias","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"J\u00e4ger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkomiet","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Priller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1298-197X","authenticated-orcid":false,"given":"Cora","family":"Schefft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1228-6846","authenticated-orcid":false,"given":"Paul J.","family":"Wirsching","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibylle","family":"Hau\u00dfleiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Juckel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4001-8542","authenticated-orcid":false,"given":"Philipp","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0645-9034","authenticated-orcid":false,"given":"David H. 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AH\n                      \n                      reported receiving personal fees from AbbVie, axunio, Advanz Pharma, Boehringer-Ingelheim, Janssen-Cilag, Teva, Lundbeck, Recordati, Rovi and Otsuka outside the submitted work; serving as editor of the German schizophrenia treatment guidelines and as first author of the World Federation of Societies of Biological Psychiatry schizophrenia treatment guidelines; and serving on advisory boards of AbbVie, Boehringer-Ingelheim, Janssen-Cilag, Lundbeck, Recordati, Rovi and Otsuka.\n                      \n                        JP\n                      \n                      has received research support from DFG (SFB\/TRR167, 265, 418), BMFTR\/DLR (01EE2503B), MRC (UK DRI), and serves on the steering committee of the SINAPPS2 trial.\n                      \n                        JR\n                      \n                      received speaker\u2019s honoraria from Janssen, Hexal, Neuraxpharm and Novartis.\n                      \n                        NH\n                      \n                      has received funding from the DFG (#530229798) and honoraria for travel and lectures from Eisai GmbH and Eli Lilly, as well as travel honoraria from Bristol Myers Squibb.\n                      \n                        AN\n                      \n                      has received honoraria for speaking from J&J.\n                      \n                        SW\n                      \n                      has received speaker honoraria from Lundbeck, Mepha, and Neurolite.\n                      \n                        TK\n                      \n                      has received personal honoraria for advisory boards from Alexion\/Astra Zeneca, UCB, Merck and Biogen and for speaker honoraria\/chairs and\/or lectures\/education from Alexion\/Astra Zeneca, Novartis Pharma, Roche Pharma, Horizon Therapeutics\/Amgen and Chugai Pharma.\n                      \n                        SGM\n                      \n                      : He discloses having received honoraria for lecturing and travel expenses for attending meetings and has received financial research support from Bayer, Bayer Schering, Biogen Idec, Genzyme, Merck Serono, Merck Sharp & Dohme, Novartis, Novo Nordisk, Sanofi-Aventis and Teva.\n                      \n                        SCT\n                      \n                      discloses having received speaker honoraria from Novartis, Teva, Merck, Roche, Amgen and Biogen, travel funding from Merck, Roche and Novartis and serving on advisory boards for Roche, Novartis and Merck.\n                      \n                        BW\n                      \n                      has received research support from DFG, BMFTR, Dietmar-Hopp-Stiftung, Klaus-Tschira-Stiftung, Argenx, Novartis, Roche, and honoraria for speaking and\/or travel compensation from Alexion, Argenx, INSTAND, Neuraxpharm, Novartis, Roche.\n                      \n                        CG\n                      \n                      is supported by the Deutsche Forschungsgemeinschaft (GE 2519\/7-2, 8-2, 9-2, GRK3136\/1, FOR3004\/2), HORIZON Doctoral Network 101227384 IGNITION, the German Federal Ministry of Research, Technology and Space (01GM1908E), and the Schilling Foundation.\u00a0He discloses having received speaker honoraria, travel funding, and having served on advisory boards for Argenx, Roche, Alexion, AstraZeneca, Kyova.\n                      \n                        NM:\n                      \n                      He is supported by the European Joint Program for Neurodegenerative Diseases (EJPRD) IGNITEMIND (01ED2506A), the Deutsche Forschungsgemeinschaft (ME 5173\/3-1) as partner of the European Rare Disease Research Alliance (ERDERA). The ERDERA initiative has received funding from the European Union\u2019s Horizon Europe research and innovation programme under grant agreement N\u00b0101156595. He discloses having received honoraria for lecturing and travel expenses for attending meetings from Biogen Idec, GlaxoSmith Kline, Teva, Novartis Pharma, Bayer Healthcare, Genzyme, Alexion Pharmaceuticals, Fresenius Medical Care, Diamed, UCB Pharma, AngeliniPharma, BIAL and Sanofi-Aventis, has received royalties for consulting from UCB Pharma, Alexion Pharmaceuticals and Sanofi and has received financial research support from Euroimmun, Fresenius Medical Care, Diamed, Alexion Pharmaceuticals, Novartis Pharma, and Sanofi.\n                      \n                        FL\n                      \n                      : He is supported by E-Rare Joint Transnational research support (ERA-Net, LE3064\/2-1), European Joint Program for Neurodegenerative Diseases (EJPRD) IGNITEMIND (01ED2506B), ERA-Net MICE-AE (01EW2507B), Stiftung Pathobiochemie of the German Society for Laboratory Medicine and HORIZON MSCA 2022 Doctoral Network 101119457 \u2014 IgG4-TREAT and 101227384 IGNITION. He discloses having received speaker honoraria from Grifols, Teva, Biogen, Bayer, Roche, Novartis, Fresenius, travel funding from Merck, Grifols and Bayer and serving or having served on advisory boards for Argenx, Roche, Biogen and Alexion. All other authors declare no potential conflicts of interest.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}]}}