{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T17:42:14Z","timestamp":1774460534795,"version":"3.50.1"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Our study aims to examine the risk factors for comorbid psychosis in pediatric patients hospitalized for anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis and its impact on hospital outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a cross-sectional study using the nationwide inpatient sample (NIS 2018\u20132019). We included 3,405 pediatric inpatients (age 6\u201317 years) with a primary discharge diagnosis of anti-NMDAR encephalitis. We used binomial logistic regression model to evaluate the odds ratio (OR) of variables (demographic and comorbidities) associated with comorbid psychosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The prevalence of comorbid psychosis in anti-NMDAR encephalitis inpatients was 5.3%, and majorly constituted of adolescents (72.2%) and females (58.3%). In terms of race, Blacks (OR 2.41), and Hispanics (OR 1.80) had a higher risk of comorbid psychosis compared to Whites. Among comorbidities, encephalitis inpatients with depressive disorders (OR 4.60), sleep-wake disorders (OR 3.16), anxiety disorders (OR 2.11), neurodevelopmental disorders (OR 1.95), and disruptive behavior disorders (OR 2.15) had a higher risk of comorbid psychosis. Anti-NMDAR encephalitis inpatients with comorbid psychosis had a longer median length of stay at 24.6 days (vs. 9.8 days) and higher median charges at $262,796 (vs. $135,323) compared to those without psychotic presentation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Adolescents, females, and Blacks with encephalitis have a higher risk of psychotic presentation leading to hospitalization for anti-NMDAR encephalitis. Identification of demographic predictors and comorbidities can aid in early recognition and intervention to optimize care and potentially reduce the healthcare burden.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0296870","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T18:24:20Z","timestamp":1707848660000},"page":"e0296870","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Pediatric anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis: Exploring psychosis, related risk factors, and hospital outcomes in a nationwide inpatient sample: A cross-sectional study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5079-4492","authenticated-orcid":true,"given":"Sanobar","family":"Jaka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sukhnoor","family":"Singh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3915-3680","authenticated-orcid":true,"given":"Sreshatha","family":"Vashist","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5305-8183","authenticated-orcid":true,"given":"Sandesh","family":"Pokhrel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ericka","family":"Saldana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albulena","family":"Sejdiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8051-6255","authenticated-orcid":true,"given":"Sanjana","family":"Taneja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abimbola","family":"Arisoyin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja","family":"Mogallapu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sasidhar","family":"Gunturu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9256-6823","authenticated-orcid":true,"given":"Anil","family":"Bachu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2895-9155","authenticated-orcid":true,"given":"Rikinkumar S.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"issue":"4","key":"pone.0296870.ref001","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1097\/INF.0000000000002551","article-title":"Epidemiology and Etiology of Severe Childhood Encephalitis in The Netherlands.","volume":"39","author":"D de Blauw","year":"2020","journal-title":"Pediatr Infect Dis J."},{"issue":"6","key":"pone.0296870.ref002","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.jinf.2022.04.026","article-title":"Global magnitude of encephalitis burden and its evolving pattern over the past 30 years.","volume":"84","author":"H Wang","year":"2022","journal-title":"J Infect"},{"issue":"4\u20135","key":"pone.0296870.ref003","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1080\/09602010600989620","article-title":"The epidemiology of acute encephalitis.","volume":"17","author":"J Granerod","year":"2007","journal-title":"Neuropsychol Rehabil"},{"issue":"3","key":"pone.0296870.ref004","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1097\/WCO.0000000000000199","article-title":"Epidemiology and outcomes of acute encephalitis.","volume":"28","author":"A. 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