Cerebrospinal fluid findings in patients with severe mental disorders

Introduction Interest in the immunological pathways that play a role in the etiology and pathophysiology of a subgroup of patients with severe mental disorders has increased in recent years. Particularly, the association and detection of antineuronal autoantibodies and inflammatory changes in the cerebrospinal fluid (CSF) in a subgroup of patients have been a key research focus. As a result of this development, international consensus criteria for autoimmune psychosis have recently been published for the first time.

Methods We plan to analyze an unselected, retrospective cohort of patients with schizophrenia spectrum, and affective disorders who had a lumbar puncture to exclude a secondary, organic cause of their symptoms in the Department of Psychiatry and Psychotherapy of the University hospital in Freiburg. We will analyze alterations in CSF basic parameters (white blood cell count, protein concentration, albumin quotient, IgG index, and oligoclonal bands), several antineuronal antibody findings in the CSF and serum, and their association with cerebral magnetic resonance imaging and electroencephalographic findings.

Results The results should be presented descriptively and discussed with regard to the concept of autoimmune psychosis at the congress of the DGBP and AGNP 2020.

Conclusion The diagnostic clarification of underlying secondary autoimmune alterations in patients with schizophreniform and affective psychosis is of growing importance, as these new insights lead to new therapeutic anti-inflammatory treatment alternatives for a subgroup of patients. The limitations of the uncontrolled and retrospective study design will also be discussed.