Supplementary information for: Clinical, neuroimmunologic, and CSF investigations in first episode psychosis

Objectives: To report the neuropsychiatric features and frequency of N-methyl-d-aspartate receptor (NMDAR) and other neuronal IgG antibodies in patients with first episode psychosis (FEP), and assess the performance of reported warning signs and criteria for autoimmune psychosis (AP). Methods: Prospective observational study of patients with FEP assessed for neuropsychiatric symptoms, serum and CSF neuronal antibodies (brain immunohistochemistry, cell-based assays, live neurons), and warning signs and criteria of AP. Previous autoimmune FEP series were reviewed. Findings: 105 patients were included; median age 30 years (range 14-75), 44 (42%) female. None had neuronal antibodies. Two/105 (2%) had CSF pleocytosis, 4/100 (4%) brain MRI abnormalities, and 3/73 (4%) EEG alterations. Thirty-four (32%) and 39 (37%) patients fulfilled two sets of warning signs of AP, and 21 (20%) fulfilled criteria of possible or probable AP, yet none developed AP. The cause of FEP was psychiatric in 101...研究目的：本研究旨在报告首发精神病（first episode psychosis, FEP）患者的神经精神特征、N-甲基-D-天冬氨酸受体（N-methyl-d-aspartate receptor, NMDAR）及其他神经元IgG抗体的检出频率，并评估已报道的自身免疫性精神病（autoimmune psychosis, AP）预警征象与诊断标准的应用效能。 研究方法：本研究为前瞻性观察研究，对纳入的首发精神病患者开展神经精神症状评估、血清及脑脊液（cerebrospinal fluid, CSF）神经元抗体检测（采用脑组织免疫组化、细胞基检测法、活神经元检测技术），并评估其AP预警征象与诊断标准；同时回顾既往首发精神病自身免疫相关系列研究。 研究结果：本研究共纳入105例患者，中位年龄30岁（年龄范围14~75岁），其中女性44例（占42%）。所有患者均未检出神经元抗体。2例（占2%，105例中）存在脑脊液细胞增多，4例（占4%，100例中）存在脑磁共振成像（magnetic resonance imaging, MRI）异常，3例（占4%，73例中）存在脑电图（electroencephalogram, EEG）改变。34例（32%）与39例（37%）分别符合两套AP预警征象，21例（20%）符合可能或很可能的AP诊断标准，但无一例最终发展为自身免疫性精神病。首发精神病的病因在101例中为精神源性……