Psychopathology of psychiatric patients presenting autoantibodies against neuroglial antigens

Insa Maria Grenzer; Aaron Levin Juhl; Bianca Teegen; Dirk Fitzner; Jens Wiltfang; Niels Hansen

doi:10.3389/fpsyt.2022.945549

Psychopathology of psychiatric patients presenting autoantibodies against neuroglial antigens

Front Psychiatry. 2022 Nov 10:13:945549. doi: 10.3389/fpsyt.2022.945549. eCollection 2022.

Authors

Insa Maria Grenzer^{1

2}, Aaron Levin Juhl^{1

2}, Bianca Teegen³, Dirk Fitzner⁴, Jens Wiltfang^{1

5

6}, Niels Hansen^{1

2}

Affiliations

¹ Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.
² Translational Psychoneuroscience, University Medical Center Göttingen, Göttingen, Germany.
³ Clinical Immunological Laboratory Prof. Stöcker, Groß Grönau, Germany.
⁴ Department of Neurology, University Medical Center Göttingen, Göttingen, Germany.
⁵ German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany.
⁶ Neurosciences and Signaling Group, Department of Medical Sciences, Institute of Biomedicine, University of Aveiro, Aveiro, Portugal.

Abstract

Background: Autoantibody-mediated psychiatric disorder is often difficult to diagnose as the clinical features of psychiatric disorder associated with neural autoantibodies are often similar. Thus, it is of major relevance to investigate whether psychopathology can differentiate between both disease entities as a biomarker and help us in searching for specific autoantibodies associated with psychiatric symptoms.

Methods: We enrolled 154 patients of the Department of Psychiatry and Psychotherapy of the University Medical Center Göttingen with psychopathology data and retrospectively evaluated their patient records using the classification systems AMDP (Arbeitsgemeinschaft für Methodik und Dokumentation in der Psychiatrie) and HiTOP (Hierarchical Taxonomy of Psychopathology).

Results: We identified 35 psychiatric patients revealing autoantibodies in their serum and/or cerebrospinal fluid (CSF) and 119 with no autoantibodies. Relying on the AMDP system, many more psychiatric patients with serum autoantibodies (51%) had problems with orientation than those without autoantibodies (32%) (p < 0.05). Furthermore, fewer psychiatric patients with serum autoantibodies exhibited a blunted affect (11.4 vs. 32.8%, p < 0.01) and affective rigidity (20 vs. 45%, p < 0.01). In particular, psychiatric patients presenting CSF autoantibodies (indicating an autoimmune symptomatic basis) experience more loss of vitality (5%) than those without autoantibodies (0%) (p < 0.05). Another interesting finding is that according to the AMDP classification, a manic syndrome is much more frequent in autoantibody-positive (8.6%) than autoantibody-negative psychiatric patients (0.8%) (p < 0.05). Another aspect is the more frequent occurrence of attention and memory deficits in patients with autoantibodies against intracellular targets compared with targets on the membrane surface.

Conclusion: Our findings indicate that neural autoantibodies in psychiatric patients could indicate a phenotype more often characterized by a manic syndrome, orientation disturbances within the cognitive spectrum, and fewer affect disturbances characterized by less blunted affect and not as seriously impaired feelings of vitality compared to controls. The novelty of our approach is the extensive autoantibody tests for various psychiatric syndromes in combination with a profound psychometric measurement with two different scales.

Keywords: AMDP system; HiTOP classification; autoimmunity; neural autoantibody; psychiatry; psychopathology.