Psychiatric Outcomes and Its Predictors in Autoimmune Encephalitis
Abstract number :
2.242
Submission category :
6. Cormorbidity (Somatic and Psychiatric)
Year :
2023
Submission ID :
412
Source :
www.aesnet.org
Presentation date :
12/3/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Palak Patel, MD – JFK University Medical Center, Hackensack Meridian Health
Maria Pleshkevich, PhD – NYU Langone Medical Center; Julien Hebert, MD – Columbia-NYP Medical Center; Ramy gabarin, MD – Temerty Faculty of Medicine, University of Toronto; Sydney Lee, MD – Temerty Faculty of Medicine, University of Toronto; Doris Xia, DO – NYU Langone Medical Center; Claude Steriade, MD, CM – NYU Langone Medical Center
Rationale:
About 12-60% of patients with autoimmune encephalitis (AE) develop mood and anxiety symptoms after treatment.1,2,3 Most studies have been retrospective, survey based, and lacked a systematic evaluation. This study aims to characterize long-term psychiatric outcomes and their predictors using standardized scales.
Methods:
We retrospectively identified patients ages 18-100 treated at the New York University Langone Medical Center and Toronto Western Hospital 2008 through 2021 with a diagnosis of AE using Graus diagnostic criteria. Patients were evaluated prospectively using the Mini Neuropsychiatric Inventory (MINI) 7.0.2 and Profile of Mood States-2 (POMS-2). We used descriptive analysis to assess the frequency of categorical variables, Chi-square, Fisher’s exact, and Mann-Whitney U tests for group differences.
Results:
A total of 57 subjects (male=20, female=37) with a mean age of 42.1 ±17.4 years were included. Median time to follow-up was 5 years (IQR = 5, range = 27). Subtypes included anti-NMDA, anti-LGI1, anti-GAD65, anti-CASPR2 and antibody negative AE. A total of 33% of subjects had been previously diagnosed with a psychiatric disorder. 22/41 (53%) had a new diagnosis of a psychiatric disorder on follow-up on MINI and 12/42 (28%) reported mood disturbance on the POMS-2. New diagnoses included MDD (14%), BPAD1 (2.4%), GAD (7.3%), panic disorder (17%), agoraphobia (7.3%), SAD (9.7), Current Mild Alcohol Use Disorder (4.8%) and current suicidality (2.4%). Only 39% of those in the NYU cohort with a new diagnosis were receiving treatment at the last follow-up. Predictors of mood disorder diagnosis on the MINI included past psychiatric history (PPH) (p = .011), hospitalization (p = .027) and treatment (p = .001), a suicidal ideation/attempt (p= .012), prior use of anti-depressants/anxiolytics (p = .001), LPDs on EEG (p = .024), abnormal MRI (p = .012), and ICU admission (p = .049). Predictors of mood disorder on the POMS-2 included PPH (U = 324, p = .008) and psychiatric symptoms at the last follow-up (U = 214, p < .001).
Cormorbidity (Somatic and Psychiatric)