Autoimmune psychosis and the challenge for psychiatry

<h3>Biography</h3> Belinda Lennox is Professor of Psychiatry and Head of Department of Psychiatry, University of Oxford and Honorary Consultant Psychiatrist in the Early Intervention in Psychosis service for Oxford Health NHS FT. Her interests are in discovering the causes of and developing more effective treatments for those with severe mental illness and in implementing those discoveries into clinical practice. She has led research on the autoimmune basis of severe mental illness. There are many lines of evidence to suggest that a proportion of severe mental illness has an autoimmune basis, however to date there have not been any biomarkers to identify individuals that might benefit from immune modifying treatments. This has potentially changed with the discovery of pathogenic antibodies in patients with autoimmune encephalitis. There are many parallels between autoimmune encephalitis and primary psychiatric disorders, however whilst this new knowledge has led to a rapid and widespread change in clinical practice in neurology, there has not been an equivalent change in practice for psychiatry. I will discuss the current level of evidence around the concept of autoimmune mental illness and whether patients require treating with immunotherapy rather than psychotropic medication. I will explore how this challenges our current ways of working and ask whether psychiatry needs to transform to be able to adequately investigate and treat patients with severe mental illness.