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Updated: Apr 6, 2026

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Autoimmune Encephalitis in Postpartum Psychosis.

Veerle Bergink1, Thaís Armangue1, Maarten J Titulaer1

  • 1From the Erasmus Medical Center, Department of Psychiatry, Rotterdam, the Netherlands; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Service of Neurology, Hospital Clínic, University of Barcelona, Barcelona, Spain; the Erasmus Medical Center, Department of Neurology, Rotterdam, the Netherlands; Columbia University Medical Center, Department of Psychiatry, and New York State Psychiatric Institute, New York; University of Pennsylvania, Department of Neurology, Philadelphia; and Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.

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Summary

Postpartum psychosis may indicate autoimmune encephalitis. Two of 96 patients had anti-N-methyl-D-aspartate receptor antibodies, suggesting screening for this condition is crucial.

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Area of Science:

  • Neuroimmunology
  • Psychiatry

Background:

  • Postpartum psychosis is linked to immunological alterations.
  • Autoimmune encephalitis is a potential cause of severe psychiatric episodes.

Observation:

  • A cohort of 96 postpartum psychosis patients and 64 controls underwent CNS autoantibody screening.
  • Immunohistochemistry and immunocytochemistry identified antibodies in patient serum.

Findings:

  • 4% of patients showed neuropil labeling; 2 had confirmed anti-N-methyl-D-aspartate (NMDA) receptor antibodies.
  • No ovarian teratomas were found in antibody-positive patients.
  • Two patients with anti-NMDA receptor antibodies developed extrapyramidal symptoms.

Implications:

  • Systematic screening for anti-NMDA receptor autoantibodies is recommended for postpartum psychosis.
  • Consider anti-NMDA receptor encephalitis in young women with acute psychosis and neurological symptoms.