Psychiatric manifestations of encephalitis

Area of Science:

• Neurology
• Psychiatry
• Infectious Diseases

Background:

• Encephalitis is a severe neurological condition with infectious or autoimmune origins.
• Presenting psychiatric symptoms can delay diagnosis and treatment.
• Early recognition of psychiatric manifestations is crucial for timely intervention.

Purpose of the Study:

• To determine the frequency and clinical spectrum of psychiatric symptoms in encephalitis patients.
• To identify differences in psychiatric manifestations between autoimmune and infectious encephalitis.
• To inform earlier recognition and treatment initiation for encephalitis.

Main Methods:

• Retrospective study of 642 adult patients meeting International Encephalitis Consortium (IEC) or Graus criteria (2005-2023).
• Data collected from two hospital systems in Houston, Texas, and Baltimore, Maryland.
• Psychiatric manifestations categorized into behavior, psychosis, mood, sleep disturbances, and catatonia.

Main Results:

• Nearly half (49.6%) of patients presented with psychiatric symptoms.
• Autoimmune encephalitis had a higher frequency of psychiatric symptoms (78.2%) compared to viral (35.2%).
• Patients with psychiatric symptoms were younger, had longer hospital stays, and poorer outcomes.

Conclusions:

• Psychiatric symptoms are prevalent in encephalitis across various causes.
• The pattern of psychiatric symptoms can help differentiate between autoimmune and infectious etiologies.
• Identifying psychiatric symptoms is vital for improving patient outcomes in encephalitis.