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Psychiatric and behavioural sequelae following encephalitis: a systematic review and meta-analysis
Cameron J Watson1,2, Jack B Fanshawe3,4, Danish Hafeez2,5
1Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
Brain Communications
|June 22, 2026
Summary
Encephalitis survivors often face long-term mental health issues like depression and anxiety, affecting at least a quarter of them. Infectious causes showed higher mood symptom rates compared to autoimmune ones.
Area of Science:
- Neuroscience
- Psychiatry
- Public Health
Background:
- Encephalitis survivors frequently experience chronic neuropsychiatric sequelae.
- The prevalence and patterns of these mental health outcomes are poorly understood.
Purpose of the Study:
- To systematically review and meta-analyze the prevalence of psychiatric and behavioral symptoms post-encephalitis.
- To compare outcomes between infectious and autoimmune encephalitis, and explore etiological and age-related differences.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines, searching multiple databases.
- Included 101 observational studies (n=4703) reporting psychiatric outcomes ≥3 months post-encephalitis.
- Random-effects meta-analyses estimated pooled prevalence; subgroup analyses and meta-regression explored influencing factors.
Main Results:
- Pooled prevalence estimates: depression (26.9%), anxiety (22.8%), disinhibition (20.5%), emotional instability (22.9%).
- Infectious encephalitis had higher rates of mood symptoms (75.2%) vs. autoimmune (30.9%).
- Follow-up duration, cohort age, and female proportion influenced symptom prevalence.
Conclusions:
- Psychiatric sequelae are common post-encephalitis, comparable to neurological complications.
- Significant heterogeneity underscores the need for prospective studies, standardized criteria, and outcome sets.
- Improved care and research require better characterization of mental health outcomes in encephalitis survivors.
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