Prevalence, Severity and Predictors of Psychiatric Disorders in Patients with Autoimmune Disorder

Authors

  • Abhinav Ankur Department of Medicine. Vardhman Mahavir medical college, New Delhi.
  • Dimple Gupta Senior Resident, Department of Psychiatry. Hamdard Institute of medical sciences and research, New Delhi
  • Bushra Zahoor Assistant Professor, Department of Psychiatry, Hamdard Institute of medical sciences and research, New Delhi.

DOI:

https://doi.org/10.37506/18g8hq58

Keywords:

Autoimmune, depression, psychosis, anxiety.

Abstract

In recent years, there has been growing attention to the idea that immunological pathways may play a role in some types of psychotic disorders. Researchers have become particularly interested in the connection between autoimmune diseases and psychotic disorders. Genetic studies have linked immune-related genetic markers with schizophrenia, and clinical studies have found elevated levels of inflammatory markers in individuals with psychosis. Additionally, several large-scale epidemiologic studies have found a positive association between autoimmune diseases and psychosis. Specifically, autoimmune diseases like multiple sclerosis and lupus are known to have a higher incidence of neuropsychiatric symptoms, including psychosis, compared to healthy individuals. Research has shown a link between autoimmune conditions and greater chances of experiencing mental health problems.

There is a proposed connection between autoimmune diseases and schizophrenia that works both ways. Previous findings underlined an association between autoimmune disorders and schizophrenia, with evidence of a reciprocal relationship. In addition, having a family history of autoimmune diseases may elevate the likelihood of developing psychotic disorders. This review will examine the epidemiological evidence that supports the association between autoimmune diseases and psychosis. Possible explanations for this link will be explored, including shared genetic risk factors, the impact of infections on autoimmunity and psychotic disorders, and the role of the microbiome. The review will also discuss the effects of autoantibodies and T- and B-cell dysregulation on both disease categories and the need for further research. Examining the connection between autoimmune diseases and psychosis is essential in understanding the etiological mechanisms of psychotic disorders and highlighting the significance of somatic comorbidity in patients with these disorders.

Author Biographies

  • Abhinav Ankur, Department of Medicine. Vardhman Mahavir medical college, New Delhi.

     Senior Resident, Department of Medicine. Vardhman Mahavir medical college, New Delhi.

  • Dimple Gupta, Senior Resident, Department of Psychiatry. Hamdard Institute of medical sciences and research, New Delhi

    Senior Resident, Department of Psychiatry. Hamdard Institute of medical sciences and research, New Delhi

  • Bushra Zahoor, Assistant Professor, Department of Psychiatry, Hamdard Institute of medical sciences and research, New Delhi.

    Assistant Professor, Department of Psychiatry, Hamdard Institute of medical sciences and research, New Delhi.

References

Ms K, J D. The emerging link between autoimmune disorders and neuropsychiatric disease. J Neuropsychiatry Clin Neurosci [Internet]. 2011 Winter [cited 2023 Aug 2];23(1). Available from: https://pubmed.ncbi.nlm.nih.gov/21304144/

Najjar S, Pearlman D, Zagzag D, Golfinos J, Devinsky O. Glutamic acid decarboxylase autoantibody syndrome presenting as schizophrenia. The Neurologist. 2012 Mar;18(2):88–91.

Antibodies and neuronal autoimmune disorders of the CNS | SpringerLink [Internet]. [cited2023 Aug 2]. Available from: https://link.springer.com/article/10.1007/s00415-009-5431-9

Lennox BR, Coles AJ, Vincent A. Antibody-mediated encephalitis: a treatable cause of schizophrenia. Br J Psychiatry J Ment Sci. 2012 Feb;200(2):92–4.

Zandi MS, Irani SR, Lang B, Waters P, Jones PB, McKenna P, et al. Disease-relevant autoantibodies in first-episode schizophrenia. J Neurol. 2011 Apr;258(4):686–8.

Bing [Internet]. [cited 2023 Aug 2]. Bataller L, Kleopa KA, Wu GF, Rossi JE, Rosenfeld MR, Dalmau J: Autoimmune limbic encephalitis in 39 patients: immunophenotypes and outcomes. J Neurol Neurosurg Psychiatry 2007, 78:381–385.Availablefrom:https://www.bing.com:9943/search?q=Bataller+L%2C+Kleopa+KA%2C+Wu+GF%2C+Rossi+JE%2C+Rosenfeld+MR%2C+Dalmau+J%3A+Autoimmune+limbic+encephalitis+in+39+patients%3A+immunophenotypes+and+outcomes.+J+Neurol+Neurosurg+Psychiatry+2007%2C+78%3A381–385.&cvid=839fe25cd1aa4d53bc609e34e07bb4ec&aqs=edge..69i57j69i64.642j0j4&FORM=ANAB01&PC=HCTS

Kendler KS. The dappled nature of causes of psychiatric illness: replacing the organic-functional/hardware-software dichotomy with empirically based pluralism. Mol Psychiatry. 2012 Apr;17(4):377–88.

Neurosyphilis is a cause of cognitive decline and psychiatric symptoms at younger age. | Semantic Scholar [Internet]. [cited 2023 Aug 2]. Available from: https://www.semanticscholar.org/paper/Neurosyphilis-as-a-cause-of-cognitive-decline-and-Keskin-Sunter/a4ef62cb0da9a35724ecfbba8df195fe9a887bfe

Eisenberger NI, Berkman ET, Inagaki TK, Rameson LT, Mashal NM, Irwin MR. Inflammation-induced anhedonia: endotoxin reduces ventral striatum responses to reward. Biol Psychiatry. 2010 Oct 15;68(8):748–54.

Hackett ML, Yapa C, Parag V, Anderson CS. Frequency of depression after stroke: a systematic review of observational studies. Stroke. 2005 Jun;36(6):1330–40.

Papakostas GI, Shelton RC, Kinrys G, Henry ME, Bakow BR, Lipkin SH, et al. Assessment of a multi-assay, serum-based biological diagnostic test for major depressive disorder: a pilot and replication study. Mol Psychiatry. 2013 Mar;18(3):332–9.

Prediction of pediatric unipolar depression using multiple neuromorphometric measurements: A pattern classification approach - PMC [Internet]. [cited 2023 Aug 7]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4355046/

Nestadt G, Samuels J, Riddle M, Bienvenu OJ, Liang KY, LaBuda M, et al. A family study of obsessive-compulsive disorder. Arch Gen Psychiatry. 2000 Apr;57(4):358–63.

Stefansson H, Ophoff RA, Steinberg S, Andreassen OA, Cichon S, Rujescu D, et al. Common variants conferring risk of schizophrenia. Nature. 2009 Aug 6;460(7256):744–7.

Rowland TA, Marwaha S. Epidemiology and risk factors for bipolar disorder. Ther Adv Psychopharmacol. 2018 Apr 26;8(9):251–69.

Müller N, Schwarz MJ. The immune-mediated alteration of serotonin and glutamate: towards an integrated view of depression. Mol Psychiatry. 2007 Nov;12(11):988–1000.

Gałecki P, Florkowski A, Bieńkiewicz M, Szemraj J. Functional polymorphism of cyclooxygenase-2 gene (G-765C) in depressive patients. Neuropsychobiology. 2010;62(2):116–20.

Uranova NA, Vostrikov VM, Orlovskaya DD, Rachmanova VI. Oligodendroglial density in the prefrontal cortex in schizophrenia and mood disorders: a study from the Stanley Neuropathology Consortium. Schizophr Res. 2004 Apr 1;67(2–3):269–75.

Davis S, Thomas A, Perry R, Oakley A, Kalaria R, O’Brien J. Glial fibrillary acidic protein in late life major depressive disorder: an immunocytochemical study. J Neurol Neurosurg Psychiatry. 2002 Nov;73(5):556–60.

Deficits in small interneurons in prefrontal and cingulate cortices of schizophrenic and schizoaffective patients - PubMed [Internet]. [cited 2023 Aug 7]. Available from: https://pubmed.ncbi.nlm.nih.gov/1747023/

Loss and altered spatial distribution of oligodendrocytes in the superior frontal gyrus in schizophrenia - ScienceDirect [Internet]. [cited 2023 Aug 7]. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0006322303002373

Flynn SW, Lang DJ, Mackay AL, Goghari V, Vavasour IM, Whittall KP, et al. Abnormalities of myelination in schizophrenia detected in vivo with MRI and post-mortem with analysis of oligodendrocyte proteins. Mol Psychiatry. 2003 Sep;8(9):811–20.

Bayer TA, Buslei R, Havas L, Falkai P. Evidence for activation of microglia in patients with psychiatric illnesses. Neurosci Lett. 1999 Aug 20;271(2):126–8.

Steiner J, Bogerts B, Sarnyai Z, Walter M, Gos T, Bernstein HG, et al. Bridging the gap between the immune and glutamate hypotheses of schizophrenia and major depression: Potential role of glial NMDA receptor modulators and impaired blood-brain barrier integrity. World J Biol Psychiatry Off J World Fed Soc Biol Psychiatry. 2012 Oct;13(7):482–92.

A quantitative immunohistochemical study of astrocytes in the entorhinal cortex in schizophrenia, bipolar disorder and major depression: Absence of significant astrocytosis — Johns Hopkins University [Internet]. [cited 2023 Aug 7]. Available from:https://pure.johnshopkins.edu/en/publications/a-quantitative-immunohistochemical-study-of-astrocytes-in-the-ent

Rao JS, Harry GJ, Rapoport SI, Kim HW. Increased excitotoxicity and neuroinflammatory markers in postmortem frontal cortex from bipolar disorder patients. Mol Psychiatry. 2010 Apr;15(4):384–92.

Neurovascular unit dysfunction with blood-brain barrier hyperpermeability contributes to major depressive disorder: a review of clinical and experimental evidence - Document - Gale Academic OneFile [Internet]. [cited 2023 Aug 7]. Availablefrom: https://go.gale.com/ps/i.do?id=GALE%7CA534679621&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=17422094&p=AONE&sw=w&userGroupName=anon%7Ee017a63f&aty=open-web-entry

Chen SK, Tvrdik P, Peden E, Cho S, Wu S, Spangrude G, et al. Hematopoietic origin of pathological grooming in Hoxb8 mutant mice. Cell. 2010 May 28;141(5):775–85.

Dias C, Cruz JF, Fonseca AM. The relationship between multidimensional competitive anxiety, cognitive threat appraisal, and coping strategies: A multi-sport study. Int J Sport Exerc Psychol. 2012 Mar 1;10(1):52–65.

Role of the gut microbiome in chronic diseases: a narrative review | European Journal of Clinical Nutrition [Internet]. [cited 2023 Aug 23]. Available from: https://www.nature.com/articles/s41430-021-00991-6

The microbiome in autoimmune diseases - PubMed [Internet]. [cited 2023 Aug 23]. Available from: https://pubmed.ncbi.nlm.nih.gov/29920643/

The Dynamic Interplay between the Gut Microbiota and Autoimmune Diseases - PMC [Internet]. [cited 2023 Aug 23]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6854958/

Sharif K, Watad A, Coplan L, Lichtbroun B, Krosser A, Lichtbroun M, et al. The role of stress in the mosaic of autoimmunity: An overlooked association. Autoimmun Rev. 2018 Oct;17(10):967–83.

Downloads

Published

2024-07-04

How to Cite

Prevalence, Severity and Predictors of Psychiatric Disorders in Patients with Autoimmune Disorder. (2024). Indian Journal of Public Health Research & Development, 15(3), 12-19. https://doi.org/10.37506/18g8hq58