Keywords
Coronavirus
Psychosis
Hallucinations
Delusions
Psychotic Disorder
Categories
How to Cite
Abstract
Introduction: Psychotic disorder has been rarely reported in patients with COVID-19 infection and also in patients affected by the pandemic but who do not have COVID-19 infection. It is unclear if the disorder occurs due to the stress of the pandemic or is due to a cerebral infection of the virus.
Methods: on PubMed we searched for all reports of patients who developed a new psychosis during the COVID-19 pandemic to review their symptomatology.
Results: Psychotic symptoms were similar in onset, description, duration and severity in patients who had been infected and those who were affected by the pandemic but did not have the infection. In both groups, most patients were young, without previous psychiatric history, had experienced severe external stress due to the pandemic, had an abrupt onset of symptoms, had severe hallucinations and delusions and needed psychiatric hospitalization. The disorder commonly lasted about a week, after which anti-psychotic medications could be stopped.
Conclusion: External psychological stress and not cerebral COVID-19 infection is the likely cause of psychotic disorder in both infected and uninfected patients.
References
World Health Organization: WHO Coronavirus (COVID-19) Dashboard. [Accessed 2021 Sep 13]. Available from: https://covid19.who.int/
Asmundson GJG, Taylor S. Coronaphobia revisted: A state-of-the-art on pandemic-related fear, anxiety, and stress. J Anxiety Disord. 2020 Dec; 76:102326. https://doi.org/10.1016/j.janxdis.2020.102326
Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar-Poli P, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 2020 Jul; 7(7):611-27. https://doi.org/10.1016/s2215-0366(20)30203-0
Abbott A. COVID's mental-health toll: how scientists are tracking a surge in depression. Nature. 2021 Feb; 590(7845):194-5. https://doi.org/10.1038/d41586-021-00175-z
Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020 Aug; 52:102066. https://doi.org/10.1016/j.ajp.2020.102066
Panchal N, Kamal R, Cox C, Garfield R. The implications of COVID-19 for mental health and substance abuse. KFF. 2021 Feb 10. [Accessed 2021 Sept 13]. Available from: https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/view/footnotes/
Schuppe J. I gave this to my dad: COVID-19 survivors grapple with guilt of infecting family. NBC News. 2020 May 16. [Accessed 2021Sep 13]. Available from: https://www.nbcnews.com/news/us-news/i-gave-my-dad-covid-19-survivors-grapple-guilt-infecting-n1207921
Voo TC, Senguttuvan M, Tam CC. Family Presence for Patients and Separated Relatives During COVID-19: Physical, Virtual, and Surrogate. J Bioeth Inq. 2020 Dec; 17(4):767-72. https://doi.org/10.1007/s11673-020-10009-8
Sahoo S, Mehra A, Dua D, Suri V, Malhotra P, Yaddanapudi LN, et al. Psychological experience of patients admitted with SARS-CoV-2 infection. Asian J Psychiatr. 2020 Dec;54:102355. https://doi.org/10.1016/j.ajp.2020.102355
Pun BT, Badenes R, Heras La Calle G, Orun OM, Chen W, Raman R, et al. Prevalence and risk factors for delirium in critically ill patients with COVID-19 (COVID-D): a multicentre cohort study. Lancet Respir Med. 2021 Mar; 9(3): 239-250. https://doi.org/10.1016/s2213-2600(20)30552-x
Harapan BN, Yoo HJ. Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19). J Neurol. 2021 Sep; 286(9): 3059-3071. https://doi.org/10.1007/s00415-021-10406-y
Wang L, Shen Y, Li M, Chuang H, Ye Y, Zhao H, et al. Clinical manifestations and evidence of neurological involvement in 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis. J Neurol. 2020 Oct; 267(10):2777-89. https://doi.org/10.1007/s00415-020-09974-2
Helms J, Kremer S, Merdji H, Clere-Jehl R, Schenck M, Kummerlen C, et al. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med. 2020 Jun; 382(23):2268-70. https://doi.org/10.1056/nejmc2008597
Almqvist J, Granberg T, Tzortzakakis A, Klironomos S, Kollia E, Öhberg C, et al. Neurological manifestations of coronavirus infections - a systematic review. Ann Clin Transl Neurol. 2020;7(10):2057-71. https://doi.org/10.1002/acn3.51166
Brown E, Gray R, Lo Monaco S, O'Donoghue B, Nelson B, Thompson A, et al. The potential impact of COVID-19 on psychosis: A rapid review of contemporary epidemic and pandemic research. Schizophr Res. 2020 Aug; 222:79-87. https://doi.org/10.1016/j.schres.2020.05.005
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020 Mar 14; 395(10227):912-20. https://doi.org/10.1016/s0140-6736(20)30460-8
Parra A, Juanes A, Losada CP, Álvarez-Sesmero S, Santana VD, Martí I, et al. Psychotic symptoms in COVID-19 patients. A retrospective descriptive study. Psychiatry Res. 2020 Sep; 291:113254. https://doi.org/10.1016/j.psychres.2020.113254
Iqbal Y, Al Abdulla MA, Albrahim S, Latoo J, Kumar R, Haddad PM. Psychiatric presentation of patients with acute SARS-CoV-2 infection: a retrospective review of 50 consecutive patients seen by a consultation-liaison psychiatry team. BJPsych Open. 2020 Sep;6(5):e109. https://doi.org/10.1192/bjo.2020.85
Rentero D, Juanes A, Losada CP, Álvarez S, Parra A, Santana V, et al. New-onset psychosis in COVID-19 pandemic: a case series in Madrid. Psychiatry Res. 2020 Aug; 290:113097. https://doi.org/10.1016/j.psychres.2020.113097
Paterson RW, Brown RL, Benjamin L, Nortley R, Wiethoff S, Bharucha T, et al. The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings. Brain. 2020 Oct 1;143(10):3104-20. https://doi.org/10.1093/brain/awaa240
Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020 Jul; 87:18-22. https://doi.org/10.1016/j.bbi.2020.03.031
Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020 Jun; 92(6):552-5. https://doi.org/10.1002/jmv.25728
Mahapatra A, Sharma P. Case series associated with COVID-19 pandemic in causing psychiatric morbidity. Gen Psychiatry. 2021 Jan 4; 34(1):e100343. https://doi.org/10.1136/gpsych-2020-100343
Watson CJ, Thomas RH, Solomon T, Michael BD, Nicholson TR, Pollak TA. COVID-19 and psychosis risk: Real or delusional concern? Neurosci Lett. 2021 Jan 10; 741:135491. https://doi.org/10.1016/j.neulet.2020.135491
Smith CM, Komisar JR, Mourad A, Kincaid BR. COVID-19-associated brief psychotic disorder. BMJ Case Rep. 2020 Aug 11; 13(8): e236940. https://doi.org/10.1136/bcr-2020-236940
Chacko M, Job A, Caston F, George P, Yacoub A, Cáceda R. COVID-19-Induced Psychosis and Suicidal Behavior: Case Report. SN Compr Clin Med. 2020 Sep 26:1-5. https://doi.org/10.1007/s42399-020-00530-7
Lanier CG, Lewis SA, Patel PD, Ahmed AM, Lewis PO. An Unusual Case of COVID-19 Presenting as Acute Psychosis. J Pharm Pract. 2020 Dec 7:897190020977721. https://doi.org/10.1177/0897190020977721
Lu S, Wei N, Jiang J, Wu L, Sheng J, Zhou J, et al. First report of manic-like symptoms in a COVID-19 patient with no previous history of a psychiatric disorder. J Affect Disord. 2020 Dec 1; 277:337-40. https://doi.org/10.1016/j.jad.2020.08.031
Lim ST, Janaway B, Costello H, Trip A, Price G. Persistent psychotic symptoms following COVID-19 infection. BJPsych Open. 2020 Jul 22; 6(5):e105. https://doi.org/10.1192/bjo.2020.76
Losee S, Hanson H. COVID-19 Delirium with Psychosis: A Case Report. S D Med. 2020 Aug; 73(8):346-9. [Accessed 2021 Sep 13]. Available from: https://www.unboundmedicine.com/medline/citation/32809292/COVID-19_Delirium_with_Psychosis:_A_Case_Report.
Haddad PM, Al Abdulla M, Latoo J, Iqbal Y. Brief psychotic disorder associated with quarantine and mild COVID-19. BMJ Case Rep. 2020 Dec;13(12): e240088. https://doi.org/10.1136/bcr-2020-240088
Mawhinney JA, Wilcock C, Haboubi H, Roshanzamir S. Neurotropism of SARS-CoV-2: COVID-19 presenting with an acute manic episode. BMJ Case Rep. 2020 Jun 14;13(6):e236123. https://doi.org/10.1136/bcr-2020-236123
Gillett G, Jordan I. Severe psychiatric disturbance and attempted suicide in a patient with COVID-19 and no psychiatric history. BMJ Case Rep. 2020 Oct 31; 13(10):e239191. https://doi.org/10.1136/bcr-2020-239191
Majadas S, Pérez J, Casado-Espada NM, Zambrana A, Bullón A, Roncero C. Case with psychotic disorder as a clinical presentation of COVID-19. Psychiatry Clin Neurosci. 2020 Oct; 74(10):551-2. https://doi.org/10.1111/pcn.13107
Lorenzo-Villalba N, Jannot X, Syrovatkova A, Michel V, Andrès E. SARS-CoV-2 infection and psychiatric manifestations in a previous healthy patient. Caspian J Intern Med. 2020; 11(Suppl 1):566-8. https://doi.org/10.22088/cjim.11.0.566
Clouden TA. Persistent Hallucinations in a 46-Year-Old Woman After COVID-19 Infection: A Case Report. Cureus. 2020 Dec 9;12(12):e11993. https://doi.org/10.7759/cureus.11993
Correa-Palacio AF, Hernandez-Huerta D, Gómez-Arnau J, Loeck C, Caballero I. Affective psychosis after COVID-19 infection in a previously healthy patient: a case report. Psychiatry Res. 2020 Aug; 290:113115.https://doi.org/10.1016/j.psychres.2020.113115
Varatharaj A, Thomas N, Ellul MA, Davies NWS, Pollak TA, Tenorio EL, et al. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study. Lancet Psychiatry. 2020 Oct; 7(10):875-82. https://doi.org/10.1016/s2215-0366(20)30287-x
Ferrando SJ, Klepacz L, Lynch S, Tavakkoli M, Dornbush R, Baharani R, et al. COVID-19 Psychosis: A Potential New Neuropsychiatric Condition Triggered by Novel Coronavirus Infection and the Inflammatory Response? Psychosomatics. Sep-Oct 2020; 61(5):551-5. https://doi.org/10.1016/j.psym.2020.05.012
Noone R, Cabassa JA, Gardner L, Schwartz B, Alpert JE, Gabbay V. Letter to the Editor: New onset psychosis and mania following COVID-19 infection. J Psychiatr Res. 2020 Nov;130:177-9. https://doi.org/10.1016/j.jpsychires.2020.07.042
Subramanyam AA, Nachane HB, Mahajan NN, Shinde S, D Mahale S, Gajbhiye RK. Postpartum psychosis in mothers with SARS-CoV-2 infection: A case series from India. Asian J Psychiatr. 2020 Dec; 54:102406.https://doi.org/10.1016/j.ajp.2020.102406
Jaworowski S, Weiser M, Gropp C, Malka M. Three Cases of COVID-19-related First Onset Brief Reactive Psychosis. Isr Med Assoc J. 2020 Oct; 22(10):612.
Rivas VCMO, Hernández-Huerta D, Silva CPD, Gómez-Arnau J. Reactive Psychosis in a Health Care Worker During the COVID-19 Pandemic. Prim Care Companion CNS Disord. 2020 Jul 9;22(4): 20l02692. https://doi.org/10.4088/pcc.20l02692
Huarcaya-Victoria J, Herrera D, Castillo C. Psychosis in a patient with anxiety related to COVID-19: A case report. Psychiatry Res. 2020 Jul; 289:113052. https://doi.org/10.1016/j.psychres.2020.113052
Zulkifli NA, Sivapatham S, Guan NC. Brief psychotic disorder in relation to coronavirus, COVID-19 outbreaks: a case report. Malay J Psychiatry. 2020;29(1).67-72. [Accessed 2021 Sep 13]. Available from: https://www.mjpsychiatry.org/index.php/mjp/article/view/534
D Agostino A, D'Angelo S, Giordano B, Cigognini AC, Chirico ML, Redaelli C, et al. Brief Psychotic Disorder During the National Lockdown in Italy: An Emerging Clinical Phenomenon of the COVID-19 Pandemic. Schizophr Bull. 2021 Jan;47(1):15-22. https://doi.org/10.1093/schbul/sbaa112
Chandra PS, Shiva L, Nagendrappa S, Ganjekar S, Thippeswamy H. COVID 19 related Psychosis as an interface of fears, socio-cultural issues and vulnerability- case report of two women from India. Psychiatry Res. 2020 Aug; 290:113136. https://doi.org/10.1016/j.psychres.2020.113136
Finatti F, Pigato G, Pavan C, Toffanin T, Favaro A. Psychosis in Patients in COVID-19-Related Quarantine: A Case Series. Prim Care Companion CNS Disord. 2020 May 14;22(3):20l02640. https://doi.org/10.4088/pcc.20l02640
Shanbour A, Khalid Z, Fana M. Psychosis and Infodemic Isolation Resulting in First Inpatient Hospitalization During the COVID-19 Pandemic A Case Series. Prim Care Companion CNS Disord. 2020 Jun 4; 22(3): 20l02649. https://doi.org/10.4088/pcc.20l02649
Lazzari C, Nusair A, Shoka A, Hein SM, Rabottini M. Case reports of first psychiatric presentations during CoViD-19 pandemic. Riv Psichiatr. Sep-Oct 2020; 55(5):319-321. https://doi.org/10.1708/3457.34465
Fischer M, Coogan AN, Faltraco F, Thome J. COVID-19 paranoia in a patient suffering from schizophrenic psychosis - a case report. Psychiatry Res. 2020 Jun; 288:113001. https://doi.org/10.1016/j.psychres.2020.113001
Valdés-Florido MJ, López-Díaz Á, Palermo-Zeballos FJ, Martínez-Molina I, Martín-Gil VE, Crespo-Facorro B, et al. Reactive psychoses in the context of the COVID-19 pandemic: Clinical perspectives from a case series. Rev Psiquiatr Salud Ment. Apr-Jun 2020;13(2):90-4. https://doi.org/10.1016/j.rpsm.2020.04.009
Diagnostic and statistical manual of mental disorders 5th ed. Am Psych Assoc. Washington; D.C: 2013.
Oh ES, Fong TG, Hshieh TT, Inouye SK. Delirium in Older Persons: Advances in Diagnosis and Treatment. JAMA. 2017 Sep 26; 318(12):1161-74. https://doi.org/10.1001/jama.2017.12067
Moreno-Küstner B, Martín C, Pastor L. Prevalence of psychotic disorders and its association with methodological issues. A systematic review and meta-analyses. PLoS One. 2018 Apr 12; 13(4):e0195687. https://doi.org/10.1371/journal.pone.0195687
Kępińska AP, Iyegbe CO, Vernon AC, Yolken R, Murray RM, Pollak TA. Schizophrenia and Influenza at the Centenary of the 1918-1919 Spanish Influenza Pandemic: Mechanisms of Psychosis Risk. Front Psychiatry. 2020 Feb 26;11:72. https://doi.org/10.3389/fpsyt.2020.00072
Menninger KA. Influenza and schizophrenia. An analysis of post-influenzal "dementia precox," as of 1918, and five years later further studies of the psychiatric aspects of influenza. 1926. Am J Psychiatry. 1994 Jun; 151(6 Suppl):182-7. https://doi.org/10.1176/ajp.151.6.182
Kar SK, Oyetunji TP, Prakash AJ, Ogunmola OA, Tripathy S, Lawal MM, et al. Mental health research in the lower-middle-income countries of Africa and Asia during the COVID-19 pandemic: A scoping review. Neurol Psychiatry Brain Res. 2020 Dec; 38:54-64. https://doi.org/10.1016/j.npbr.2020.10.003
Parker AM, Sricharoenchai T, Raparla S, Schneck KW, Bienvenu OJ, Needham DM. Posttraumatic stress disorder in critical illness survivors: a metaanalysis. Crit Care Med. 2015 May; 43(5):1121-9. https://doi.org/10.1097/ccm.0000000000000882
Webster R, Holroyd S. Prevalence of psychotic symptoms in delirium. Psychosomatics. Nov-Dec 2000; 41(6):519-22. https://doi.org/10.1176/appi.psy.41.6.519
Meagher DJ, Moran M, Raju B, Gibbons D, Donnelly S, Saunders J, et al. Phenomenology of delirium. Assessment of 100 adult cases using standardised measures. Br J Psychiatry. 2007 Feb; 190:135-41. https://doi.org/10.1192/bjp.bp.106.023911
Kotfis K, Williams Roberson S, Wilson JE, Dabrowski W, Pun BT, Ely W. COVID-19: ICU delirium management during SARS-CoV-2 pandemic. Crit Care. 2020 Apr 28; 24(1):176. https://doi.org/10.1186/s13054-020-02882-x
Mian A, Khan S. Coronavirus: the spread of misinformation. BMC Med. 2020 Mar 18; 18(1):89. https://doi.org/10.1186/s12916-020-01556-3
Paz C. All the President’s lies about the Coronavirus: An unfinished compendium of Trump’s overwhelming dishonesty during a national emergency. Atlantic. 2020 Nov 2; 2020. [Accessed 2021 Sep 14]. Available from: https://www.theatlantic.com/politics/archive/2020/11/trumps-lies-about-coronavirus/608647/
Symptoms of COVID-19. Cent Dis Control Prev. 2021 Feb 22. [Accessed 2021Sep 14). Available from: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain Behav Immun. 2020 Jul; 87:34-9. https://doi.org/10.1016/j.bbi.2020.04.027
Hernandez H. COVID-19 patients experiencing psychosis months after recovery. Click2houston. 2020 Nov 19. [Accessed 2021 Sep 14]. Available from: https://www.click2houston.com/health/2020/11/20/covid-19-patients-experiencing-psychosis-months-after-recovery/
Belluck P. Small Number of Covid Patients Develop Severe Psychotic Symptoms. New York Times. 2020 Dec 28. [Accessed 2021 Sep 14). Available from: https://www.nytimes.com/2020/12/28/health/covid-psychosis-mental.html
Sweet J. Can COVID-19 cause psychosis? This is what we know so far. Verywellmind. 2021 Sep 14. [Accessed 2021 Sep 14]. Available from: https://www.verywellmind.com/can-covid-19-cause-psychosis-5095259
Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020 Jun 1; 77(6):683-90. https://doi.org/10.1001/jamaneurol.2020.1127
Karambelkar PV, Rojulpote CS, Saeed F, Pichiarello C, Patel N, Sharma A. The neurological manifestations of COVID-19 - A case series. J Clin Transl Res. 2020 Oct 17;6(4):187-9.
Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Takamino J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 2020 May; 94:55-8. https://doi.org/10.1016/j.ijid.2020.03.062
Virhammar J, Kumlien E, Fällmar D, Frithiof R, Jackmann S, Sköld MK, et al. Acute necrotizing encephalopathy with SARS-CoV-2 RNA confirmed in cerebrospinal fluid. Neurology. 2020 Sep 8; 95(10):445-9. https://doi.org/10.1212/wnl.0000000000010250
Bohmwald K, Gálvez NMS, Ríos M, Kalergis AM. Neurologic Alterations Due to Respiratory Virus Infections. Front Cell Neurosci. 2018 Oct 26; 12:386. https://doi.org/10.3389/fncel.2018.00386
Duong L, Xu P, Liu A. Meningoencephalitis without respiratory failure in a young female patient with COVID-19 infection in Downtown Los Angeles, early April 2020. Brain Behav Immun. 2020 Jul; 87:33. https://doi.org/10.1016/j.bbi.2020.04.024
Solomon IH, Normandin E, Bhattacharyya S, Mukerji SS, Keller K, Ali AS, et al. Neuropathological Features of Covid-19. N Engl J Med. 2020 Sep 3; 383(10):989-92. https://doi.org/10.1056/nejmc2019373
Song E, Zhang C, Israelow B, Lu-Culligan A, Prado AV, Skriabine S, et al. Neuroinvasion of SARS-CoV-2 in human and mouse brain. J Exp Med. 2021 Mar 1; 218(3):e20202135. https://doi.org/10.1084/jem.20202135
Iadecola C, Anrather J, Kamel H. Effects of COVID-19 on the Nervous System. Cell. 2020 Oct 1; 183(1):16-27.e1. https://doi.org/10.1016/j.cell.2020.08.028
Giné Servén E, Boix Quintana E, Guanyabens Buscà N, Casado Ruiz V, Torres Rivas C, Niubo Gurgui M, et al. Considerations of psychotic symptomatology in anti-NMDA encephalitis: Similarity to cycloid psychosis. Clin Case Rep. 2019 Nov 7; 7(12):2456-61. https://doi.org/10.1002/ccr3.2522
El-Mallakh RS, Furdek C. Cycloid Psychosis. Am J Psychiatry. 2018 Jun; 175(6):502-5. https://doi.org/10.1176/appi.ajp.2017.17030282
Rolland B, Jardri R, Amad A, Thomas P, Cottencin O, Bordet R. Pharmacology of hallucinations: several mechanisms for one single symptom? Biomed Res Int. 2014; 2014:307106. https://doi.org/10.1155/2014/307106
Balu DT. The NMDA Receptor and Schizophrenia: From Pathophysiology to Treatment. Adv Pharmacol. 2016; 76:351-82. https://doi.org/10.1016/bs.apha.2016.01.006
Panariello A, Bassetti R, Radice A, Rossotti R, Puoti M, Corradin M, et al. Anti-NMDA receptor encephalitis in a psychiatric Covid-19 patient: A case report. Brain Behav Immun. 2020 Jul; 87:179-81. https://doi.org/10.1016/j.bbi.2020.05.054
Moideen S, Thomas R, Suresh Kumar PN, Uvais NA, Ul Haq Katshu MZ. Psychosis in a patient with anti-NMDA-receptor antibodies experiencing significant stress related to COVID-19. Brain Behav Immun Health. 2020 Aug; 7:100125. https://doi.org/10.1016/j.bbih.2020.100125
Franke C, Ferse C, Kreye J, Reincke SM, Sanchez-Sendin E, Rocco A, et al. High frequency of cerebrospinal fluid autoantibodies in COVID-19 patients with neurological symptoms. Brain Behav Immun. 2021 Mar; 93:415-419. https://doi.org/10.1016/j.bbi.2020.12.022
Dahm L, Ott C, Steiner J, Stepniak B, Teegen B, Saschenbrecker S, et al. Seroprevalence of autoantibodies against brain antigens in health and disease. Ann Neurol. 2014 Jul; 76(1):82-94. https://doi.org/10.1002/ana.24189
Sarkis RA, Coffey MJ, Cooper JJ, Hassan I, Lennox B. Anti- N-Methyl-D-Aspartate Receptor Encephalitis: A Review of Psychiatric Phenotypes and Management Considerations: A Report of the American Neuropsychiatric Association Committee on Research. J Neuropsychiatry Clin Neurosci. 2019; 31(2):137-42. https://doi.org/10.1176/appi.neuropsych.18010005
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Abhishek Mohan MD et al.
