Collaborative Response for Overlapping Symptoms of Somatic and Mental Illness in Neurological Disorders

At Westmead Hospital, a group of participants presenting with psychiatric symptoms, such as first episode psychosis and/or atypical/treatment resistant schizophrenia, depression, or a combination of psychotic and mood disorder features, were investigated with a subset judged to have an immune contribution to their condition (positive serum and cerebral spinal fluid autoantibodies or other markers of neuroinflammation). These participants underwent immunomodulatory therapy, with standard treatment associated monitoring at Westmead Hospital. Adult participants over the age of 18 with a diagnosis of autoimmune encephalitis made by the treating neurologist/immunologist and who received a trial of immunosuppressive therapy (e.g. corticosteroids, intravenous immunoglobulins, plasmapheresis, cyclophosphamide, rituximab, mycophenolate) will be included in an analysis of clinical data collected from eMR records. Research samples and data will be collected only after participant consent is obtained, at every visit to site, up to November 30, 2030. The frequency of observation will vary, dependant on how often the participant attends clinical visits as standard of care. Data will only be collected from the Western Sydney Local Health District (WSLHD) eMR and will include information readily available in the clinical notes and letters, discharge and admission summaries, pathology results, or any other forms of documentation available on eMR. Data will be re-identifiable at time of collection but will be de-identified at time of analysis. Blood samples for biobanking for future research will be collected after receiving participant consent, Data variables to be collected and analysed include the following, where questionnaires, tests or procedures have been performed as part of routine standard of care and the data is available in the participant’s eMR. No questionnaires, tests or procedures will be performed for the purpose of this study in addition to routine standard of care. • Demographic information (e.g., date of birth, gender, weight, height) • Medical history and co-morbidities • Neuropsychiatric symptomatology and presentation • Brain imaging (MRI and PET) • Clinical progress • Social and occupational functioning • Autoimmune encephalitis diagnosis and severity • Immunological markers and autoantibodies • Details of immunomodulatory and psychotropic therapy (e.g., type, dosage, duration) • Clinical course and treatment outcomes of autoimmune encephalitis • Occurrence and nature of adverse events, including standardised clinic letters to record adverse events with consistent terminology • Relapse rates and time to relapse