Keep looking for biological causes

A letter from our February edition.

I wonder if a group exists within our profession, increasingly uncompromising in its opposition to possible biological bases of ‘functional’ mental health difficulties, that would advocate the abandonment of broad-based research into such factors.

I also wonder if the view would be shared by the proportion of young people who become severely unwell and go on to receive diagnoses of schizophrenia but who actually have a form of autoimmune encephalitis, an inflammatory illness of the brain, treatable with immunotherapy (Lennox et al., 2012). It is now thought that perhaps 5 to 10 per cent of cases of first episode psychosis may be caused by antibodies identifiable by current methods (Zandi et al., 2011) (encephalitis has historically been recognised as classically neurological: headaches, seizures, cognitive and language disturbance, even coma and death).

For the benefit of our patients/clients, and for professional credibility, it is important to be tolerant of the potentially diverse origins of future advances in mental health care.

Patrick Vesey
Consultant Clinical Neuropsychologist
Nottingham University Hospitals NHS Trust

References
Zandi, M.S. et al. (2011). Disease-relevant autoantibodies in first episode schizophrenia. Journal of Neurology, 258(4), 686–688.
Lennox, B.R. et al. (2012). Antibody-mediated encephalitis: a treatable cause of schizophrenia. British Journal of Psychiatry, 200, 92–94.

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