From mild encephalitis hypothesis to autoimmune psychosis

Abstract

A historical and personal perspective is presented from research on the involvement of Bornavirus infection into the etiology of neurological and psychiatric disorders and the road to propose the Mild Encephalitis (ME) hypothesis of severe mental disorders, including a supportive role of Pula congresses herein. ME hypothesis was initially criticized by many though yet early on supported by striking results from experimental treatments of severe therapy-resistant schizophrenic and affective syndromes, both types of severe mental disorders responding well to CSF filtration, and later increasingly from CSF studies in psychiatric cohorts. Recent, accumulated findings from internationally performed studies demonstrate an important role of immune-inflammatory abnormalities in large subgroups of severe psychiatric disorders. Beyond, in small subgroup of cases just now first international consensus criteria were established, how to define and treat Autoimmune Psychosis (AP). These AP criteria match with an autoimmune subtype of ME. Such new diagnosis for psychiatry is most relevant in clinical practice as majority of AP/ME cases can be successfully treated with various, rather aggressive, immune-modulatory treatments. Further, ME and AP subtypes are expected to prevail and become described in the future.