Effects of leptin and ghrelin on neural alcohol cue-reactivity, alcohol craving and relapse in alcohol use disorder: two opposing players?

recommend routine screening for AE in all FEP patients, yet three recent studies report on 279 FEP patients in which CSF analysis revealed no antibodies.Conversely, other investigators endorse selective screening for neuronal antibodies in patients having warning signs for AE.Herken & Prüss (2017) identify "yellow" and "red flags" for AE in psychiatric patients, such as decreased level of consciousness, movement disorders, speech dysfunction, and autonomic dysfunction among others [4].However, these warning signs appear later in the course of the disease which leads to a delay in diagnosis and treatment.This has prompted some authors to search for a specific psychiatric phenotype in order to identify patients with AE in an early phase.Eloi Gin e-Serv en et al. ( 2021) argue that the psychiatric features of anti-NMDAR encephalitis meet the criteria for cycloid psychosis: acute psychotic episodes with a sudden onset and a fluctuant clinical pattern mostly characterized by confusion, delusions, hallucinations, motility disturbances (including catatonia) and oscillations of mood [5].Thus, identifying this risk phenotype early in the disease course would ensure rapid diagnosis and initiation of therapy before the onset of neurological warning signs.Conclusion: Despite numerous studies, there is currently no consensus regarding the testing for neuronal antibodies in FEP patients.While some authors recommend routine screening, others argue for selective testing in patients with either warning signs for AE or risk psychiatric phenotypes such as cycloid psychosis.Thus, the pursuit of shaping clear criteria regarding the testing for neuronal antibodies in FEP patients continues and warrants further studies.References