Two-thirds of NMDA receptor encephalitis patients carry symptoms into the post-acute years

The edition in brief

Seventy patients with post-acute NMDA receptor encephalitis in Berlin, matched to 70 healthy controls and studied a median 22.2 months from onset, had improved dramatically on clinical scales yet 67 per cent still had residual symptoms - memory dysfunction in 61 per cent and psychiatric symptoms in 36 per cent, with the psychiatric picture shifting from psychosis-dominant at peak illness to affective-dominant afterwards. Structural MRI showed reduced morphological complexity in both hippocampi and a fronto-cingulo-temporal cluster, and the alterations were greater in patients with persistent symptoms. A secondary analysis of a randomised trial in 85 adults with active suicidal ideation or recent attempt found brief cognitive behavioural therapy and present-centred therapy both improved pain interference, social functioning and physical functioning, with most gain in the first three months and no significant difference between treatments. A meta-analysis of 27 studies comparing 904 people with schizophrenia-spectrum psychosis against 1039 controls found no evidence of altered reliance on prior expectations (g = 0.03, 95 per cent CI -0.27 to 0.34), and no association with delusions or hallucinations, which undercuts a generalised predictive processing account. Twelve trials of acute exercise in 739 children and adolescents showed reduced state anxiety but with 95 per cent heterogeneity, and subgroup estimates that ranged from -0.19 to -2.97. A five-year survival analysis of 865 mental health apps found 53.6 per cent were removed, with Android-only apps carrying more than double the hazard.