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A systematic review and quantitative synthesis of the long-term psychiatric sequelae of pediatric autoimmune encephalitis.
- Source :
-
Journal of Affective Disorders . Jul2022, Vol. 308, p449-457. 9p. - Publication Year :
- 2022
-
Abstract
- <bold>Background: </bold>Long-term neuropsychiatric sequelae of autoimmune encephalitis (AE) remain understudied, particularly in pediatric-onset AE. We aimed to synthesize the published data on ongoing psychiatric symptoms in pediatric-onset AE.<bold>Methods: </bold>The Pubmed, PyscINFO, Web of Science databases were searched from their inception years to August 23, 2021, and 29 studies were identified and analyzed. We also performed a quantitative synthesis of available patient data from the 29 studies combined with a cohort of anti-NMDA receptor (NMDAR) AE from our institution to examine the associations between acute treatment course and long-term psychiatric outcome.<bold>Results: </bold>At long-term follow up, 52.4% of the cases with pediatric-onset AE had any persistent symptom and 36.0% had at least one psychiatric symptom. Pooled data found that 36.3% of pediatric-onset anti-NMDAR AE had ongoing psychiatric symptoms. Using a univariate logistic regression analysis, we found that abnormal initial EEG, use of certain immunotherapies, and persistent cognitive impairments were associated with ongoing psychiatric symptoms.<bold>Limitations: </bold>Limitations of the existing literature included a significant paucity of outcomes measured using consistent, objective methods. Limitations of the systematic review included the wide variability among the studies reviewed, which rendered a meta-analysis impossible and beyond the scope of the paper.<bold>Conclusion: </bold>Chronic psychiatric and behavioral problems remain present in one-third of children months to years after onset of AE. Larger scaled prospective observational studies with a consistent standardized battery of testing are needed to examine impact of specific clinical features and immunotherapies on long-term mental health outcomes. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 01650327
- Volume :
- 308
- Database :
- Academic Search Index
- Journal :
- Journal of Affective Disorders
- Publication Type :
- Academic Journal
- Accession number :
- 156941922
- Full Text :
- https://doi.org/10.1016/j.jad.2022.04.027