A study led by Dr Belinda Lennox, a consultant psychiatrist at Oxford Health, has found that specific antibodies (proteins usually produced by the body in response to a foreign threat) are associated with the start of schizophrenia.

The study, published in the journal Lancet Psychiatry, is the first to identify this association.

If you are interested in participating in the study or would like to find out more, please email ppip@psych.ox.ac.uk

Antibodies that target proteins within the body

In a sample of patients including those from Oxford Health, the study found that a significant percentage of people having their first episode of psychosis (a break from reality, and one of the signs of schizophrenia) had certain kinds of antibodies in their blood. This includes antibodies that target a complex protein known as the NMDA receptor, found on the surface of brain cells.

Antibodies against the NMDA receptor are known to cause encephalitis, a life-threatening inflammation of the brain. But for the first time, the study by Dr Lennox shows that the same antibodies are also found in people with early signs of schizophrenia.

A significant percentage

Dr Lennox,  who is also affiliated with the Oxford University Department of Psychiatry, said: ‘We have shown that 8.8% of people with a first episode of psychosis have an antibody in their blood that may be responsible for their illness.”

The only way to detect these antibodies is through doing a blood test, as patients with antibodies do not have different symptoms from other people with psychosis.
Dr Belinda Lennox

Fresh hope

The discovery offers fresh hope in terms of new treatment possibilities for people experiencing psychosis. This is because the rapid identification and removal of the same antibodies associated with encephalitis leads to a dramatic improvement, and often complete a cure from the illness.

Dr Lennox and her team have successfully treated a number of patients experiencing psychosis, who have these antibodies, using this pioneering form of immunotherapy.

“It began with a devastating psychotic episode and subsequent issues with my memory, sleep, temperature and emotional control.”

Sarah, one of Dr Lennox’s patients, said: “My mood was in total flux, swinging from hallucinations and insomnia to sleeping all day and getting severely depressed.”

“It took over a year before the autoimmune side of my illness was picked up on through a fortunate research trial. Three years following my episode I have finally responded after two infusions of immune drugs. I am regaining nearly all of my previous function. It has been like a miracle cure. It is terrifying to imagine that without the correct treatment my symptoms might never have improved.”

“Psychosis, caused by NMDA antibodies, could have dominated and even claimed my life.”

Dr Lennox says: “The next important step for this study is to work out whether removing the antibodies will treat psychosis in the same established way as is now used for encephalitis.”

“To do this the research team are starting a randomised controlled trial of immune treatment in people with psychosis and antibodies, starting in 2017.”