Immunopsychiatry

The rapidly growing field of immunopsychiatry combines expertise and insights from immunology, psychiatry and neuroscience to understand the role of inflammation and other immune processes in causing and treating mental illness. This represents a major shift in mental health science, traditionally focused on psychological and neuronal mechanisms of depression, psychosis and dementia. This book provides the first comprehensive overview of recent, inter-disciplinary research linking disordered function of the immune system to the brain and mental illness. It offers a broad and deep perspective on the implications of immune system involvement in psychiatric disorders, including a balanced focus on basic science and clinical applications. Chapters cover the scientific evidence linking immune processes to major mental illnesses such as schizophrenia, depression, anxiety and dementia. An invaluable guide for graduate students, doctors in training, scientific researchers and others interested in the link between the immune system and mental health.

This book presents a thorough and critical review of current knowledge on the role of immunology in major psychiatric disorders and its potential applications. The opening chapters offer general information on the immune influence of the brain to provide readers with a better understanding of the end of immune privilege. The book then examines possible underlying mechanisms leading to psychiatric disorders, from early infections to pro-inflammatory markers, stress, and immune genetic background, linking etiology and psychiatry. The third section describes each disorder (ie autism, schizophrenia, bipolar disorder, depression...) with an overview of underlying immune dysfunctions. Lastly, the authors discuss the innovative immune-therapies that may result from the discovery of immune system biomarkers and their associated mechanisms. A better understanding of the role of the immune system in psychiatric disorders makes it possible to identify stratification biomarkers, to explain underlying mechanisms, and to develop innovative, efficient, targeted treatment strategies and management. As such, the book is of value to clinicians, mental health professionals, mental health researchers, immunologists, industry practitioners, and various stakeholders in the mental health field.

In recent years, a dedicated effort has been made to understand the immune dysfunction that is associated with major psychiatric disorders. The expanding knowledge of the immune system as a major homeostatic system has been very helpful in indicating new potential biomarkers and therapeutic targets to reduce the burden of psychiatric disorders. Indeed, immune cells, their secreted molecules, and cell signalling events are highly promising. Yet, the literature on immunology of psychiatric disorders is still dispersed, and only a few attempts have been made to consolidate the current knowledge in this expanding area. This book assembles and presents the available data on the immune/inflammatory dysfunction in psychiatric disorders, indicating the potential of immune mechanisms as either biomarkers or therapeutic targets, as well as discussing the challenges ahead of incorporating this knowledge into clinical practice. An international team of senior experts in the field review all psychiatric disorders in order to provide an integrated, in-depth understanding of the role of immune changes in psychiatric diseases for mental health clinicians as well as for researchers in immunology, psychiatry, neurology, and pharmacology.

An essential book summarizing cutting-edge evidence on the role of the immune system and immunotherapies in psychiatric disorders.

In recent years, a dedicated effort has been made to understand the immune dysfunction that is associated with major psychiatric disorders. The expanding knowledge of the immune system as a major homeostatic system has been very helpful in indicating new potential biomarkers and therapeutic targets to reduce the burden of psychiatric disorders. Indeed, immune cells, their secreted molecules, and cell signalling events are highly promising. Yet, the literature on immunology of psychiatric disorders is still dispersed, and only a few attempts have been made to consolidate the current knowledge in this expanding area. This book assembles and presents the available data on the immune/inflammatory dysfunction in psychiatric disorders, indicating the potential of immune mechanisms as either biomarkers or therapeutic targets, as well as discussing the challenges ahead of incorporating this knowledge into clinical practice. An international team of senior experts in the field review all psychiatric disorders in order to provide an integrated, in-depth understanding of the role of immune changes in psychiatric diseases for mental health clinicians as well as for researchers in immunology, psychiatry, neurology, and pharmacology.

As seen on "CBS This Morning" Worldwide, depression will be the single biggest cause of disability in the next twenty years. But treatment for it has not changed much in the last three decades. In the world of psychiatry, time has apparently stood still...until now with Edward Bullmore's The Inflamed Mind: A Radical New Approach to Depression. A Sunday Times (London) Top Ten Bestseller In this game-changing book, University of Cambridge profressor of psychiatry Edward Bullmore reveals the breakthrough new science on the link between depression and inflammation of the body and brain. He explains how and why we now know that mental disorders can have their root cause in the immune system, and outlines a future revolution in which treatments could be specifically targeted to break the vicious cycles of stress, inflammation, and depression. The Inflamed Mind goes far beyond the clinic and the lab, representing a whole new way of looking at how mind, brain, and body all work together in a sometimes misguided effort to help us survive in a hostile world. It offers insights into how we could start getting to grips with depression and other mental disorders much more effectively in the future.

Neuroinflammation is a burgeoning area of interest in academia and biopharma, with a broadly acknowledged role in many central nervous system (CNS) disorders. However, there is little agreement on the pathophysiological mechanisms that underlie the manifestations of neuroinflammation in the CNS compartment and how neuroinflammation operates as a driver and also as a consequence of disease in the brain. Moreover, another unclear area is how to translate increased understanding of the mechanisms that underlie neuroinflammation and its manifestations in the CNS to therapeutics. To address these gaps in understanding mechanisms and how to translate that understanding into therapeutics, the Forum on Neuroscience and Nervous System Disorders of the National Academies of Sciences, Engineering, and Medicine convened a workshop on March 20-21, 2017, bringing together key leaders in the field from industry, academia, and governmental agencies to explore the role and mechanisms of neuroinflammation in a variety of CNS diseases. The workshop also considered strategies to advance the identification and validation of biomarkers of neuroinflammation that could accelerate development of therapies, bringing much-needed treatments to patients with disorders ranging from neuroinflammatory diseases such as multiple sclerosis (MS) to neuropsychiatric disorders such as depression. This publication summarizes the presentations and discussions from the workshop.

Growing evidence derived from cerebrospinal fluid (CSF), neuropathological, imaging, genetic, and epidemiological studies link neuroinflammation and immune dysregulation to a subset of individuals with a variety of severe mental disorders (SMDs), including affective and non-affective psychotic disorders. Further, the recent discoveries of neuronal surface antibodies (NSAs) in autoimmune encephalitis (AE) presenting with diverse neuropsychiatric disorders such as psychosis and cognitive decline, among many others, provides further support to the notion that CNS autoimmunity and neuroinflammation can contribute to the neurobiology of psychiatric disturbances. Further, these immune mechanisms may contribute to a subset of patients currently diagnosed as having treatment-resistant SMDs such as schizophrenia and major depressive disorder. Additionally, mounting data indicate that various infections can serve as an immunological trigger of aberrant immune responses, presumably by causing release of excess neural antigen, thereby giving rise to NSAs or aberrant immune cellular responses to give rise to primary or secondary psychiatric disorders such as schizophrenia and those associated with AE, respectively. Collectively, these findings support the “mild encephalitis” hypothesis of SMD. The significant overlap among AE-associated psychosis, systemic autoimmune disorder-associated psychosis, and psychotic disorders associated with pathological processes involving inflammation and immune dysregulation has also prompted some authors to adopt the term “autoimmune psychosis” (AP). This term reflects that this psychosis subtype is mechanistically linked to complex neuroimmune and inflammatory signalling abnormalities that can be responsive to early immunomodulatory treatment. It also suggests that a subset of AP might represent an incomplete or “forme fruste” subtype of AE presenting with dominant or pure psychiatric symptoms mimicking primary psychiatric illnesses. Because data indicate that delayed diagnosis and treatment may lead to permanent sequelae, early recognition of AP utilizing neurodiagnostic workup (e.g., CSF analysis, neuroimaging, and EEG) and its early treatment with appropriate immunotherapy are paramount to a meaningful recovery. This eBook will provide an overview of the current knowledge and research areas from epidemiology, risk factors and diagnosis to the management of these conditions, in this rapidly emerging field, helping to bridge the gaps in knowledge that currently exist in the disciplines of Psychiatry, Neurology, and Neuroimmunology.