Anti-NMDAR encephalitis most commonly presents to psychiatric services, so early identification of this disorder is essential. We aim to validate the two screening criteria (Scott et al. and Herken and Pruss) which have been proposed to identify first episode psychosis patients who should have anti-NMDAR antibody testing. The performance of the screening criteria were assessed using anti-NMDAR encephalitis cases published in the literature, and antibody positive and negative cases from a state-wide cohort (Queensland, Australia). Sensitivity, specificity and area under receiver operator characteristic curve analysis was performed. There were 258 anti-NMDAR encephalitis cases and 103 control cases, which demonstrated high performance of both Scott et al. "screening recommended" criteria (sensitivity 97.3%, specificity 85.4%, AUC 0.914) and Herken and Pruss "yellow flags" criteria (sensitivity 91.5%, specificity 83.5%, AUC 0.875). These criteria remained accurate when neurological variables were excluded, and in cases without psychosis. The Scott et al. "screening not recommended", and Herken and Pruss "red flags" criteria did not demonstrate clinical utility for first episode psychosis case screening. The screening criteria with good performance identify an atypical picture of psychiatric presentation with increased risk of anti-NMDAR positivity prior to overt neurological symptoms or investigations and may be beneficial to include in the routine psychiatric assessment process.

中文翻译：

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在精神病学中筛查抗NMDAR脑炎。

抗NMDAR脑炎最常见于精神科，因此尽早发现这种疾病至关重要。我们旨在验证两项筛查标准（Scott等人和Herken和Pruss），这些标准已被提议用于鉴定应进行抗NMDAR抗体检测的首发精神病患者。使用文献中发表的抗NMDAR脑炎病例以及全州队列（澳大利亚昆士兰州）的抗体阳性和阴性病例评估了筛选标准的效果。进行了接收者操作者特征曲线分析下的敏感性，特异性和面积。抗NMDAR脑炎258例，对照103例，均表现了Scott等人的优良表现。“推荐筛查”标准（敏感性97.3％，特异性85.4％，AUC 0。914）和Herken和Pruss的“黄旗”标准（敏感性91.5％，特异性83.5％，AUC 0.875）。当排除神经系统变量和没有精神病时，这些标准仍然是准确的。斯科特等。“不建议进行筛查”，Herken和Pruss的“危险信号”标准并未显示出对首发精神病病例筛查的临床实用性。表现良好的筛查标准可识别出非典型的精神病表现，在出现明显的神经系统症状或检查之前，其抗NMDAR阳性风险增加，可能有益于常规的精神病评估过程。当排除神经系统变量和没有精神病时，这些标准仍然是准确的。斯科特等。“不推荐筛查”，Herken和Pruss的“危险信号”标准并未证明对首发精神病病例筛查具有临床实用性。表现良好的筛查标准可识别出非典型的精神病表现，在出现明显的神经系统症状或检查之前，其抗NMDAR阳性风险增加，可能有益于常规的精神病评估过程。当排除神经系统变量和没有精神病时，这些标准仍然是准确的。斯科特等。“不建议进行筛查”，Herken和Pruss的“危险信号”标准并未显示出对首发精神病病例筛查的临床实用性。表现良好的筛查标准可识别出非典型的精神病表现，在出现明显的神经系统症状或检查之前，其抗NMDAR阳性风险增加，可能有益于常规的精神病评估过程。