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Peer-reviewedCC BYThe British journal of psychiatry : the journal of mental science

Applying immunity and metabolism to psychiatry: lost, or in translation?

  • Riccardo De Giorgi1
  • Margaret K Hahn2
  • Thomas Cheliotis-James3
  • Emily CC Smith2
  • Brenda WJH Penninx4
  • Toby Pillinger3
  • Adam Al-Diwani1
4 affiliations
  1. 1Department of Psychiatry, , ,
  2. 2, ,
  3. 3Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, , ,
  4. 4Department of Psychiatry, , , ,
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Abstract

Immunologic, metabolic, and increasingly ‘immuno-metabolic’ approaches, are prominent in contemporary psychiatric discourse, yet translation into clinical practice remains variable. In this Feature, we pragmatically ask where signal ends and speculation begins, and what this means for the clinical psychiatrist.

Autoimmune encephalitis provides a rare but instructive yardstick in which antibody-based mechanisms map onto distinct neuropsychiatric syndromes and respond to targeted immunotherapy. However, while the broader concept of autoimmune psychosis may extend beyond this tightly defined niche, it remains largely experimental and requires stronger evidence.

More broadly applicable concepts, including an immuno-metabolic subtype of depression, are increasingly supported by mechanistic work, with attendant treatment implications, although differentiation from routine holistic care remains less clear. In psychosis and severe mental illness, immune and cardiometabolic dysfunction may contribute to both psychiatric and physical disease burden beyond lifestyle or treatment effects alone. Emerging therapies, including GLP-1-based approaches, may bind these threads together with gains for body and mind, but specific evaluation within psychiatry continues.

Overall, our view is that the opportunities are not lost, but for robust translation, there is an ongoing need for precise, incremental research, inter-disciplinary collaboration and rigorous communication of nuance.

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Cite

BibTeXRIS
BibTeX
@article{giorgi2026applying,
  title = {{Applying immunity and metabolism to psychiatry: lost, or in translation?}},
  author = {Riccardo De Giorgi and Margaret K Hahn and Thomas Cheliotis-James and Emily CC Smith and Brenda WJH Penninx and Toby Pillinger and Adam Al-Diwani},
  journal = {The British journal of psychiatry : the journal of mental science},
  year = {2026},
  month = jul,
  doi = {10.1192/bjp.2026.10714},
  url = {https://europepmc.org/article/PMC/PMC7619676},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Applying immunity and metabolism to psychiatry: lost, or in translation?
AU  - Riccardo De Giorgi
AU  - Margaret K Hahn
AU  - Thomas Cheliotis-James
AU  - Emily CC Smith
AU  - Brenda WJH Penninx
AU  - Toby Pillinger
AU  - Adam Al-Diwani
PY  - 2026
DA  - 2026/07/14
JO  - The British journal of psychiatry : the journal of mental science
DO  - 10.1192/bjp.2026.10714
UR  - https://europepmc.org/article/PMC/PMC7619676
AB  - Immunologic, metabolic, and increasingly ‘immuno-metabolic’ approaches, are prominent in contemporary psychiatric discourse, yet translation into clinical practice remains variable. In this Feature, we pragmatically ask where signal ends and speculation begins, and what this means for the clinical psychiatrist.  Autoimmune encephalitis provides a rare but instructive yardstick in which antibody-based mechanisms map onto distinct neuropsychiatric syndromes and respond to targeted immunotherapy. However, while the broader concept of autoimmune psychosis may extend beyond this tightly defined niche, it remains largely experimental and requires stronger evidence.  More broadly applicable concepts, including an immuno-metabolic subtype of depression, are increasingly supported by mechanistic work, with attendant treatment implications, although differentiation from routine holistic care remains less clear. In psychosis and severe mental illness, immune and cardiometabolic dysfunction may contribute to both psychiatric and physical disease burden beyond lifestyle or treatment effects alone. Emerging therapies, including GLP-1-based approaches, may bind these threads together with gains for body and mind, but specific evaluation within psychiatry continues.  Overall, our view is that the opportunities are not lost, but for robust translation, there is an ongoing need for precise, incremental research, inter-disciplinary collaboration and rigorous communication of nuance.
SN  - 0007-1250
SN  - 1472-1465
ER  -