Brain relevant antibodies, such as anti-NMDAR antibodies, have been associated with autoimmune encephalitis, which can present with psychiatric symptoms, including psychosis. However, clinical presentations vary greatly, and none are pathognomonic of an autoimmune encephalitis. Further, autoimmune disorders, and indeed infections and other conditions, can present with psychiatric features. Reciprocally, antipsychotics themselves have effects  on the immune system. Rates of true autoimmune encephalitides are relatively low in people with long-standing psychotic illnesses, but they do exist. Dr Tom Pollak will present his latest research in this field along with guidance on decision making in clinical practice. 

The assessment and management psychotic disorders in later life is complicated by co-morbid conditions, drug interactions and age-related changes in speed of metabolism. In her talk, entitled, “Managing complex psychosis across the age range - can we individualise treatment?” Prof Suzanne Reeves will present the existing evidence on this complexity. She will also present her research on the relative importance of the effects of age, sex, smoking status and ethnicity on clozapine pharmacokinetics, and how to use this knowledge to improve the safety of clozapine prescribing.

In his talk, entitled "Clozapine-induced obsessive compulsive symptoms - what is the evidence?" Prof James MacCabe will present his work on the prevalence and correlates of obsessive-compulsive symptoms in people with psychotic illnesses such as schizophrenia, schizoaffective disorder, and bipolar disorder. He will also highlight his research on the relationship which exists between the anti-psychotic drug, clozapine, and existing and emergent obsessional and compulsive symptomatology, as well as discuss the guidance for the management of obsessional symptoms on clozapine in clinical practice. 

Chair: Professor Fiona Gaughran, National Psychosis Unit, South London and Maudsley Trust, London, Institute of Psychiatry, Psychology and Neuroscience, London

Professor Suzanne Reeves, University College London, London

Dr Thomas Pollak, Institute of Psychiatry, Psychology and Neuroscience, London, South London and Maudsley Foundation Trust, London

Professor James MacCabe, National Psychosis Unit, South London and Maudsley Trust, London, Institute of Psychiatry, Psychology and, Neuroscience, London