| Resumo: | Schizophrenia is a common, severe and very disabling mental disease with high mortality rates and significant social impact. It is a psychotic disorder characterized by hallucinations, delusions, negative symptoms, as well as cognitive impairment and irrational behavioral. Its etiopathogenesis is still unknown, with both associated cellular and cognitive changes remaining a mystery, and no curative treatment is currently available. The pathologic mechanism should be heterogeneous and multifactorial, and it is likely that it concerns a spectrum of disease, grouped in a schizophrenic syndrome. There is a growing body of evidence that associates a subgroup of schizophrenic patients to a dysfunction of the immune system, including epidemiological and genetic links, overlaps in clinical course between schizophrenia and autoimmune diseases, and immune abnormalities detected in serological samples of patients. Recently, autoantibodies targeting proteins on the neuronal cell surface have been identified in a range of syndromes which display psychotic symptoms. These antibodies are believed to be directly pathogenic and have been described in patients with autoimmune encephalitis, including anti-N-methyl-D-aspartate receptor encephalitis, a newly discovered synaptic autoimmune disorder that manifests with prominent psychiatric symptoms early in its course. Causative role of autoimmune encephalitis in schizophrenia has been the subject of several recent studies, mostly employing cell-based assays, seeking to establish the scope and disease-relevance of these antibodies. A novel research concept concerning this possible role is the mild encephalitis hypothesis of schizophrenia. This review concentrates on some of the evidence of greater importance regarding this autoimmune encephalitis hypothesis, and proceeds to analyze its possible repercussions in psychiatric practice. It is concluded that this new approach could revolutionize schizophrenia management, foreseeing a new diagnosis system and more effective therapies for psychotic patients.
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