Impacts of climate change and human activities on three Glires pests of the Qinghai-Tibet Plateau.

BACKGROUND: The range of Glires is influenced by human activities and climate change. However, the extent to which human activities and environmental changes have contributed to this relationship remains unclear. We examined alterations in the distribution changes and driving factors of the Himalayan marmot, plateau pika, and plateau zokor on the Qinghai-Tibet Plateau (QTP) using the maximum entropy (MaxEnt) model and a geographical detector (Geodetector). RESULTS: The MaxEnt model showed that the contribution rates of the human footprint index (HFI) to the distribution patterns of the three types of Glires were 46.70%, 58.70%, and 59.50%, respectively. The Geodetector results showed that the distribution pattern of the Himalayan marmot on the QTP was influenced by altitude and the normalized difference vegetation index (NDVI). The distribution patterns for plateau pikas and plateau zokors were driven by HFI and NDVI. Climate has played a substantial role in shaping suitable habitats for these three Glires on the QTP. Their suitable area is expected to decrease over the next 30-50 years, along with their niche breadth and overlap. Future suitable habitats for the three Glires tended to shift toward higher latitudes on the QTP. CONCLUSION: These findings underscore the impacts of environmental and human factors on the distribution of the three Glires on the QTP. They have enhanced our understanding of the intricate relationships between Glires niches and environments. This can aid in identifying necessary interventions for developing effective early warning systems and prevention strategies to mitigate Glires infestations and plague epidemics on the QTP. © 2024 Society of Chemical Industry.

Spermatocytes are the terminals of germ cell differentiation in plateau zokor (Eospalax baileyi) during the non-breeding season.

Plateau zokor (Eospalax baileyi) is a subterranean rodent and seasonal breeder. During the non-breeding season, the testicles regress, leading to the arrest of spermatogenesis and loss of fertility. The identification of the specific germ cell type at which spermatogenesis is arrested, as well as potential regulatory factors during the non-breeding season, is important for understanding seasonal spermatogenesis in subterranean species. This study analyzed genes in spermatocytes of plateau zokor by referring to single-cell RNA results in mice. We discovered that spermatogenesis is arrested at the spermatocyte during the non-breeding season, which was corroborated via immunofluorescence staining results. The analysis of gene expression during different stages of meiotic prophase I has revealed that germ cell development may be arrested, starting from zygonema, during the non-breeding season. Meanwhile, we discovered that the apoptosis genes were up-regulated, leading to apoptosis in spermatocytes. To confirm that the germ cell differentiation was blocked during the non-breeding season due to a decrease in the androgen level, we used androgen receptor antagonist (flutamide) to intervene in the breeding season and found that the inner diameter of the seminiferous tubules was significantly reduced, spermatogenesis was arrested, and spermatocytes underwent apoptosis. This study revealed that spermatocytes are the terminal of germ cell differentiation in plateau zokor during the non-breeding season and that the arrest of differentiation is attributed to a decline in androgen levels. Our results complement the theoretical basis of seasonal reproduction in plateau zokor.

Emerging role of the crosstalk between gut microbiota and liver metabolome of subterranean herbivores in response to toxic plants.

Plant secondary metabolites (PSMs) are a defense mechanism against herbivores, which in turn use detoxification metabolism to process ingested and absorbed PSMs. The feeding environment can cause changes in liver metabolism patterns and the gut microbiota. Here, we compared gut microbiota and liver metabolome to investigate the response mechanism of plateau zokors (Eospalax baileyi) to toxic plant Stellera chamaejasme (SC) in non-SC and SC grassland (-SCG and +SCG). Our results indicated that exposure to SC in the -SCG population increased liver inflammatory markers including prostaglandin (PG) in the Arachidonic acid pathway, while exposure to SC in the +SCG population exhibited a significant downregulation of PGs. Secondary bile acids were significantly downregulated in +SCG plateau zokors after SC treatment. Of note, the microbial taxa Veillonella in the -SCG group was significantly correlated with liver inflammation markers, while Clostridium innocum in the +SCG group had a significant positive correlation with secondary bile acids. The increase in bile acids and PGs can lead to liver inflammatory reactions, suggesting that +SCG plateau zokors may mitigate the toxicity of SC plants by reducing liver inflammatory markers including PGs and secondary bile acids, thereby avoiding liver damage. This provides new insight into mechanisms of toxicity by PSMs and counter-mechanisms for toxin tolerance by herbivores.

Seasonal patterns of miRNA and mRNA expression profiles in the testes of plateau zokors (Eospalax baileyi).

The gonads of seasonal breeding animals undergo periodic annual changes in morphology, physiological hormones, and gene expression levels. To clarify the regulatory mechanism of miRNAs in the seasonal testicular development and spermatogenesis of plateau zokors, the miRNA expression profiles in their testicles during breeding and non-breeding seasons were analyzed. In total, 447 miRNAs, including 366, 81, and 167 known, novel, and differentially expressed (DE) miRNAs, respectively, were determined in the testes. Compared to the non-breeding season, 90 DE miRNAs were upregulated and 77 DE miRNAs were downregulated during the breeding season. By analysing the miRNA and mRNA expression profiles, we predicted 2096 significant target mRNAs. According to the miRNA-mRNA interaction network, target mRNAs with DE miRNAs were related to testicular development and spermatogenesis. GO indicated that target mRNAs were enriched in spermatogenesis, cell differentiation, multicellular biological development, and flagellated sperm movement and were associated with regulating testicular development and spermatogenesis. KEGG suggested that target mRNAs were enriched in lipid and fructose metabolism and provided energy and material for spermatogenesis. The target mRNA of rno-miR-24-3p was determined to be Polyubiquitin-B (UBB). Our results provide a reference for revealing the mechanism by which miRNAs regulate testicular development and spermatogenesis in plateau zokors, which has important implications for understanding the regulation of seasonal reproduction in animals.

Himalayan Marmot (Marmota himalayana) Redistribution to High Latitudes under Climate Change.

Climate warming and human activities impact the expansion and contraction of species distribution. The Himalayan marmot (Marmota himalayana) is a unique mammal and an ecosystem engineer in the Qinghai-Tibet Plateau (QTP). This pest aggravates grassland degradation and is a carrier and transmitter of plagues. Therefore, exploring the future distribution of Himalayan marmots based on climate change and human activities is crucial for ecosystem management, biodiversity conservation, and public health safety. Here, a maximum entropy model was explored to forecast changes in the distribution and centroid migration of the Himalayan marmot in the 2050s and 2070s. The results implied that the human footprint index (72.80%) and altitude (16.40%) were the crucial environmental factors affecting the potential distribution of Himalayan marmots, with moderately covered grassland being the preferred habitat of the Himalayan marmot. Over the next 30-50 years, the area of suitable habitat for the Himalayan marmot will increase slightly and the distribution center will shift towards higher latitudes in the northeastern part of the plateau. These results demonstrate the influence of climate change on Himalayan marmots and provide a theoretical reference for ecological management and plague monitoring.

Comparative analysis of microRNA and messengerRNA expression profiles in plateau zokor testicular cells under reproductive suppression.

Introduction: Reproductive suppression is an adaptive strategy that affects the success rate and reproductive efficiency in animals, which in turn affects population continuation and evolution. However, no studies on the miRNAs in testicular development and spermatogenesis regulatory mechanisms under reproductive suppression have been reported. Methods: In this study, the differentially expressed (DE) miRNAs, miRNA-mRNA interaction network and function of the plateau zokor testicular cells of non-breeders and breeders during the breeding season were comprehensively analyzed by transcriptomics. Results: In total, 381 known and 94 novel miRNAs were determined. Compared with that in the breeders, 70 downregulated and 68 upregulated DE miRNAs were identified in the non-breeders. We predicted 1670 significant target mRNAs by analyzing the miRNA and mRNA expression profiles. According to the miRNA-mRNA interaction network, the target mRNAs of the DE miRNAs were related to testicular development and spermatogenesis. GO indicate that the target mRNAs were related to testicular development and spermatogenesis. KEGG indicate that pathways of target mRNAs enrichment related to testicular development, spermatogenesis, and energy metabolism. PROK2 was determined as the target mRNA of rno-miR-143-3p. Discussion: Our study offers a basis for the regulatory mechanisms of miRNAs in testicular development and spermatogenesis in plateau zokor under reproductive suppression and offers a reference for reproductive regulation.

Environmental and climatic drivers of phenotypic evolution and distribution changes in a widely distributed subfamily of subterranean mammals.

How environmental factors shape species morphology and distributions is a key issue in ecology, especially in similar environments. Species of Myospalacinae exhibit widespread distribution spanning the eastern Eurasian steppe and the extreme adaptation to the subterranean environment, providing an excellent opportunity for investigating species responses to environmental changes. At the national scale, we here use geometric morphometric and distributional data to assess the environmental and climatic drivers of morphological evolution and distribution of Myospalacinae species in China. Based on phylogenetic relationships of Myospalacinae species constructed using genomic data in China, we integrate geometric morphometrics and ecological niche models to reveal the interspecific variation of skull morphology, trace the ancestral state, and assess factors influencing interspecific variation. Our approach further allows us to project future distributions of Myospalacinae species throughout China. We found that the interspecific morphology variations were mainly concentrated in the temporal ridge, premaxillary-frontal suture, premaxillary-maxillary suture, and molars, and the skull morphology of the two current species in Myospalacinae followed the ancestral state; temperature and precipitation were important environmental variables influencing skull morphology. Elevation, temperature annual range, and precipitation of warmest quarter were identified as dominant factors affecting the distribution of Myospalacinae species in China, and their suitable habitat area will decrease in the future. Collectively, environmental and climate changes have an effect on skull phenotypes of subterranean mammals, highlighting the contribution of phenotypic differentiation in similar environments in the formation of species phenotypes. Climate change will further shrink their habitats under future climate assumptions in the short-term. Our findings provide new insights into effects of environmental and climate change on the morphological evolution and distribution of species as well as a reference for biodiversity conservation and species management.

Potential Role of Anti-Müllerian Hormone in Regulating Seasonal Reproduction in Animals: The Example of Males.

Seasonal reproduction is a survival strategy by which animals adapt to environmental changes to improve their fitness. Males are often characterized by a significantly reduced testicular volume, indicating that they are in an immature state. Although many hormones, including gonadotropins, have played a role in testicular development and spermatogenesis, research on other hormones is insufficient. The anti-Müllerian hormone (AMH), which is a hormone responsible for inducing the regression of Müllerian ducts involved in male sex differentiation, was discovered in 1953. Disorders in AMH secretion are the main biomarkers of gonadal dysplasia, indicating that it may play a crucial role in reproduction regulation. A recent study has found that the AMH protein is expressed at a high level during the non-breeding period of seasonal reproduction in animals, implying that it may play a role in restricting breeding activities. In this review, we summarize the research progress on the AMH gene expression, regulatory factors of the gene's expression, and its role in reproductive regulation. Using males as an example, we combined testicular regression and the regulatory pathway of seasonal reproduction and attempted to identify the potential relationship between AMH and seasonal reproduction, to broaden the physiological function of AMH in reproductive suppression, and to provide new ideas for understanding the regulatory pathway of seasonal reproduction.

Reproductive Suppression Caused by Spermatogenic Arrest: Transcriptomic Evidence from a Non-Social Animal.

Reproductive suppression is an adaptive strategy in animal reproduction. The mechanism of reproductive suppression has been studied in social animals, providing an essential basis for understanding the maintenance and development of population stability. However, little is known about it in solitary animals. The plateau zokor is a dominant, subterranean, solitary rodent in the Qinghai-Tibet Plateau. However, the mechanism of reproductive suppression in this animal is unknown. We perform morphological, hormonal, and transcriptomic assays on the testes of male plateau zokors in breeders, in non-breeders, and in the non-breeding season. We found that the testes of non-breeders are smaller in weight and have lower serum testosterone levels than those of breeders, and the mRNA expression levels of the anti-Müllerian hormone (AMH) and its transcription factors are significantly higher in non-breeder testes. Genes related to spermatogenesis are significantly downregulated in both meiotic and post-meiotic stages in non-breeders. Genes related to the meiotic cell cycle, spermatogenesis, flagellated sperm motility, fertilization, and sperm capacitation are significantly downregulated in non-breeders. Our data suggest that high levels of AMH may lead to low levels of testosterone, resulting in delayed testicular development, and physiological reproductive suppression in plateau zokor. This study enriches our understanding of reproductive suppression in solitary mammals and provides a basis for the optimization of managing this species.

Effects of different management practices on soil microbial community structure and function in alpine grassland.

Management practices, such as grazing exclusion and reseeding, have been implemented to mitigate the degradation of grassland. Low grazing intensities and reseeding increase grass production. Nevertheless, few studies have investigated the effects of these measures on the soil microbial community structure and function in the Qinghai Tibetan Plateau (QTP). To reveal the effects of management practices on soil microbes and give a reference to assess and improve ecosystems functions, we here evaluated the impact of various types of grazing (exclusion, seasonal, and traditional), reseeding (annual oat (Avena fatua) grassland (RO) and perennial artificial grassland cultivated >10 y), and integrated restoration (weed control and no-tillage reseeding) measures on soil microbial community structure and function in the QTP. The Shannon-Wiener diversity indices were highest for prokaryotes under RO and for fungi under integrated grassland restoration. Relative Actinobacteria abundance was higher under seasonal grazing than that under integrated grassland restoration. The latter had relatively higher abundances of Betaproteobacteria, Alphaproteobacteria, and Deltaproteobacteria and comparatively lower abundance of Thermoleophilia. There were significantly higher abundances of plant pathogens under seasonal grazing than those under other managements. There were significantly high proportions of pathotrophs and saprotrophs (10.0%) under seasonal and traditional grazing, respectively. The proportion of pathotrophs under integrated restoration (10.0%) was about seven-fold greater than that under grazing exclusion (1.5%). The relative differences among treatments in terms of soil water content, plant biomass, and soil C:N partially explained the differences in their prokaryotic community compositions. Increases in soil organic carbon and C:N may explain the observed changes in the soil fungal communities. The management practices affected soil microorganisms mainly by altering the soil nutrient profile. Grazing attracted specific pathotrophs and saprotrophs while repelling certain plant pathogens. Hence, modulations in soil microbial community structure and function must be considered in the process of planning for the implementation of grassland degradation management measures.

Assessing the win-win situation of forage production and soil organic carbon through a short-term active restoration strategy in alpine grasslands.

Introduction: Grassland degradation has seriously affected the ecological environment and human livelihood. To abate these, implementing effective management strategies to restore and improve the service functions and productivity of degraded grasslands is crucial. Methods: To evaluate the influences of restoration measures combined with different grazing intensities on short-term (1 year) grassland restoration, the changes in soil physicochemical properties, as well as plant traits under restoration measures of different grazing intensities, reseeding, and fertilization, were analyzed. Results: Soil organic carbon (SOC) increased to varying degrees, whereas available nutrients decreased under all combined restoration measures. Reseeding, alone and in combination with fertilization, substantially increased SOC, improved grassland vegetation status, and enhanced grassland productivity. The aboveground biomass of Gramineae and the total aboveground biomass increased under the combined restoration measures of transferring livestock out of the pasture 45 days in advance, reseeding, and fertilization (T4). Redundancy analysis revealed a strong correlation between grassland vegetation characteristics, SOC, and available potassium. Considering soil and vegetation factors, the short-term results suggested that the combination measures in T4had the most marked positive impact on grassland restoration. Discussion: These findings offer valuable theoretical insights for the ecological restoration of degraded grasslands in alpine regions.

Antifertility effects of levonorgestrel, quinestrol, and their mixture (EP-1) on plateau zokor in the Qinghai-Tibetan Plateau.

The plateau zokor (Eospalax baileyi) is a key species in the Qinghai-Tibetan Plateau ecosystem, and fertility control could be an ideal approach to manage populations of this subterranean species. In this laboratory study, we explored the effects of the mixture of levonorgestrel and quinestrol (EP-1, 1:2), quinestrol (E), and levonorgestrel (P) on the reproductive status of plateau zokors. Groups of 5 animals of each sex were treated with different concentrations of EP-1 (1, 5, and 10 mg/kg), E (0.33, 3.3, and 6.6 mg/kg), and P (0.67, 3.35, and 6.7 mg/kg) by oral gavage over 7 successive days and killed on day 15. Body mass reduction was observed in the EP-1 and E groups. EP-1 and E significantly reduced the weight of testis and epididymis at 10 and 3.3 mg/kg, respectively. Sperm count and motility were significantly reduced by 5 mg/kg EP-1 and 0.33 mg/kg E. The levels of serum testosterone, estradiol, luteinizing hormone, and follicle stimulating hormone were significantly reduced by 5 mg/kg EP-1 and 3.3 mg/kg E. EP-1 and E significantly increased the uterine and ovarian weights at 10 and 3.3 mg/kg, respectively. In the plateau zokors, treatment with P had no influence on the reproductive status. These data demonstrate that EP-1 and E have an inhibitory effect on a range of reproductive parameters in the plateau zokors. Further assessment is required to determine the effects on breeding and recruitment in enclosure or field experiments.

Seasonal Expression of Gonadotropin Genes in the Pituitary and Testes of Male Plateau Zokor (Eospalax baileyi).

The gonadotropins, luteinizing hormone (LH) and follicle stimulating hormone (FSH), are glycoprotein hormones in the hypothalamic-pituitary-gonadal (HPG) axis and regulate mammalian reproduction. The expression of these genes in the plateau zokor (Eospalax baileyi) is poorly understood. We characterized the immunolocalization of the luteinizing hormone receptor (LHR) and follicle stimulating hormone receptor (FSHR) in the testes and evaluated the positive immunohistochemical results and the relative mRNA expression of gonadotropin genes. During the non-breeding season (September), the relative testes weight and the seminiferous tubule diameter were significantly reduced. All germ cell types were observed during the breeding season (May), whereas only spermatogonia were observed during the non-breeding season. LHR was present in the Leydig cells whereas FSHR was present in the Sertoli cells. The mean optical density was higher during the breeding season. The mRNA expression of LHß and FSHß was lower in the pituitary but LHR and FSHR genes expression were higher in the testes during the breeding season. These data elucidate the expression of gonadotropin genes in the HPG axis of the male plateau zokor and suggest that gonadotropins play a vital role in the regulation of seasonal breeding.

A brief web-based screening plus emotional-disorder health education was associated with improvement of mental health awareness and service-seeking attitudes among patients seeking nonpsychiatric clinical services in China.

OBJECTIVES: Low recognition and intervention rates of emotional disorders among nonpsychiatric clinical patients are primarily attributable to poor mental health awareness of patients and a paucity of mental health care resources. This study aims to investigate the association of a resource-saving brief web-based emotional-disorder self-screening plus a health self-education program (BWBED-SS + HSE) with improved mental health awareness and service-seeking attitudes among nonpsychiatric clinical patients. METHOD: A sample of 2065 patients seeking health services in nonpsychiatric clinical settings underwent BWBED-SS + HSE using mobile terminals. Participants were defined as being at high risk of anxiety and/or depression according to the optimal cut-off point of ≥11 on the Huaxi emotional-distress index (HEI). RESULTS: The rate of participants at high risk of anxiety and/or depression was 6.63%. Following participation in the BWBED-SS + HSE, after controlling for demographics, type of hospital, and test time, the rates of participants considering themselves as having an emotional disorder and willing to seek mental health services among those at high risk of anxiety and/or depression increased from 29.93% to 47.45% (adjusted odds ratio [aOR] = 2.28, p = .002) and from 11.68% to 29.93% (aOR = 3.65, p < .001), respectively. CONCLUSIONS: The BWBED-SS + HSE were associated with improved mental health awareness and service-seeking attitudes among patients seeking nonpsychiatric clinical services in China.

Geometric morphometric analysis of the plateau zokor (Eospalax baileyi) revealed significant effects of environmental factors on skull variations.

The plateau zokor (Eospalax baileyi) is employed as an ideal model for examining the relationships between phenotypic and ecological adaptations to the underground conditions in which the skull morphology evolves to adapt to tunnel environment. We evaluated the influence of environmental factors (altitude, temperature, and precipitation) and geographical distance on the variations in skull morphology of a native subterranean rodent plateau zokor population. Thin-plate spline showed that the trend of morphological changes along the CV1 axis was as follows: the two zygomatic arch and the two postorbital processes moved down, the two mastoid processes and the tooth row moved upward, and the tympanic bulla grew longer. The changes along the CV2 axis were as follows: the nasal bone and the tooth row became longer, the distance between the two anterior tips of zygomatic arch lengthened, the infraorbital foramen became smaller, the whole posterior part of the skull became shorter, the zygomatic bone and the two posterior tips of zygomatic arch moved down, and the foramen magnum became bigger. Thus we found significant differences in the skull shape among the seven populations studied. Along with the reduction in the altitude and increase in the mean annual temperature and mean annual precipitation, the nasal bone became shorter, the distance between the two anterior tips of the zygomatic arch became shorter, the whole posterior part of the skull lengthened, the infraorbital foramen became smaller, the two mastoid processes moved upward, and the occipital bone moved down on the dorsal surface of the skull. On the ventral surface of the skull, with an increase in the altitude, mean annual temperature, and mean annual precipitation, the tympanic bulla became shorter, the tooth row moved down, and the foramen magnum became smaller. The morphological changes in the skull were significantly positively correlated with environmental factors. Finally, there was a significant positive correlation between the Procrustes distance matrix of the skull and the geographic distance matrix, which indicates that the evolution of the plateau zokor follows the distance isolation model, but it needs to be further explored from genetic perspectives.

Associations of Suicidality with Adverse Life Events, Psychological Distress and Somatic Complaints in a Chinese Medical Student Sample.

The present study aimed to examine the associations of suicidality with psychological distress, somatic symptoms, and stressors in medical school students. We conducted a cross-sectional survey of medical students at a large, top-ranked medical school. A total sample of 662 medical students (269 men) completed a battery of self-reported questionnaire. Of the respondents, 136 (20.5%) reported having suicidal ideation, 40 (6.0%) reported having planned suicide, and 10 (1.5%) reported having attempted suicide during the previous year. Students from rural areas and the 3rd year of study reported higher levels of suicidal ideation than their counterparts. General pain/fatigue was associated with suicidal ideation and planning, while interpersonal difficulties were associated only with suicidal ideation. This study provides evidence linking severe psychological distress, general pain/fatigue, interpersonal stress and psychosocial factors with suicide risk among Chinese medical students which provides targets for future psychological interventions.

The 6-item Kessler psychological distress scale to survey serious mental illness among Chinese undergraduates: Psychometric properties and prevalence estimate.

OBJECTIVE: To evaluate the psychometric properties of the 6-item Kessler psychological distress scale (K6) in screening for serious mental illness (SMI) among undergraduates in a major comprehensive university in China. METHOD: The K6 was self-completed by 8289 randomly sampled participants. A group of them (n=222) were re-assessed using K6 and interviewed using the Chinese version of Composite International Diagnostic Interview 3.1 (CIDI-3.1). RESULTS: The test-retest reliability of the K6 scale was 0.79, the Cronbach's alpha was 0.84, and its area under the receiver operating curve (AUC) for diagnosing CIDI-3.1 SMI was 0.85 (95% CI=0.80-0.90). For the optimal cut-off of K6 (12/13), the sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and classification accuracy (AC) were 0.83, 0.79, 0.60, 0.93, and 0.80, respectively. The 12-month prevalence of SMI was estimated as 3.97% using this optimal cut-off. Binary logistic regression analysis (including gender, ethnicity, grade, number of siblings and family residency location) showed that only family residency location in rural areas compared to urban areas was significantly associated with more SMI. CONCLUSIONS: This study documented the value of using the K6 for detecting SMI in Chinese undergraduate populations and supported its cross-cultural reliability and validity.

Anti-N-methyl-d-aspartate receptor encephalitis in a patient with a 7-year history of being diagnosed as schizophrenia: complexities in diagnosis and treatment.

Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a form of autoimmune encephalitis associated with antibodies against the NR1 subunits of NMDARs. Although new-onset acute prominent psychotic syndromes in patients with NMDAR encephalitis have been well documented, there is a lack of case studies on differential diagnosis and treatment of anti-NMDAR encephalitis after a long-term diagnostic history of functional psychotic disorders. The present study reports an unusual case of anti-NMDAR encephalitis. The patient had been diagnosed with schizophrenia 7 years earlier, and was currently hospitalized for acute-onset psychiatric symptoms. The diagnosis became unclear when the initial psychosis was confounded with considerations of other neurotoxicities (such as neuroleptic malignant syndrome). Finally, identification of specific immunoglobulin G NR1 autoantibodies in the cerebrospinal fluid and greater effectiveness of immunotherapy over antipsychotics alone (which has been well documented in anti-NMDAR encephalitis) indicated the diagnosis of anti-NMDAR encephalitis in this case. Based on the available evidence, however, the relationship between the newly diagnosed anti-NMDAR encephalitis and the seemingly clear, long-term history of schizophrenia in the preceding 7 years is uncertain. This case report illustrates that psychiatrists should consider anti-NMDAR encephalitis and order tests for specific immunoglobulin G NR1 autoantibodies in patients presenting with disorientation, disturbance of consciousness, cognitive deficit, dyskinesia, autonomic disturbance, or rapid deterioration, even with a seemingly clear history of a psychiatric disorder and no specific findings on routine neuroimaging, electroencephalography, or cerebrospinal fluid tests in the early stage of the illness.