Pre-clinical medicine
Immunology
Immunology is the study of the body's defence system: how it fights infection and how it can go wrong in allergy, autoimmunity and immune deficiency. Research increasingly links inflammation and immune processes to mental illness.
Depth by stage, Pre-U → Consultant (details)
What is it?
Immunology covers innate and adaptive immunity, antibodies and immune cells, vaccination, allergy, autoimmune disease, transplant rejection and immune deficiency.
It is usually taught alongside microbiology and pathology, and connects to many clinical specialties.
It is a fast-moving field, and research on the brain-immune connection is an active area in psychiatry.
Why does a psychiatrist need it?
Autoimmune encephalitis (for example anti-NMDA receptor encephalitis) can first appear as acute psychosis, and spotting it can be life-saving. Lupus and thyroid autoimmunity can cause mood and cognitive symptoms. Clozapine can cause dangerous falls in white cells, requiring regular blood monitoring. Research also links chronic inflammation with depression, though this is not yet routine in treatment.
What level is expected at each stage?
Scale: 1. Aware → 2. Understands → 3. Applies → 4. Masters / Teaches. What the levels mean.
- Pre-UNot expected
- Pre-clinicalUnderstandsUnderstands how the immune system works and fails.
- ClinicalAwareAware of immune-mediated diseases in clinical rotations.
- HousemanshipUnderstandsUnderstands allergy and anaphylaxis management and immunosuppression risks.
- Medical officerAwareAware of immune issues in patient care.
- Psych traineeUnderstandsUnderstands psychoneuroimmunology, autoimmune causes of psychosis and drug-induced blood dyscrasias.
- Specialist / consultantUnderstandsUnderstands current evidence and when to involve neurology or immunology.
What are the key topics?
Immune system basics
- Innate immunity: barriers, phagocytes, complement
- Adaptive immunity: T cells and B cells
- Antibodies and their classes
- Cytokines and inflammation
When immunity goes wrong
- Hypersensitivity and allergy, including anaphylaxis
- Autoimmune diseases such as lupus and thyroid disease
- Immunodeficiency, including HIV
- Transplant immunology (introductory)
Immunology and the brain
- Autoimmune encephalitis (for example anti-NMDA receptor)
- Inflammation and depression: the research picture
- Paediatric autoimmune neuropsychiatric conditions (debated)
- Drug-induced agranulocytosis and neutropenia (clozapine monitoring)
Practical immunology
- Vaccination programmes
- Immunological tests and their meaning
- Immunosuppressant drugs
How is it learned and assessed?
- Lectures and PBL integrated with microbiology and pathology
- MCQ and short-answer exams
- Psychoneuroimmunology may appear in psychiatry basic sciences exams
Typical textbooks and resources
- Roitt's Essential Immunology — Wiley-Blackwell
- Janeway's Immunobiology — W. W. Norton/Garland Science
- Basic Immunology — Abbas, Lichtman and Pillai (Elsevier)
- Immunology at a Glance — Wiley-Blackwell
Titles are widely used examples; editions change. Use university libraries or legitimate purchases.
Common questions
Can the immune system cause psychosis?
In some cases, yes. Autoimmune encephalitis can present with sudden psychosis, confusion or seizures, and it needs urgent medical treatment. It is uncommon but important not to miss.
Why are blood counts checked with clozapine?
Clozapine can rarely cause a dangerous drop in white blood cells, which fight infection. Regular blood monitoring is required so that the drug can be stopped quickly if this happens.