Psychiatric disorders in Systemic Lupus Erythematosus.

West Indian Med J. 1996 Jun;45(2):48-50.

Source

Maudsley Hospital, London, UK.

Abstract

The symptoms of Systemic Lupus Erythematosus (SLE) may include altered mental function. The present study sought to determine whether the psychiatric disorders are due to the disease itself or to the stress of having a chronic disease. Forty-five SLE patients attending outpatient clinics at the Port-of-Spain General Hospital in Trinidad were compared with two control groups: patients with chronic debilitating diseases similar to SLE in terms of chronicity and treatment (n = 44) and non-diseased individuals (n = 48). The Structured Clinical Interview for DSM III-R was used to identify psychiatric disorders. Both the SLE and the chronic illness groups had more psychiatric illness (44% and 39%, respectively) when compared with the non-diseased controls (2%) (p < 0.001). Major depression was the most common diagnosis among both diseased groups. However, psychotic illnesses (schizophrenic-type psychosis and bipolar disorders) were more prevalent in the SLE group (11.1% vs 0%, p = 0.02). These results indicate that major depression in SLE may be related more to the effects of a chronic illness than to SLE itself. However, the occurrence of psychotic symptoms may be related to SLE disease and needs further study.

Systemic lupus erythematosus presenting as mania.

Acta Psychiatr Scand. 2000 May;101(5):406-8; discussion 408.

Source

Trafford General Hospital, Davyhulme, Manchester, UK.

Abstract

OBJECTIVE:

Psychiatric manifestations of systemic lupus erythematosus (SLE) are well recognized but usually occur in the later stages of the illness, with organic syndromes being the most common. This case highlights the fact that SLE can present with mania.

METHOD:

Single case report.

RESULTS:

A 32-year-old woman was admitted to hospital with her first manic illness. Physical examination and investigations revealed her to be suffering from SLE although this had not been previously diagnosed. Her physical and psychiatric symptoms settled rapidly following treatment with prednisolone and chlorpromazine.

CONCLUSION:

The case emphasizes the polymorphous manifestations of SLE and the importance of considering physical disorders in patients with a first episode of psychosis.

Neuropsychiatric systemic lupus erythematosus presenting as bipolar I disorder with catatonic features.

Psychosomatics. 2009 Sep-Oct;50(5):543-7.

Source

Department of Psychiatry, SUNY Upstate, NY 13210, USA. alaoa@upstate.edu

Abstract

BACKGROUND:

The American College of Rheumatology has defined 19 neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE) involving the central, peripheral, and autonomic nervous systems. Neuropsychiatric manifestations of lupus (NPSLE) have been shown to occur in up to 95% of pediatric patients with SLE.

OBJECTIVE:

The authors describe a 15-year-old African American young woman with a family history positive for bipolar I disorder and schizophrenia, who presented with symptoms consistent with an affective disorder.

METHOD:

The patient was diagnosed with Bipolar I disorder with catatonic features and required multiple hospitalizations for mood disturbance. Two years after her initial presentation, the patient was noted to have a malar rash and subsequently underwent a full rheumatologic work-up, which revealed cerebral vasculitis.

RESULTS:

NPSLE was diagnosed and, after treatment with steroids, the patient improved substantially and no longer required further psychiatric medication or therapy.

CONCLUSION:

Given the especially high prevalence of NPSLE in pediatric patients with lupus, it is important for clinicians to recognize that neuropsychiatric symptoms in an adolescent patient may indeed be the initial manifestations of SLE, as opposed to a primary affective disorder.

Psychiatric manifestations in systemic lupus erythematosus.

Autoimmun Rev. 2007 Jun;6(6):421-6. Epub  2007 Mar 12.

Source

Department of Internal Medicine, Bezhanijska Kosa University Medical Center, Belgrade University, Serbia and Montenegro. Ljudmila_Stojanovich@yahoo.com

Abstract

Psychiatric abnormalities are common in systemic lupus erythematosus (SLE) with a prevalence of 17% to 75%, reflecting different methods of patient selection and assessment, the different professional orientation of clinicians, and lack of an accepted consensus for diagnosing active neuropsychiatric lupus (NPSLE). The psychiatric syndromes included in the ACR Neuropsychiatric Lupus Nomenclature Committee criteria are cognitive dysfunction, acute confusional state (delirium), anxiety disorder, mood disorder, and psychosis. In SLE patients, identification of psychiatric phenomena and the generation of a differential diagnosis are crucial. Possible mechanisms include vascular injury and pathogenic antibodies. Treatment strategies are based on small case studies. The purpose of this review is to discuss clinical manifestations, pathogenesis and the present therapeutic options in psychiatric lupus.

PMID:
17537389
[PubMed – indexed for MEDLINE]

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