title: Short-term outcome of neuropsychiatric events in systemic lupus erythematosus upon enrollment into an international inception cohort study.
abstract: OBJECTIVE
  To determine the short-term outcome of neuropsychiatric (NP) events upon enrollment into an international inception cohort of patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  The study was performed by the Systemic Lupus International Collaborating Clinics. Patients were enrolled within 15 months of SLE diagnosis and NP events were characterized using the American College of Rheumatology case definitions. Decision rules were derived to identify NP events attributable to SLE. Physician outcome scores of NP events and patient-derived mental component summary (MCS) and physical component summary (PCS) scores of the Short Form 36 were recorded.
  
  
  RESULTS
  There were 890 patients (88.7% female) with a mean +/- SD age of 33.8 +/- 13.4 years and mean disease duration of 5.3 +/- 4.2 months. Within the enrollment window, 271 (33.5%) of 890 patients had at least 1 NP event encompassing 15 NP syndromes. NP events attributed to SLE varied from 16.5% to 33.9% using alternate attribution models and occurred in 6.0-11.5% of patients. Outcome scores for NP events attributed to SLE were significantly better than for NP events due to non-SLE causes. Higher global disease activity was associated with worse outcomes. MCS scores were lower in patients with NP events, regardless of attribution, and were also lower in patients with diffuse and central NP events. There was a significant association between physician outcome scores and patient MCS scores only for NP events attributed to SLE.
  
  
  CONCLUSIONS
  In SLE patients, the short-term outcome of NP events is determined by both the characteristics and attribution of the events.
authors.affiliation: Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, NS, Canada. john.hanly@cdha.nshealth.ca
authors.forename: J G
authors.initials: JG
authors.lastname: Hanly
authors.forename: M B
authors.initials: MB
authors.lastname: Urowitz
authors.forename: L
authors.initials: L
authors.lastname: Su
authors.forename: J
authors.initials: J
authors.lastname: Sanchez-Guerrero
authors.forename: S C
authors.initials: SC
authors.lastname: Bae
authors.forename: C
authors.initials: C
authors.lastname: Gordon
authors.forename: D J
authors.initials: DJ
authors.lastname: Wallace
authors.forename: D
authors.initials: D
authors.lastname: Isenberg
authors.forename: G S
authors.initials: GS
authors.lastname: Alarcón
authors.forename: J T
authors.initials: JT
authors.lastname: Merrill
authors.forename: A
authors.initials: A
authors.lastname: Clarke
authors.forename: S
authors.initials: S
authors.lastname: Bernatsky
authors.forename: M A
authors.initials: MA
authors.lastname: Dooley
authors.forename: P R
authors.initials: PR
authors.lastname: Fortin
authors.forename: D
authors.initials: D
authors.lastname: Gladman
authors.forename: K
authors.initials: K
authors.lastname: Steinsson
authors.forename: M
authors.initials: M
authors.lastname: Petri
authors.forename: I N
authors.initials: IN
authors.lastname: Bruce
authors.forename: S
authors.initials: S
authors.lastname: Manzi
authors.forename: M
authors.initials: M
authors.lastname: Khamashta
authors.forename: A
authors.initials: A
authors.lastname: Zoma
authors.forename: J
authors.initials: J
authors.lastname: Font
authors.forename: R
authors.initials: R
authors.lastname: Van Vollenhoven
authors.forename: C
authors.initials: C
authors.lastname: Aranow
authors.forename: E
authors.initials: E
authors.lastname: Ginzler
authors.forename: O
authors.initials: O
authors.lastname: Nived
authors.forename: G
authors.initials: G
authors.lastname: Sturfelt
authors.forename: R
authors.initials: R
authors.lastname: Ramsey-Goldman
authors.forename: K
authors.initials: K
authors.lastname: Kalunian
authors.forename: J
authors.initials: J
authors.lastname: Douglas
authors.forename: K
authors.initials: K
authors.lastname: Qiufen Qi
authors.forename: K
authors.initials: K
authors.lastname: Thompson
authors.forename: V
authors.initials: V
authors.lastname: Farewell
mesh_terms: D000328:Adult; D002493:Central Nervous System Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D007391:International Cooperation; D008180:Lupus Erythematosus, Systemic / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests