title: Common mental disorders and psychological distress in systemic lupus erythematosus are not associated with disease activity.
abstract: Psychiatric diagnosis in patients with systemic lupus erythematosus (SLE) is controversial: variations have been reported in frequency, diagnostic assays, associations with disease activity, autoantibodies, and contributing social factors. Eighty-three consecutive non-selected Chilean patients with SLE were evaluated for: (i) 26 common mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), using the Mini-International Neuropsychiatric Interview (MINI-plus); (ii) psychological suffering measured by Hospital Anxiety and Depression Scale (HADS); (iii) ACR 1999 neuropsychiatric (NP)SLE criteria; (iv) SLE disease activity (SLEDAI-2K); (v) cumulative damage (SLICC/ACR); and (vi) anti-ribosomal P antibodies by enzyme-linked immunoassay and immunoblot. Psychiatric diagnoses occurred in 44.6% of patients; the most frequent (21.7%) was major depressive episode (MDE). No association with lupus activity was observed in patients with a DSM-IV diagnosis or MDE or psychological suffering. ACR 1999 NPSLE criteria were present in 42.2% of patients, the majority corresponding to mood (28.9%) or anxiety disorders (15.6%). Suicidal risk was present in 9.6% of patients. Anti-ribosomal P antibodies (13.3%) were not associated with DSM-IV diagnosis. Severe psychiatric disorders in SLE are common and not associated with disease activity.
authors.affiliation: Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: E
authors.initials: E
authors.lastname: Jarpa
authors.forename: M
authors.initials: M
authors.lastname: Babul
authors.forename: J
authors.initials: J
authors.lastname: Calderón
authors.forename: M
authors.initials: M
authors.lastname: González
authors.forename: M E
authors.initials: ME
authors.lastname: Martínez
authors.forename: M
authors.initials: M
authors.lastname: Bravo-Zehnder
authors.forename: C
authors.initials: C
authors.lastname: Henríquez
authors.forename: S
authors.initials: S
authors.lastname: Jacobelli
authors.forename: A
authors.initials: A
authors.lastname: González
authors.forename: L
authors.initials: L
authors.lastname: Massardo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear; D001323:Autoantibodies / Q000276:immunology; D002677:Chile; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012269:Ribosomal Proteins / Q000276:immunology; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D012269:Ribosomal Proteins