title: Prevalence of Cognitive Disorders in Patients with Systemic Lupus Erythromatosus; a Cross-sectional Study in Rasoul-e-Akram Hospital, Tehran, Iran.
abstract: BACKGROUND
  Neuropsychological manifestations are present in 60% of patients with Systemic Lupus Erythematosus (SLE) among which cognitive dysfunction is the most common. This study aims to determine the prevalence of cognitive disorders in SLE patients, and the relationship between cognitive disorder domains and depression and anxiety.
  
  
  METHODS
  In this cross-sectional study, 54 patients with SLE and 48 healthy subjects were included. Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT) and Trail Making Test part A (TMT-A) were used to screen for cognitive impairments. All subjects were evaluated with the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) to determine depression and anxiety as probable confounding variables.
  
  
  RESULTS
  The mean MMSE scores in SLE and control group patients (26.12 ± 3.58 and 28.01 ± 1.99, respectively) were significantly different (P = 0.001). The sub-scores in all areas assessed with MMSE were lower in SLE patients; however, it was only significant in the areas of orientation, recall and language (P < 0.05). SLE patients showed a significantly poorer performance in TMT compared to healthy controls (P = 0.01). The CDT according to the Watson scoring system showed significant difference between the two groups (P = 0.03). The Sunderland scoring system also indicated poorer performance in the SLE group, but the difference was not significant.
  
  
  CONCLUSIONS
  Our study showed that cognitive disorders are more than 3-fold higher in SLE patients compared to normal subjects. The most impaired domains include orientation, Memory (recall), Language, Executive function, and psychomotor speed. Anxiety and depression are mostly correlated with domains included in the MMSE test.
authors.affiliation: School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
authors.forename: Aliyeh
authors.initials: A
authors.lastname: Mahdavi Adeli
authors.affiliation: Rassoul Akram Hospital, Associate Professor of Iran University of Medical Sciences (IUMS), Tehran, Iran.
authors.forename: Anousheh
authors.initials: A
authors.lastname: Haghighi
authors.affiliation: Professor of Psychiatry, School of Behavioral Sciences and Mental Health, Mental Health Research Centre, Iran University of Medical Sciences (IUMS), Tehran, Iran. MD, MBA. WHO Collaborating Center in mental health, Director.
authors.forename: Seyed Kazem
authors.initials: SK
authors.lastname: Malakouti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology*; D003072:Cognition Disorders / Q000209:etiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D055815:Young Adult