title: The effects of corticosteroids on cognitive flexibility and decision-making in women with lupus.
abstract: The aim of this study was to investigate the possible effects of corticosteroids in women with systemic lupus erythematosus (SLE) in two processes of executive function: cognitive flexibility and decision-making. To that end, we evaluated 121 women divided into three groups: 50 healthy women, 38 women with SLE not receiving corticosteroid treatment and 33 women with SLE receiving corticosteroid treatment. Cognitive flexibility was measured with the Trail Making Tests A and B; decision-making was measured with the Iowa Gambling Task. Additionally, demographic (age and education level), clinical (SLE Disease Activity Index (SLEDAI), Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI) and disease duration) and psychological characteristics (stress vulnerability, perceived stress and psychopathic symptomatology) were evaluated. The results showed that both SLE groups displayed poorer decision-making than the healthy women ( p = 0.006) and also that the SLE group receiving corticosteroid treatment showed lower cognitive flexibility than the other two groups ( p = 0.030). Moreover, SLE patients showed poorer scores than healthy women on the following SCL-90-R subscales: somatisation ( p = 0.005), obsessions and compulsions ( p = 0.045), depression ( p = 0.004), hostility ( p = 0.013), phobic anxiety ( p = 0.005), psychoticism ( p = 0.016) and positive symptom total ( p = 0.001). In addition, both SLE groups were more vulnerable to stress ( p = 0.000). These findings help to understand the effects of corticosteroid treatment on cognitive flexibility and decision-making, in addition to the disease-specific effects suffered by women with SLE.
authors.affiliation: 1 Department of Clinical Psychology, University of Granada, Granada, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Montero-López
authors.affiliation: 2 Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Alicante, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Santos-Ruiz
authors.affiliation: 3 Systemic Autoimmune Disease Unit, Internal Medicine Service, Virgen de las Nieves University Hospital, Granada, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Navarrete-Navarrete
authors.affiliation: 4 Systemic Autoimmune Disease Unit, Internal Medicine Service, San Cecilio Clinical Hospital, Granada, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Ortego-Centeno
authors.affiliation: 1 Department of Clinical Psychology, University of Granada, Granada, Spain.|5 Mind, Brain and Behavior Research Centre (CIMCYC). Granada, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Pérez-García
authors.affiliation: 1 Department of Clinical Psychology, University of Granada, Granada, Spain.|5 Mind, Brain and Behavior Research Centre (CIMCYC). Granada, Spain.
authors.forename: M I
authors.initials: MI
authors.lastname: Peralta-Ramírez
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000494:pharmacology*; D000328:Adult; D003071:Cognition / Q000187:drug effects*; D003657:Decision Making / Q000187:drug effects*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000523:psychology; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Corticosteroids; decision-making; executive function; flexibility; systemic lupus erythematosus (SLE)