Prevalence of Neuropsychiatric Disorders in Patients With Systemic Lupus Erythematosus (SLE).

Abstract

BACKGROUNDNeuropsychiatric systemic lupus erythematosus (NPSLE) is a serious and well‐known complication of systemic lupus erythematosus (SLE). There are few studies on the population‐based estimates of the prevalence of NPSLE and its manifestations. Reliable prevalence estimates are needed to quantify the burden of the disease and to direct the attention of policy makers to magnitude of suffering associated with SLE. We aimed to quantify the prevalence of NPSLE in different population settings.METHODSWe searched PubMed from January 2009 to June 2019 to identify studies relevant to this review. Databases searches combined terms from three themes: all age groups/general population, psychosis, neuropsychiatric impairment, mental disorders and delusions; and SLE, lupus, and systemic lupus erythematosus. Terms were searched as both keywords (title/abstract words) and subject headings as appropriate. We also searched original papers relevant to this review from the retrieved articles. For case classification and case ascertainment, NPSLE was classified according to the American College of Rheumatology guidelines.RESULTWe excluded 79 from the initial 105 articles from the screening of titles and abstracts. The remaining 26 full text articles were reviewed and 9 were included in the review. The major neuropsychiatric comorbidities that were observed from the studies were major depression, headaches, seizures and cerebrovascular diseases. The prevalence estimates of neuropsychiatric disorders in NPSLE patients were as follows: major depression in patients (17%–52%) headaches (38.8%–60%), seizures (26.4%–63%), and cerebrovascular diseases (26%–38.8%). The overall prevalence estimates of NPSLE varies from 11% to 60% of all SLE patients.CONCLUSIONThis study confirms that the burden of neuropsychiatric manifestations of SLE, including major depression, seizures, cerebrovascular disease is high. Further studies are needed to elucidate the pathogenesis of neurological involvement in patients with SLE and to address the risk factors for NPSLE.Support or Funding InformationAmerican Association for Anatomists