Shared pathological mechanisms of systemic lupus erythematosus and affective disorders

Abstract

The high prevalence and variability of neurological and psychiatric symptoms in systemic lupus erythematosus has become the basis for emphasizing the special neuropsychiatric form of the disorder. Affective disorders (pathological changes in mood and anxiety) are the second most common neuropsychiatric manifestations in patients with systemic lupus erythematosus. However, the current nomenclature primarily focuses on the general clinical manifestations of affective disorders in neuropsychiatric form systemic lupus erythematosus, without evaluating the problems of their etiopathogenesis. Thereby, the aim of this review is the integration of information on the pathological mechanisms of depression and anxiety in patients with systemic lupus erythematosus. The available data on the biological aspects of the anxiety and depression in systemic lupus erythematosus indicate that the complex pathological models may be the best approach for studying, diagnosing, and treating comorbid pathology. The latter can be based on expanding the existing clinical categories, supplementing them with data on pathological mechanisms specific to particular sub-cohorts of patients. Such an approach can provide the specific and most effective preventive, diagnostic and therapeutic measures for each category of patients.