BackgroundStudies on cognitive impairment in patients with past history of neuropsychiatric lupus (NPSLE) were often confounded by psychiatric and other disease related factors.ObjectivesThis study aims to evaluate cognitive function in NPSLE patients in relation to psychiatric factors longitudinally in comparison to matched controls.MethodsNPSLE patients and matched disease and healthy controls were examined by full battery of neurocognitive tests that covered 8 cognitive domains at 2 time-points 12 months apart. Depressive and anxiety symptoms were measured by HADS.Results18 NPSLE and 18 patients with systemic lupus erythematosus (SLE) who had no previous cerebral involvement (non-NPSLE) matched to age, sex and disease duration, and 16 age- and sex- matched healthy subjects were recruited. NPSLE patients consistently reported more cognitive symptoms and anxiety symptoms than non-NPSLE patients over both time-points. NPSLE patients had significantly worse simple and complex attention, memory, reasoning and visuospatial processing compared to non-NPSLE patients, among which memory and simple attention remained significantly impaired after adjustment to confounders. Anxiety and depressive symptoms were found to have an effect on raw scores but not demographically adjusted T score of neurocognitive tests. Unlike non-NPSLE subjects, NPSLE patients also failed to demonstrate practice effect upon re-evaluation over 12 months. Both NPSLE and non-NPSLE patients had worse memory than healthy subjects, with deficiency in more memory tests for NPSLE patients.ConclusionsNPSLE patients had significantly worse and persistently impaired cognitive functions involving memory, visuospatial processing and complex attention and impaired learning compared to non-NPSLE patients over 12-month re-assessment.Disclosure of InterestNone declared

BackgroundCognitive function and mood disturbance are common in patients with systemic lupus erythematosus (SLE).ObjectivesThis study aims to examine whether SLE patients have more features of adult attention deficit hyperactivity disorder (ADHD) and their relation to anxiety and depressive symptoms.MethodsSymptoms and clinically significant items of the inattention and hyperactivity/impulsivity domains of ADHD were examined in Part A and Part B by the screening instrument of ADHD Self-Reported Scale (ASRS) respectively. Anxiety and depressive symptoms were measured by HADS-A and HADS-D respectively.ResultsThere were no differences in symptom scores of inattention and hyperactivity/impulsivity between inactive SLE patients (n=117) and age- and sex- matched controls (n=64). However, SLE patients had more clinically significant items in the inattention domain compared with controls (p=0.006), particularly among those who had previous cerebral involvement (p=0.004). Patients who had psychiatric diseases had more clinically significant items of the hyperactivity/impulsivity domain (p=0.006). Possible ADHD was found in 7.7% of SLE and 6.3% of healthy subjects (p=1.00) by the screening tool. Patients with higher inattention symptom scores were more likely to be unemployed but not for duration of education and smoking habit. Anxiety and depressive symptoms correlated with ADHD symptoms. HADS-A was independent predictive factor for clinically significant symptoms of inattention (p<0.001) and hyperactivity/impulsivity (p=0.04) by logistic regression.ConclusionsInactive SLE patients, particularly those who had previous cerebral lupus, had more clinically significant symptoms of inattention but not hyperactivity/impulsivity reflecting underlying cognitive impairment. Anxiety and depressive symptoms were common confounders for ADHD-like symptoms.Disclosure of InterestNone declared