Neuropsychiatric manifestations of systemic lupus erythematosus: Iranian experience

Borhani‐Haghighi, Afshin; Haza, Shahab Ghasem

doi:10.4103/0972-2327.64633

Cited by 16 publications

(11 citation statements)

References 14 publications

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“…Although several past studies reported a low prevalence of psychosis [5,7,22], our study finding (43%) correlated with the ones from Western India (75%) [30], Thailand (22.3%) [26], and Iran (26.4%) [11] where psychosis was among the most frequently reported symptoms. Cerebrovascular disease was the least common manifestation among our participants (7%) which was consistent with previous reports (2-15%) and the possible pathomechanisms include bleeding, atherosclerosis, hypertension, and coagulopathy [11,31]. Although associations between sociodemographic factors and NPSLE development are rare in the literature [10,32], our study findings denoted a difference.…”

Section: Discussionsupporting

confidence: 91%

Pattern and prevalence of neuropsychiatric lupus: a retrospective study from a tertiary level hospital in Bangladesh

Hossain

Hawlader

Mitra

et al. 2021

Egypt J Neurol Psychiatry Neurosurg

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Background Neuropsychiatric systemic lupus erythematosus (NPSLE) is well known for its varying presentations and poor outcomes, but little is evident about its distribution and characteristics among the Bangladeshi population. This study aimed to assess the pattern and prevalence of neuropsychiatric symptoms in female systemic lupus erythematosus (SLE) patients of Bangladesh. A retrospective study was conducted at a tertiary care hospital in Dhaka, Bangladesh, between January and December 2018. One hundred female SLE patients were included in the study purposively. Data were collected on sociodemographic and clinical characteristics of diagnosed SLE cases visiting the SLE clinic and indoor medicine department. Neuropsychiatric (NP) syndromes were defined according to the widely accepted American College of Rheumatology (ACR) nomenclature and case definitions. Results A total of 244 NP events were identified in fifty-five patients. Headache was the most frequent symptom (55%), followed by cognitive dysfunction (50%), anxiety (49%), psychosis (43%), seizure (23%), depression (17%), and cerebrovascular disease (ischemic type, 7%). The NP manifestations were more prevalent among urban residents (58.2%), younger patients (41.8%), and patients with graduate-level education (34.5%). Besides, young age at diagnosis (p = 0.038), Raynaud’s phenomenon (p = 0.015), other organ involvement (p < 0.001), and time of NPSLE development (p < 0.001) were found to be significantly associated with the development of these manifestations. Conclusion NP damage is prevalent among Bangladeshi female SLE patients (55%) with headache and cognitive dysfunction being the most common symptoms. Routine screening for neuropsychiatric symptoms among suspected SLE cases and further evaluation with a larger population are warranted.

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Section: Discussionsupporting

confidence: 91%

Pattern and prevalence of neuropsychiatric lupus: a retrospective study from a tertiary level hospital in Bangladesh

Hossain

Hawlader

Mitra

et al. 2021

Egypt J Neurol Psychiatry Neurosurg

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“…[ 15 ] In another study in Shiraz University, the NPSLE prevalence was lower (11.3%) that could be because of the retrospective, hospital-based nature of this study, which failed to detect the cases of NPSLE that did not require hospitalization. [ 14 ]…”

Section: Discussionmentioning

confidence: 99%

“…In a retrospective hospital-based study in Fars province, NPSLE was observed in 11.3% of SLE patients. [ 14 ] However, in another study of Tehran, the neuropsychiatric involvement was present in 23.4% of patients. [ 15 ]…”

Section: Introductionmentioning

confidence: 99%

Neuropsychiatric manifestations in patients with systemic lupus erythematosus: A study from Iran

2016

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Background:Neuropsychiatric systemic lupus erythematosus (NPSLE) is a serious and well-known complication of systemic lupus erythematosus (SLE). There is limited evidence about the prevalence of NPSLE and its manifestations in Iran. The aim of this study was to study clinical and demographic characteristics of patients with NPSLE in an Iranian population.Materials and Methods:This was a cross-sectional study that was undertaken in two referral Clinics of Neurological and Rheumatological Disorders in Alzahra Hospital, Isfahan, Iran. Between March 2004 and June 2010, medical records of registered patients with SLE were examined. NPSLE was characterized using the American College of Rheumatology case definitions. Descriptive statistics and logistic regression were performed for statistical assessment.Results:Among 556 patients with SLE, 121 (21.7%) patients were diagnosed as NPSLE and enrolled in the study. Of whom, 94 patients were female (77.7%) and 27 patients were male (22.3%) with a female to male ratio of 3.48:1. The most common NPSLE manifestations were headache (38.8%), cerebrovascular disease (CVD) (38.8%) and seizure (26.4%). Thirty-nine patients have psychiatric disorders. Among them, 32 patients (26.4%) have periods of psychosis and mood disorder was found in 6 patients (5%).Conclusions:We identified NPSLE manifestations in 21.7% of patients; headache and CVD were the most frequent neurological manifestations. Continued studies into the pathogenesis of neurological involvement in patients with SLE are warranted.

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“…This disease has an unidentified etiology. Genetic factors and environmental stressors cause imbalanced immune system, leading to the production of antibodies and development of clinical symptoms (3).…”

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confidence: 99%

Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic lupus Erythematosus (SLE) Patients

Sahebari

Ebrahimabad

Shoraketokanlo

et al. 2019

IJPS

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Objective: The aim of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT) in the reduction of disappointment, psychological distress, and psychasthenia among patients with systemic lupus erythematosus (SLE). Method: This quasi-experimental study was conducted on 24 females with lupus who referred to the Rheumatoid Disease Research Center (RDRC) of Ghaem hospital in Mashhad, Iran. This study had a pretest-posttest control group design. The participants were randomly assigned into 2 groups of experimental and control. The experimental group was treated with ACT. Data were collected using the Beck’s Hopelessness Scale, Kessler’s Psychological Distress Inventory, and Krupp’s Psychasthenia Inventory. Results: Mean age and mean duration of illness were 37.25±4.61 and 5.12±2.33 years, respectively. The mean disappointment score and psychological distress in the experimental group were lower compared to those in control group at the post experimental stage (P<0.001). Moreover, there was a significant difference between the experimental and control groups in the mean scores of psychasthenia in the posttest stage (P<0.001). Conclusion: According to the obtained results of this study, the enhancement of psychological flexibility based on ACT positively affected disappointment, psychological distress, and psychasthenia among the lupus patients. Therefore, it can be concluded that this therapeutic approach could reduce psychasthenia in patients through clarification of the values.

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Neuropsychiatric manifestations of systemic lupus erythematosus: Iranian experience

Cited by 16 publications

References 14 publications

Pattern and prevalence of neuropsychiatric lupus: a retrospective study from a tertiary level hospital in Bangladesh

Pattern and prevalence of neuropsychiatric lupus: a retrospective study from a tertiary level hospital in Bangladesh

Neuropsychiatric manifestations in patients with systemic lupus erythematosus: A study from Iran

Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic lupus Erythematosus (SLE) Patients

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