Psychiatric Disorders among Subjects with Systemic Lupus Erythematosus in an Unselected Population

Líndal, Eiríkur; Thorlacius, Sigurður; Steinsson, Kristján; Stefánsson, Jón G.

doi:10.3109/03009749509095179

Cited by 29 publications

(12 citation statements)

References 19 publications

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“…Panic disorder was also more common, with rates up to 2.5 times higher. Few studies have examined anxiety and bipolar disorders in patients with SLE, although elevated rates of such disorders are consistent with results from smaller clinical samples (3, 5, 14) and those of Lindal et al (13), who studied an unselected population of 62 Icelandic patients with SLE. Lindal et al (13) found an increase in specific phobia, with a lifetime prevalence (26%) almost identical to ours, and similar to our study found a 2.5‐fold increase in panic disorder.…”

Section: Discussionsupporting

confidence: 60%

“…Although most research has focused on depressed mood or clinical unipolar depression in people with SLE, other research suggests that symptoms of anxiety may be equally important in this population. In an Icelandic study of 62 patients with SLE, diagnoses of agoraphobia with and without panic, specific phobia, and social phobia were more prevalent in patients with SLE than in the general population (13). Segui et al (6) reported that among 20 female patients with SLE, 40% met criteria for a psychiatric disorder, with generalized anxiety disorder (GAD) and panic disorder being the most common diagnoses.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of mood and anxiety disorders in women with systemic lupus erythematosus

Bachen¹,

Chesney²,

Criswell³

2009

Arthritis & Rheumatism

267

178

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Objective. To examine the lifetime prevalence of mood and anxiety disorders in patients with systemic lupus erythematosus (SLE). Demographic and disease-related variables were examined for association with lifetime major depressive disorder (MDD) and the presence of any mood or anxiety disorder. Methods. Three hundred twenty-six white women with SLE completed the Composite International Diagnostic Interview and the Systemic Lupus Activity Questionnaire, a self-report measure of SLE disease activity. The binomial test was used to compare the prevalence of psychiatric diagnoses in patients with SLE with a population sample of white women. Results. Sixty-five percent of the participants received a lifetime mood or anxiety diagnosis. MDD (47%), specific phobia (24%), panic disorder (16%), obsessive-compulsive disorder (9%), and bipolar I disorder (6%) were more common among patients with SLE than among other white women (P ‫؍‬ 0.00009 for specific phobia; for all other values P ‫؍‬ 0.00001). Although most patients with histories of mood disorders reported their psychiatric symptoms to a medical provider, a substantial number of patients with anxiety disorders did not. Self-reported disease activity was associated with a lifetime history of MDD (P ‫؍‬ 0.001) and presence of a mood or anxiety disorder (P ‫؍‬ 0.001), after controlling for demographic and clinical characteristics. Conclusion. Several mood and anxiety disorders were more common in women with SLE compared with the general population, and disease activity may contribute to this higher risk. Brief self-report questionnaires may help providers identify patients with these conditions, particularly when patients are reluctant to disclose their symptoms.

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Prevalence of mood and anxiety disorders in women with systemic lupus erythematosus

Bachen¹,

Chesney²,

Criswell³

2009

Arthritis & Rheumatism

267

178

View full text Add to dashboard Cite

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“…The reasons for this comorbidity are unclear. In a community sample in Iceland, it was found that social phobia was more common in individuals with Systemic Lupus Erythematosus than the general population [Lindal et al, 1995]. It is possible that particular aspects of autoimmune conditions, such as disfiguring skin rashes and arthritic changes, might lead to embarrassment and social withdrawal; however, we were unable to find studies demonstrating an association between diabetes, rheumatoid arthritis, or thyroid diseases with social phobia.…”

Section: Phobiascontrasting

confidence: 42%

The relationship between anxiety disorders and physical disorders in the U.S. National Comorbidity Survey

et al. 2005

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Although depression has clearly been shown to be associated with physical disorders, few studies have examined whether anxiety disorders are independently associated with medical conditions after adjusting for comorbid mental disorders. We examined the relationship between anxiety disorders and a wide range of physical disorders in a nationally representative sample. Data came from the National Comorbidity Survey (N=5,877, range=age 15-54 years, response rate=82.4%). The Composite International Diagnostic Interview [Kessler et al., 1998] was used to make DSM-III-R [American Psychiatric Association, 1987] mental disorder diagnoses. Physical disorders were assessed based on a list of several conditions shown to respondents. All analyses utilized multiple logistic regression to examine the relationship between past-year anxiety disorder diagnosis and past-year chronic physical disorder. Anxiety disorders were positively associated with physical disorders even after adjusting for mood disorders, substance-use disorders, and sociodemographics. Among respondents with one or more physical disorders, a comorbid anxiety disorder diagnosis was associated with an increased likelihood of disability even after adjusting for severity of pain, comorbid mood, and substance use disorders. Among specific anxiety disorders, posttraumatic stress disorder, panic attacks, and agoraphobia were more likely to be associated with specific physical disorders than generalized anxiety disorder, social phobia, or simple phobia. There is a strong and unique association between anxiety disorders and physical disorders. Clinically, the presence of an anxiety disorder among patients with physical disorders may confer a greater level of disability.

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“…Group B included patients without psychiatric manifestations other than anxiety. We did not include in group A patients with anxiety disturbance alone because in most SLE patients anxiety is considered a secondary stress reaction and not a direct manifestation of NPSLE [1,2,9-11]. …”

Section: Methodsmentioning

confidence: 99%

“…The diagnosis of psychiatric syndromes in SLE is difficult and depends on the exclusion of complications due to an iatrogenic effect of drugs, to metabolic abnormalities, or to infections [5-8]. Moreover, the diagnosis requires a careful psychiatric evaluation to exclude merely reactive psychological disturbances; in particular, anxiety may reflect a reactive process rather than a feature of NPSLE [1,2,9-11]. …”

Section: Introductionmentioning

confidence: 99%

Autoantibody profile in systemic lupus erythematosus with psychiatric manifestations: a role for anti-endothelial-cell antibodies

et al. 2004

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This study was performed to determine the correlation between psychiatric manifestations and several autoantibodies that might participate in the pathogenesis of psychiatric disorders in the course of systemic lupus erythematosus (SLE). Fifty-one unselected outpatients with SLE were enrolled. Psychiatric evaluation was performed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. The prevalence of antibodies against endothelial cells (AECA), cardiolipin, β2 glycoprotein I, Ro, Ro52, La, glial fibrillary acidic protein, ribosomal P protein, dsDNA, and nucleosomes was assessed by experimental and commercial enzyme-linked immunosorbent assays. According to the cutoff value, AECA were present in 11 of 17 (64.7%) SLE patients with psychosis and mood disorders and in 10 of 34 (29.4%) patients without psychiatric manifestations other than anxiety (P = 0.03). Moreover, the AECA binding index was significantly higher in the first group (P = 0.03). Conversely, no significant correlation was found between the presence of the other autoantibodies studied and psychiatric involvement. The results of this study suggest a relationship between AECA and psychosis and mood disorders in SLE, supporting the hypothesis of a biological origin of these disturbances.

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Psychiatric Disorders among Subjects with Systemic Lupus Erythematosus in an Unselected Population

Cited by 29 publications

References 19 publications

Prevalence of mood and anxiety disorders in women with systemic lupus erythematosus

Prevalence of mood and anxiety disorders in women with systemic lupus erythematosus

The relationship between anxiety disorders and physical disorders in the U.S. National Comorbidity Survey

Autoantibody profile in systemic lupus erythematosus with psychiatric manifestations: a role for anti-endothelial-cell antibodies

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