Psychiatric Symptoms

  • Katsuji Nishimura


Psychiatric symptoms often occur in patients with systemic lupus erythematosus (SLE). According to the American College of Rheumatology (ACR) research committee criteria for neuropsychiatric SLE (NPSLE) in 1999, the psychiatric symptoms include acute confusional state (delirium), anxiety disorder, cognitive dysfunction, mood disorder, and psychosis. Because no diagnostic gold standard exists for primary NPSLE, it is often difficult to distinguish primary cause-and-effect association of the symptom as a direct attribute of active disease from a secondary, indirect effect resulting from complications of the disease or its therapy (e.g. corticosteroids), or an effect unrelated to SLE. On one hand, conditions such as psychosis, anxiety disorder and mood disorder can also present as psychological reaction to the disease and the related stress. On the other hand, possible mechanisms include microvasculopathy and thrombosis, or autoantibodies and inflammatory mediators. Therefore, in lupus patients presenting with psychiatric symptoms, a careful diagnostic work-up including, but not limited to, psychiatric/neuropsychological assessment, immunological/medical investigation, as well as neuroimaging is crucial in delivering adequate medical care and treatment.


Lupus Psychosis Depression Anxiety Acute confusional state Cognitive dysfunction 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychiatryTokyo Women’s Medical University School of MedicineTokyoJapan

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