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Neuropsychiatric Systemic Lupus Erythematosus pp 129–140Cite as

Psychiatric Symptoms

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Abstract

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.

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Authors and Affiliations

  1. Department of Psychiatry, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan

    Katsuji Nishimura

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  1. Katsuji Nishimura
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Correspondence to Katsuji Nishimura .

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Editors and Affiliations

  1. Department of Rheumatology, Nobubara Hospital, Tatsuno, Hyogo, Japan

    Shunsei Hirohata

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Nishimura, K. (2018). Psychiatric Symptoms. In: Hirohata, S. (eds) Neuropsychiatric Systemic Lupus Erythematosus. Springer, Cham. https://doi.org/10.1007/978-3-319-76496-2_9

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