Mental disorders in patients with systemic lupus erythematosus: association with activity and the course of rheumatic disease

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Abstract

Aim. To clarify the relationship between the clinical and psychopathological features of mental disorders, clinical and laboratory manifestations of activity and the nature of the course of systemic lupus erythematosus (SLE).

Materials and methods. The study included 119 patients – 98 (82.4%) women, mean age 36.5±12.4 years (M±SD) – with a reliable diagnosis of SLE (EULAR/ACR 2019 criteria), 51 (29.5%) of them – with secondary antiphospholipid syndrome – APS (International criteria of 2006).

Results. Among patients with SLE a high frequency of anxiety-depressive spectrum disorders (ADSD) and cognitive impairment (CI) was revealed. There was an association of greater severity of depression with high SLE activity index, acute/subacute onset of the disease course according to the classification of V.A. Nasonova, relapsing-remitting and chronic active current disease activity patterns of SLE according to the classification of S. Barr – M. Petri. Anxiety disorders were associated with subacute onset and relapsing-remitting disease activity patterns of SLE and were not associated with SLE activity index. Bipolar disorder was detected more often in patients with chronic SLE. Acute psychosis/delirium was associated with acute onset of SLE. Organic CI was associated with APS, chronic onset and long quiescent disease activity patterns of SLE. The episindrome and schizotypal disorder in patients with SLE are more often caused by concomitant APS.

Conclusion. Patients with high SLE activity index should be of particular concern to rheumatologists regarding the diagnosis of depressive disorders. Patients with concomitant APS need timely diagnosis and treatment of CI and episindrome in order to improve the prognosis of the disease and the overall quality of life.

About the authors

Anastasia B. Borisova

Moscow Research Institute of Psychiatry – branch of the Serbsky National Medical Research Center of Psychiatry and Narcology; Nasonova Research Institute of Rheumatology

Author for correspondence.
Email: desolatorius@yandex.ru
ORCID iD: 0000-0001-6802-0268

младший научный сотрудник отд-ния психических расстройств при соматических заболеваниях Московского НИИ психиатрии – филиала ФГБУ «НМИЦ ПН имени В.П. Сербского», младший научный сотрудник лаборатории тромбовоспаления ФГБНУ «НИИ ревматологии им. В.А. Насоновой»

Russian Federation, Moscow; Moscow

Tatiana A. Lisitsyna

Nasonova Research Institute of Rheumatology

Email: desolatorius@yandex.ru
ORCID iD: 0000-0001-9437-406X

доктор медицинских наук, ведущий научный сотрудник лаборатории тромбовоспаления

Russian Federation, Moscow

Dmitry Yu. Veltishchev

Moscow Research Institute of Psychiatry – branch of the Serbsky National Medical Research Center of Psychiatry and Narcology; Pirogov Russian National Research Medical University

Email: desolatorius@yandex.ru
ORCID iD: 0000-0001-5210-2605

руководитель отд. трансдисциплинарных исследований Московского НИИ психиатрии – филиала ФГБУ НМИЦ ПН, профессор кафедры психиатрии фак-та дополнительного профессионального образования ФГАОУ ВО РНИМУ

Russian Federation, Moscow; Moscow

Tatiana M. Reshetnyak

Nasonova Research Institute of Rheumatology

Email: desolatorius@yandex.ru
ORCID iD: 0000-0003-3552-2522

доктор медицинских наук, профессор зав. лаборатории тромбо-воспаления

Russian Federation, Moscow

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