Predictive factors of psychiatric syndrome in patients with systemic lupus erythematosus

• DOI: 10.3389/fimmu.2024.1323209
• Publication Date: 2024-03-21T04:54:27Z
• Authors: Wenqi Geng; Shangzhu Zhang; Jinya Cao; Xia Hong; Yanping Duan; Yinan Jiang; Jing Wei
• Keywords: 0301 basic medicine; Immunology; Lupus Vasculitis, Central Nervous System; biomarkers; neuropsychiatric systemic lupus erythematosus; RC581-607; referral consultation; mental disorders; 03 medical and health sciences; systemic lupus erythematosus; Antibodies, Anticardiolipin; Antibodies, Antiphospholipid; Humans; Lupus Erythematosus, Systemic; Immunologic diseases. Allergy; Retrospective Studies; Autoantibodies

IntroductionEarly detection of neuropsychiatric systemic lupus erythematosus (NPSLE) remains a challenge in clinical settings. Previous studies have found different autoantibodies as markers for NPSLE. This study aimed to describe the distribution of psychiatric syndromes in a group of patients with systemic lupus erythematosus (SLE) and to investigate the association between psychiatric syndromes and specific autoantibodies.MethodsThis retrospective study was conducted at a single medical center in China. We reviewed medical records of hospitalized patients with SLE who were consulted by psychiatrists due to potential mental disorders. Results of serum autoantibodies and general laboratory tests were collected. The correlation between clinical variables was examined. Binary logistic regression analyses were used to determine factors related to NPSLE and different psychiatric diagnoses.ResultsAmong the 171 psychiatric manifestations in 160 patients, 141 (82.4%) were attributed to SLE. Acute confusional state (ACS) had the highest prevalence (57.4%). Anti-cardiolipin (ACL) antibody (X2 = 142.261, p < 0.001) and anti-β2 glycoprotein I (-β2GP1) antibody (X2 = 139.818, p < 0.001) varied significantly between groups, with the highest positive rate found in patients with mood disorders (27.3% and 18.2%). SLE disease activity index – 2000 (SLEDAI-2K) score excluding item ACS and item psychosis was a predictor of NPSLE (OR 1.172 [95% CI 1.105 - 1.243]).ConclusionsDisease activity reflected by SLEDAI-2K score is a predictor for NPSLE. Antiphospholipid antibodies are associated with mood disorders in SLE. Further separate investigation of neuropsychiatric disorders is needed in order to better comprehend NPSLE’s pathological mechanism.