Psychosis in Systemic Lupus Erythematosus: Results From an International Inception Cohort Study

被引：48

作者：

Hanly, John G. ^{[1
,2
]}

Li, Qiuju ^{[3
]}

Su, Li ^{[3
]}

Urowitz, Murray B. ^{[4
,5
]}

Gordon, Caroline ^{[6
]}

Bae, Sang-Cheol ^{[7
]}

Romero-Diaz, Juanita ^{[8
]}

Sanchez-Guerrero, Jorge ^{[4
,5
]}

Bernatsky, Sasha ^{[9
]}

Clarke, Ann E. ^{[10
]}

Wallace, Daniel J. ^{[11
,12
]}

Isenberg, David A. ^{[13
]}

Rahman, Anisur ^{[13
]}

Merrill, Joan T. ^{[14
]}

Fortin, Paul R. ^{[15
]}

Gladman, Dafna D. ^{[4
,5
]}

Bruce, Ian N. ^{[16
,17
]}

Petri, Michelle ^{[18
]}

Ginzler, Ellen M. ^{[19
]}

Dooley, M. A. ^{[20
]}

Steinsson, Kristjan ^{[21
]}

Ramsey-Goldman, Rosalind ^{[22
]}

Zoma, Asad A. ^{[23
]}

Manzi, Susan ^{[24
]}

Nived, Ola ^{[25
]}

Jonsen, Andreas ^{[25
]}

Khamashta, Munther A. ^{[26
]}

Alarcon, Graciela S. ^{[27
]}

van Vollenhoven, Ronald F. ^{[28
]}

Aranow, Cynthia ^{[29
]}

Mackay, Meggan ^{[29
]}

Ruiz-Irastorza, Guillermo ^{[30
]}

Ramos-Casals, Manuel ^{[31
]}

Lim, S. Sam ^{[32
]}

Inanc, Murat ^{[33
]}

Kalunian, Kenneth C. ^{[34
]}

Jacobsen, Soren ^{[35
]}

Peschken, Christine A. ^{[36
]}

Kamen, Diane L. ^{[37
]}

Askanase, Anca ^{[38
]}

Theriault, Chris ^{[1
,2
]}

Farewell, Vernon ^{[3
]}

机构：

[1] Queen Elizabeth 2 Hlth Sci Ctr, Halifax, NS, Canada

[2] Dalhousie Univ, Halifax, NS, Canada

[3] Univ Cambridge, Cambridge, England

[4] Toronto Western Hosp, Toronto, ON, Canada

[5] Univ Toronto, Toronto, ON, Canada

[6] Univ Birmingham, Birmingham, W Midlands, England

[7] Hanyang Univ Hosp Rheumat Dis, Seoul, South Korea

[8] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico

[9] McGill Univ, Montreal, PQ, Canada

[10] Univ Calgary, Calgary, AB, Canada

[11] Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA

[12] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

[13] UCL, London, England

[14] Oklahoma Med Res Fdn, 825 NE 13th St, Oklahoma City, OK 73104 USA

[15] Univ Laval, CHU Quebec, Quebec City, PQ, Canada

[16] Univ Manchester, Manchester, Lancs, England

[17] Manchester Univ NHS Fdn Trust, Manchester, Lancs, England

[18] Johns Hopkins Univ, Sch Med, Baltimore, MD USA

[19] Suny Downstate Med Ctr, Brooklyn, NY 11203 USA

[20] Univ N Carolina, Chapel Hill, NC 27515 USA

[21] Landspitali Univ Hosp, Reykjavik, Iceland

[22] Northwestern Univ, Chicago, IL 60611 USA

[23] Hairmyres Hosp, E Kilbride, Lanark, Scotland

[24] Allegheny Hlth Network, Lupus Ctr Excellence, Pittsburgh, PA USA

[25] Lund Univ, Lund, Sweden

[26] Kings Coll London, Sch Med, St Thomas Hosp, London, England

[27] Univ Alabama Birmingham, Birmingham, AL USA

[28] Karolinska Inst, Stockholm, Sweden

[29] Feinstein Inst Med Res, Manhasset, NY USA

[30] Univ Basque Country, Hosp Univ Cruces, Baracaldo, Spain

[31] Hosp Clin Barcelona, Barcelona, Spain

[32] Emory Univ, Sch Med, Atlanta, GA USA

[33] Istanbul Univ, Istanbul, Turkey

[34] Univ Calif San Diego, Sch Med, La Jolla, CA 92093 USA

[35] Copenhagen Univ Hosp, Rigshosp, Copenhagen, Denmark

[36] Univ Manitoba, Winnipeg, MB, Canada

[37] Med Univ South Carolina, Charleston, SC 29425 USA

[38] NYU, Hosp Joint Dis, New York, NY USA

来源：

ARTHRITIS & RHEUMATOLOGY | 2019年 / 71卷 / 02期

关键词：

NEUROPSYCHIATRIC EVENTS; STEROID PSYCHOSIS; ANTIPHOSPHOLIPID ANTIBODIES; PROTEIN-S; PREVALENCE; DIAGNOSIS; ASSOCIATION; VALIDATION; CRITERIA; CLASSIFICATION;

D O I：

10.1002/art.40764

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To determine, in a large, multiethnic/multiracial, prospective inception cohort of patients with systemic lupus erythematosus (SLE), the frequency, attribution, clinical, and autoantibody associations with lupus psychosis and the short- and long-term outcomes as assessed by physicians and patients. Methods Patients were evaluated annually for 19 neuropsychiatric (NP) events including psychosis. Scores on the Systemic Lupus Erythematosus Disease Activity Index 2000, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, and the Short Form 36 (SF-36) were recorded. Time to event and linear regressions were used as appropriate. Results Of 1,826 SLE patients, 88.8% were female and 48.8% were Caucasian. The mean +/- SD age was 35.1 +/- 13.3 years, the mean +/- SD disease duration was 5.6 +/- 4.2 months, and the mean +/- SD follow-up period was 7.4 +/- 4.5 years. There were 31 psychotic events in 28 of 1,826 patients (1.53%), and most patients had a single event (26 of 28 [93%]). In the majority of patients (20 of 25 [80%]) and events (28 of 31 [90%]), psychosis was attributed to SLE, usually either in the year prior to or within 3 years of SLE diagnosis. Positive associations (hazard ratios [HRs] and 95% confidence intervals [95% CIs]) with lupus psychosis were previous SLE NP events (HR 3.59 [95% CI 1.16-11.14]), male sex (HR 3.0 [95% CI 1.20-7.50]), younger age at SLE diagnosis (per 10 years) (HR 1.45 [95% CI 1.01-2.07]), and African ancestry (HR 4.59 [95% CI 1.79-11.76]). By physician assessment, most psychotic events resolved by the second annual visit following onset, in parallel with an improvement in patient-reported SF-36 summary and subscale scores. Conclusion Psychosis is an infrequent manifestation of NPSLE. Generally, it occurs early after SLE onset and has a significant negative impact on health status. As determined by patient and physician report, the short- and long-term outlooks are good for most patients, although careful follow-up is required.

引用

页码：281 / 289

页数：9

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