Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Lupus. 2011 Jan;20(1):58-66. doi: 10.1177/0961203310381773. Epub 2010 Nov 15.
Psychiatric diagnosis in patients with systemic lupus erythematosus (SLE) is controversial: variations have been reported in frequency, diagnostic assays, associations with disease activity, autoantibodies, and contributing social factors. Eighty-three consecutive non-selected Chilean patients with SLE were evaluated for: (i) 26 common mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), using the Mini-International Neuropsychiatric Interview (MINI-plus); (ii) psychological suffering measured by Hospital Anxiety and Depression Scale (HADS); (iii) ACR 1999 neuropsychiatric (NP)SLE criteria; (iv) SLE disease activity (SLEDAI-2K); (v) cumulative damage (SLICC/ACR); and (vi) anti-ribosomal P antibodies by enzyme-linked immunoassay and immunoblot. Psychiatric diagnoses occurred in 44.6% of patients; the most frequent (21.7%) was major depressive episode (MDE). No association with lupus activity was observed in patients with a DSM-IV diagnosis or MDE or psychological suffering. ACR 1999 NPSLE criteria were present in 42.2% of patients, the majority corresponding to mood (28.9%) or anxiety disorders (15.6%). Suicidal risk was present in 9.6% of patients. Anti-ribosomal P antibodies (13.3%) were not associated with DSM-IV diagnosis. Severe psychiatric disorders in SLE are common and not associated with disease activity.
系统性红斑狼疮（SLE）患者的精神科诊断存在争议：其频率、诊断检测、与疾病活动、自身抗体和相关社会因素的相关性存在差异。对 83 例连续的非选择性智利 SLE 患者进行了评估：（i）根据《精神障碍诊断与统计手册》第四版（DSM-IV）使用 Mini-国际神经精神访谈（MINI-plus）评估 26 种常见精神障碍；（ii）使用医院焦虑抑郁量表（HADS）评估心理痛苦；（iii）ACR 1999 神经精神（NP）SLE 标准；（iv）SLE 疾病活动度（SLEDAI-2K）；（v）累积损伤（SLICC/ACR）；（vi）采用酶联免疫吸附法和免疫印迹法检测抗核糖体 P 抗体。44.6%的患者出现精神科诊断；最常见的（21.7%）是重度抑郁发作（MDE）。在有 DSM-IV 诊断或 MDE 或心理痛苦的患者中，未观察到与狼疮活动相关的情况。42.2%的患者存在 ACR 1999 NPSLE 标准，其中大多数为情绪（28.9%）或焦虑障碍（15.6%）。9.6%的患者存在自杀风险。抗核糖体 P 抗体（13.3%）与 DSM-IV 诊断无关。SLE 中的严重精神障碍很常见，与疾病活动无关。
