@article{discovery10061149,
           title = {Psychosis in Systemic Lupus Erythematosus},
            year = {2019},
         journal = {Arthritis \& Rheumatology},
           month = {February},
          number = {2},
           pages = {281--289},
          volume = {71},
            note = {Copyright {\copyright} 2018 The Authors. Arthritis \& Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.},
             url = {https://doi.org/10.1002/art.40764},
          author = {Hanly, JG and Li, Q and Su, L and Urowitz, MB and Gordon, C and Bae, S-C and Romero-Diaz, J and Sanchez-Guerrero, J and Bernatsky, S and Clarke, AE and Wallace, DJ and Isenberg, DA and Rahman, A and Merrill, JT and Fortin, PR and Gladman, DD and Bruce, IN and Petri, M and Ginzler, EM and Dooley, MA and Steinsson, K and Ramsey-Goldman, R and Zoma, AA and Manzi, S and Nived, O and Jonsen, A and Khamashta, MA and Alarc{\'o}n, GS and van Vollenhoven, RF and Aranow, C and Mackay, M and Ruiz-Irastorza, G and Ramos-Casals, M and Sam Lim, S and Inanc, M and Kalunian, KC and Jacobsen, S and Peschken, CA and Kamen, DL and Askanase, A and Theriault, C and Farewell, V},
            issn = {2326-5205},
        abstract = {OBJECTIVE: To determine, in a multi-ethnic/racial, prospective SLE inception cohort, the frequency, attribution, clinical and autoantibody associations with lupus psychosis and the short and long-term outcome as assessed by physicians and patients. METHODS: Patients were evaluated annually for 19 neuropsychiatric (NP) events including psychosis. SLE disease activity 2000, SLICC/ACR damage index and SF-36 scores were collected. Time to event and linear regressions were used as appropriate. RESULTS: Of 1,826 SLE patients, 88.8\% were female, 48.8\% Caucasian. The mean{$\pm$}SD age was 35.1{$\pm$}13.3 years, disease duration 5.6{$\pm$}4.2 months and follow-up 7.4{$\pm$}4.5 years. There were 31 psychotic events in 28/1,826 (1.53\%) patients and most [(26/28; 93\%)] had a single event. In the majority of patients [20/25; (80\%)] and events [28/31; (90\%)] psychosis was attributed to SLE, usually within 3 years of SLE diagnosis. Positive associations [hazard ratio and 95\% confidence interval [HR (95\%CI)] with lupus psychosis were prior SLE NP events [3.59, (1.16, 11.14), male sex [3.0, (1.20, 7.50)], younger age at SLE diagnosis [(per 10 years younger), 1.45 (1.01, 2.07)] and African ancestry [4.59 (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 outlook is good for most patients, though careful follow-up is required. This article is protected by copyright. All rights reserved.},
        keywords = {Outcome, Psychosis, Systemic lupus erythematosus}
}