TY  - JOUR
EP  - 289
AV  - public
Y1  - 2019/02//
TI  - Psychosis in Systemic Lupus Erythematosus
KW  - Outcome
KW  -  Psychosis
KW  -  Systemic lupus erythematosus
ID  - discovery10061149
N2  - 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±SD age was 35.1±13.3 years, disease duration 5.6±4.2 months and follow-up 7.4±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.
N1  - 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.
IS  - 2
VL  - 71
SP  - 281
A1  - Hanly, JG
A1  - Li, Q
A1  - Su, L
A1  - Urowitz, MB
A1  - Gordon, C
A1  - Bae, S-C
A1  - Romero-Diaz, J
A1  - Sanchez-Guerrero, J
A1  - Bernatsky, S
A1  - Clarke, AE
A1  - Wallace, DJ
A1  - Isenberg, DA
A1  - Rahman, A
A1  - Merrill, JT
A1  - Fortin, PR
A1  - Gladman, DD
A1  - Bruce, IN
A1  - Petri, M
A1  - Ginzler, EM
A1  - Dooley, MA
A1  - Steinsson, K
A1  - Ramsey-Goldman, R
A1  - Zoma, AA
A1  - Manzi, S
A1  - Nived, O
A1  - Jonsen, A
A1  - Khamashta, MA
A1  - Alarcón, GS
A1  - van Vollenhoven, RF
A1  - Aranow, C
A1  - Mackay, M
A1  - Ruiz-Irastorza, G
A1  - Ramos-Casals, M
A1  - Sam Lim, S
A1  - Inanc, M
A1  - Kalunian, KC
A1  - Jacobsen, S
A1  - Peschken, CA
A1  - Kamen, DL
A1  - Askanase, A
A1  - Theriault, C
A1  - Farewell, V
JF  - Arthritis & Rheumatology
SN  - 2326-5205
UR  - https://doi.org/10.1002/art.40764
ER  -