Background Mental disorders (MD) in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) patients has been poorly described and recognized.
Objective To describe the frequency and spectrum of mental disorders in SLE and APS patients.
Methods 71 patients with mean (M±SD) age 38,8±11,7 years were enrolled in the study: 21 of proven SLE patients, 26 – SLE with secondary APS and 24 – with proven primary APS (PAPS). 54 (76,1%) patients were women. SLE activity was measured by SLEDAI scale. MD were diagnosed by psychiatrist in accordance with the Hospital Anxiety and Depression Scale (HADS) and ICD-10 in semi-structured interview. The severity of depression and anxiety was evaluated by Montgomery–Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A). CD were diagnosed with psychology and neuropsychology methods.
Results The patients with SLE, SLE+APS and PAPS didn’t differ in age, but in PAPS group men met more often. The groups didn’t differ in SLE activity. The rate of MD (mainly anxiety-depressive disorders) were high, highest in SLE patients. Recurrent depressive disorder met more often. The prevalence of anxiety-depressive disorders: recurrent depressive disorder, single depressive disorder, dysthymia, generalized anxiety disorder was significantly higher in SLE than in SLE+APS groups (p=0,03). Bipolar disorder didn’t meet in PAPS patients. Epileptic syndrome met more often (ns) in SLE+APS patients. The prevalence of schizotypal disorder was higher (ns) in patients with SLE (SLE and SLE+APS groups) (also higher than in population). Vascular dementia was diagnosed more often (ns) in APS patients (SLE+APS and PAPS groups). The rate of cognitive difficulties was very high in all groups, with predominance of mild and moderate impairment.
Conclusion Chronic depressive and cognitive disorders are typical for patients with SLE, SLE+APS and PAPS. Mild and moderate cognitive disorders diagnosed in PAPS-patients significantly more often (p<0,05) than in SLE patients without APS.
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