Presence of psychiatric diagnoses (n=275)* in patients with SLE visiting the Leiden NPSLE clinic (N=371) with neuropsychiatric symptoms of an inflammatory or a non-inflammatory origin
| All patients (n=371) | Non-inflammatory phenotype (n=291) | Inflammatory phenotype† (n=80) | |
| DSM-5 diagnosis at presentation, number of patients (%) | |||
| Neurodevelopmental Disorders | 5 (1) | 2 (1) | 3 (4) (0/3)‡ |
| Schizophrenia Spectrum and Other Psychotic Disorders | 16 (4) | 11 (4) | 5 (6) (5/5) |
| Bipolar and Related Disorders | 7 (2) | 5 (2) | 2 (3) |
| Depressive Disorders | 84 (23) | 74 (25) | 10 (13) (9/10) |
| Anxiety Disorders | 17 (5) | 16 (6) | 1 (1) (0/1) |
| Obsessive-Compulsive and Related Disorders | 1 (0) | 1 (0) | 0 (0) |
| Trauma- and Stressor-Related Disorders | 16 (4) | 13 (4) | 3 (4) (0/3) |
| Dissociative Disorders | 2 (1) | 2 (1) | 0 (0) |
| Somatic Symptom and Related Disorders | 1 (0) | 1 (0) | 0 (0) |
| Feeding and Eating Disorders | 0 (0) | 0 (0) | 0 (0) |
| Elimination Disorders | 0 (0) | 0 (0) | 0 (0) |
| Sleep–Wake Disorders | 2 (1) | 2 (1) | 0 (0) |
| Sexual Dysfunctions | 0 (0) | 0 (0) | 0 (0) |
| Gender Dysphoria | 0 (0) | 0 (0) | 0 (0) |
| Disruptive, Impulse-Control and Conduct Disorders | 0 (0) | 0 (0) | 0 (0) |
| Substance-Related and Addictive Disorders | 9 (2) | 8 (3) | 1 (1) (0/1) |
| Cognitive Disorders§ | 93 (25) | 60 (21) | 33 (41) (16/33) |
| Personality Disorders | 10 (3) | 9 (3) | 1 (1) (0/1) |
| Paraphilic Disorders | 0 (0) | 0 (0) | 0 (0) |
| Other Mental Disorders | 12 (3) | 7 (2) | 5 (6) (0/5) |
| Medication-Induced Movement Disorders and Other Adverse Effects of Medication | 0 (0) | 0 (0) | 0 (0) |
| None | 131 (35) | 107 (37) | 24 (30) |
| Unknown | 3 (1) | 2 (1) | 1 (1) |
*240 of 371 patients received a psychiatric diagnosis, of whom 208 received one diagnosis and 32 patients received two or more diagnoses.
†An inflammatory phenotype indicates that neuropsychiatric symptoms were attributed to lupus activity in the multidisciplinary assessment based on clinical, radiological and laboratory assessment. One patient with an inflammatory phenotype had transverse myelitis and a depressive disorder triggered by the somatic disorder.
‡(n/total n) indicates the number of patients with an inflammatory phenotype who received immunosuppressive therapy solely for this specific psychiatric manifestation.
§Cognitive disorder after exclusion of patients with other psychiatric disorders. Acute confusional state is considered a (neuro)cognitive disorder.
DSM-5, Diagnostic and Statistical Manual of Mental Disorders; NPSLE, neuropsychiatric SLE.