Psychiatric Manifestations of Systemic Lupus Erythematosus Patients in a Tertiary Care Hospital: A Cross-sectional Study

Aim and background: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with diverse neuropsychiatric manifestations which are classified and diagnosed under ACR 1999 guidelines and contribute significantly to overall disease morbidity and mortality. Data are scarce regarding neuropsychiatric manifestations of SLE in Eastern India as well as the utility of psychiatric rating scales for classifying, assessing disease severity, and prognostication. This study focuses on deriving the prevalence of psychiatric manifestations among SLE patients and their correlation with disease severity using several psychiatric rating scales and markers of disease severity. Methods: This is a single center-based cross-sectional study involving 50 consented adult SLE patients fulfilling Systemic Lupus Erythematosus International Collaboration Committee (SLICC) criteria at NRS Medical College & Hospital over 18 months using a pretested questionnaire that includes psychiatric rating scales as well as disease severity assessment tools. Patients with drug abuse, pre-existing psychiatric disorders, dyselectrolytemia, and ongoing infection were excluded from the study. Results: All the participants had anxiety disorder (100%) followed by depression (80%), psychosis (58%), mood disorders (54%), and cognitive dysfunction (8%). Systemic lupus activity measure, revised (SLAM-R) score had a positive correlation with General Health Questionnaire (GHQ) (<italic>r</italic> = 0.518, <italic>p</italic> < 0.05) and brief psychiatric rating scale (BPRS) (<italic>r</italic> = 0.589, <italic>p</italic> < 0.05). Brief psychiatric rating scale and GHQ had a positive correlation between them (<italic>r</italic> = 0.774, <italic>p</italic> < 0.05). Conclusion: Psychiatric manifestations of SLE are quite prevalent in the study niche and their clinical severity is comparable to that estimated using screening questionnaires and disease severity tools used in this study. Clinical significance: This study showed positive implications of implementing psychiatric rating scales as a screening tool in SLE patients for early diagnosis of psychiatric manifestations and use as corroborative measures of disease severity.