Neuropsychiatric Manifestations in Systemic Autoimmune Diseases

Autoimmune diseases are heterogeneous, multifactorial disorders defined by a loss of immunological tolerance to self-antigens, resulting in chronic inflammation and tissue damage. Even though the immune system dysregulation most commonly elicits physical symptoms, neuropsychiatric manifestations are frequently observed in autoimmune diseases and are associated with increased morbidity, elevated mortality, and a marked decline in health-related quality of life. Although extensively characterized in systemic lupus erythematosus (SLE) due to its epidemiological relevance and diagnostic complexity, neuropsychiatric involvement holds clinical significance across a wider spectrum of rheumatologic disorders. The frequent co-occurrence of connective tissue disorders with mood and anxiety symptoms suggests shared etiological mechanisms. The early identification of neuropsychiatric manifestations in patients with chronic autoimmune diseases represents the cornerstone of clinical management, given the substantial impact these symptoms have on individuals already burdened by debilitating conditions. We reviewed the principal neuropsychiatric manifestations associated with selected systemic autoimmune diseases: the novelty of this research lies not only in its approach to autoimmune-related neuropsychiatric symptoms but also in the special emphasis placed on the immunopathogenic mechanisms potentially responsible for these manifestations and, more significantly, on therapeutic decision-making, including an evaluation of treatment strategies targeting immune dysregulation and their potential impact on the neuropsychiatric profile, to optimize clinical outcomes and ensure patients have a comprehensive cure.