Neuropsychiatric manifestations are not uncommon in Indian lupus patients and negatively affect quality of life. (April 2018)

• Record Type: Journal Article
• Authors: Muhammed, H; Goyal, M; Lal, V; Singh, S; Dhir, V
• Is Part Of: Lupus. Volume 27:Number 4(2018)
• Page Start: 688
• Page End: 693
• Publication Date: 2018-04
• Subjects: Systemic lupus erythematosus -- neuropsychiatric manifestations; Systemic lupus erythematosus -- Periodicals; 616.772005
• DOI: 10.1177/0961203317747720
• Languages: English
• ISSNs: 0961-2033

Abstract

Objectives: The objectives of this paper are to look at the prevalence of neuropsychiatric manifestations and assess their impact on quality of life in North Indian lupus patients. Methods: The study included consecutive patients with systemic lupus erythematosus (SLE) who were older than 18 years and met the SLICC 2012 criteria. A diagnosis of a neuropsychiatric syndrome was made as per ACR 1999 definitions. Manifestations occurring at any point in time after the diagnosis of SLE were considered if a reliable history and medical records were available. Quality of life was assessed by EuroQol-5D questionnaire. Means were compared by student t test for normally distributed data. Comparison of quality of life between groups was performed by the Kruskal–Wallis test and Mann–Whitney U test. Results: This study included 101 patients of SLE with mean (±SD) age of 32.3 ± 10.0 years and a majority ( n = 92) were females. Mean (±SD) age of diagnosis of SLE was 27.8 ± 9.2 years and disease duration (after diagnosis) was 4.6 ± 4.5 years. Thirty-three patients had neuropsychiatric manifestations with a total of 42 events. The most common manifestation was headache (10%) followed by anxiety disorder (5%) and peripheral neuropathy (9%). Other NPSLE syndromes observed in the study are seizure (4%), cognitive dysfunction (4%), depression (4%), acute confusional state (2%), autonomic neuropathy (2%), movement disorder (1%), and mononeuritis multiplex (1%). On comparing the groups of NPSLE, nephritis, and neither, there was a significant difference in mobility, self-care, pain, and worry. On post hoc test, there was a significant difference between the NPSLE and neither group. Conclusion: Neuropsychiatric manifestations significantly affect quality of life in North Indian SLE patients.