Predictive factors of psychiatric syndrome in patients with systemic lupus erythematosus

Wenqi Geng; Shangzhu Zhang; Jinya Cao; Xia Hong; Yanping Duan; Yinan Jiang; Jing Wei

doi:10.3389/fimmu.2024.1323209

Predictive factors of psychiatric syndrome in patients with systemic lupus erythematosus

Front Immunol. 2024 Mar 21:15:1323209. doi: 10.3389/fimmu.2024.1323209. eCollection 2024.

Authors

Wenqi Geng^#¹, Shangzhu Zhang^#², Jinya Cao¹, Xia Hong¹, Yanping Duan¹, Yinan Jiang¹, Jing Wei¹

Affiliations

¹ Department of Psychological Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China.
² Department of Rheumatology and Clinical Immunology, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.

^# Contributed equally.

Abstract

Introduction: Early detection of neuropsychiatric systemic lupus erythematosus (NPSLE) remains a challenge in clinical settings. Previous studies have found different autoantibodies as markers for NPSLE. This study aimed to describe the distribution of psychiatric syndromes in a group of patients with systemic lupus erythematosus (SLE) and to investigate the association between psychiatric syndromes and specific autoantibodies.

Methods: This retrospective study was conducted at a single medical center in China. We reviewed medical records of hospitalized patients with SLE who were consulted by psychiatrists due to potential mental disorders. Results of serum autoantibodies and general laboratory tests were collected. The correlation between clinical variables was examined. Binary logistic regression analyses were used to determine factors related to NPSLE and different psychiatric diagnoses.

Results: Among the 171 psychiatric manifestations in 160 patients, 141 (82.4%) were attributed to SLE. Acute confusional state (ACS) had the highest prevalence (57.4%). Anti-cardiolipin (ACL) antibody (X^{2 =}142.261, p < 0.001) and anti-β2 glycoprotein I (-β2GP1) antibody (X^{2 =}139.818, p < 0.001) varied significantly between groups, with the highest positive rate found in patients with mood disorders (27.3% and 18.2%). SLE disease activity index - 2000 (SLEDAI-2K) score excluding item ACS and item psychosis was a predictor of NPSLE (OR 1.172 [95% CI 1.105 - 1.243]).

Conclusions: Disease activity reflected by SLEDAI-2K score is a predictor for NPSLE. Antiphospholipid antibodies are associated with mood disorders in SLE. Further separate investigation of neuropsychiatric disorders is needed in order to better comprehend NPSLE's pathological mechanism.

Keywords: biomarkers; mental disorders; neuropsychiatric systemic lupus erythematosus; referral consultation; systemic lupus erythematosus.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Anticardiolipin
Antibodies, Antiphospholipid
Autoantibodies
Humans
Lupus Erythematosus, Systemic* / complications
Lupus Erythematosus, Systemic* / diagnosis
Lupus Vasculitis, Central Nervous System* / diagnosis
Retrospective Studies

Substances

Autoantibodies
Antibodies, Antiphospholipid
Antibodies, Anticardiolipin

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National High Level Hospital Clinical Research Funding (2022-PUMCH-B-093), the STI2030-Major Projects (2021ZD0202001), and the Capital Funds for Health Improvement and Research (2022-2-4012).