Lupus & antiphospholipid syndrome
Neuropsychiatric symptoms in systemic lupus erythematosus: mixed methods analysis of patient-derived attributional evidence in the international INSPIRE project
Authors' conclusion
We found evidence indicating varying levels of direct attributability of both common and previously unexplored neuropsychiatric symptoms in SLE patients, with hallucinations and severe headache assessed as the most directly attributable.
Study context
- Population
- Systemic lupus erythematosus (SLE) patients, controls, inflammatory arthritis (IA) patients and clinicians in the international INSPIRE projectincluding 400 clinicians
- Participants
- 2,817 patients
- Comparison
- SLE patients vs controls and IA patients
- SLEn = 609
- Controlsn = 463reference
- IAn = 489
- Outcome
- Neuropsychiatric symptoms: prevalence and direct attributability to SLE
Methodological detailsinternational, quantitative and qualitative analysis
- International
- Quantitative and qualitative analysis
Main finding
As reported in the abstract
SLE patients reporting resolution/improvement of fatigue, positive sensory symptoms, severe headache and cognitive dysfunction with corticosteroids
Over 45%
Further findings
| Outcome | P value |
|---|---|
| Severe headache, SLE vs IASLE vs IA | P = 0.008 |
| Severe headache, SLE vs IASLE vs IA | P < 0.001 |
Neuropsychiatric symptoms relapsing/remitting with other disease symptoms (e.g. joint pain) in SLE and IA
- Multiple neuropsychiatric symptoms relapsed/remitted with other disease symptoms such as joint pain
Qualitative: discussion of attributional evidence
- Clinicians and patients reported insufficient time to discuss patient-reported attributional evidence
- Symptoms viewed as indirectly related/non-attributable often less prioritized for discussion and treatment
Original publication
Neuropsychiatric symptoms in systemic lupus erythematosus: mixed methods analysis of patient-derived attributional evidence in the international INSPIRE project. Rheumatology (Oxford). Published 22 March 2024. doi:10.
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