Prevalence and identification of neuropsychiatric symptoms in systemic autoimmune rheumatic diseases: an international mixed methods study
Authors' conclusion
Neuropsychiatric symptom self-reported prevalences are significantly higher in SARDs than controls, and are greatly underestimated by most clinicians.
Study context
- Population
- Patients with systemic autoimmune rheumatic diseases (SARDs) (8 SARD groups), controls and clinicians, international113 in-depth interviews
- Participants
- 1,853 / 463 / 289
- Exposure
- SARDs patients vs controls; patients vs clinicians
- SARDsn = 1,853
- Controlsn = 463reference
- Cliniciansn = 289
- Outcome
- Self-reported lifetime prevalence of 30 neuropsychiatric symptoms (cognitive, sensorimotor, psychiatric)
- Follow-up
- Lifetime
Methodological detailsinternational, survey, in-depth interviews analysed thematically
- International
- Survey
- In-depth interviews analysed thematically
Main finding
As reported in the abstract
Self-reported lifetime prevalence of 30 neuropsychiatric symptoms
- Prevalences of all 30 symptoms significantly higher in SARDs than controls
Observational data: associations, not effects.
Further findings
| Outcome | SARDs | Clinicians | P value |
|---|---|---|---|
| Never/rarely asking or being asked about mental health symptomsClinicians vs SARDs | 74% | 4% | P < 0.001 |
- Patients never/rarely reporting mental health symptoms to clinicians · SARDs vs Clinicians · over 50% of patients vs clinician estimate <10%
- P < 0.001
- Patients never/rarely reporting mental health symptoms to clinicians — SARDs patients never/rarely reporting
- Over 50%
- Patients never/rarely reporting mental health symptoms to clinicians — Clinician estimate
- <10%
Current depression and anxiety (validated instruments)
- SARDs patients with current depression
- 55%
- SARDs patients with current anxiety
- 57%
Barriers to identifying neuropsychiatric symptoms (thematic)
- Limits to knowledge, guidelines, objective tests and inter-speciality cooperation
- Subjectivity, invisibility and believability of symptoms
- Under-eliciting, under-reporting and under-documenting
Original publication
Prevalence and identification of neuropsychiatric symptoms in systemic autoimmune rheumatic diseases: an international mixed methods study. Rheumatology (Oxford). Published 26 July 2023. doi:10.
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