A study of prevalence of psychosis and other psychiatric disorders and correlation of disease activity with psychiatric disorders in patients with systemic lupus erythematosus: A case control study

AIM OF THE STUDY: To study the prevalence of psychosis and other psychiatric disorders in patients with systemic lupus Erythematosus and to correlate the disease activity with psychiatric disorders in patients with systemic lupus Erythematosus and compare with healthy controls. OBJECTIVES: 1. To study the prevalence of psychosis and other psychiatric disorders in patients with Systemic Lupus Erythematosus. 2. To compare psychiatric morbidity, stressful life events, quality of life between cases and controls. 3. To correlate the severity of illness with psychosis and other psychiatric disorders in patients of systemic lupus erythematosus. 4. To assess the relationship between psychiatric disorders and quality of life in patients with systemic lupus Erythematosus. 5. To find the relationship between psychiatric disorders and psychosocial stressors in patients with systemic lupus erythematosus. METHODOLOGY: This study was done on a sample of 60 individuals. 30 cases with established diagnosis of Systemic lupus erythematosus, seeking consultation in the Department of Rheumatology, Government Rajaji Hospital were collected for a period of 3months and 30 healthy controls who attended hospital for minor physical ailments were also enrolled. The study was designed as case control study. They were assessed using MINI International Neuropsychiatric Interview, Hospital Anxiety Depression Scale, Presumptive Stressful Life Events Scale, WHO Quality of Life BREF, Systemic Lupus Activity Measure –Revised (SLAM-R) for measuring SLE disease activity(only for cases). The collected data were subjected to statistical analysis. RESULTS: Psychiatric disorders were present in 56.7 % of patients with Systemic lupus erythematosus. Major Depression was the most common Psychiatric disorder accounting for 23.2%, followed by Dysthymia and Generalized Anxiety Disorder in 10%. Two (2) cases had psychosis (7%) and social anxiety disorder was present in 2 cases (7%). Prevalence of psychiatric disorders (56.7%) is more in patients with Systemic Lupus Erythematosus than controls(10%). They had more stressful life events, anxiety and depression than controls. Disease severity is correlated with psychiatric morbidity. Patients with disease activity perceived stress more and they had more depression and poorer quality of life. Systemic Lupus Erythematosus Patients with psychiatric disorders had more stressful life events, anxiety and depression than patients without psychiatric disorders. Quality of life was found to be poorer in patients with psychiatric disorders than without psychiatric disorders. CONCLUSION: Thus, it is important to assess the Psychiatric co-morbidities in Systemic lupus erythematosus, since, early recognition and treatment of the same, will improve the Quality of Life in Systemic lupus Erythematosus patients, leading to a better outcome