“Prevalence of Psychosis and Other Psychiatric Disorders in Patients with Systemic Lupus Erythematosus”- A Case Control Study

Background: Systemic Lupus Erythematosus is a connective tissue, auto immune disease of which cause is unknown. In Systemic Lupus Erythematosus one or many systems are involved. Psychiatric disorders are common in Systemic Lupus Erythematosus. Psychiatric manifestations can be psychosis, mood disorders, anxiety disorders and acute confusional state. Objective: The Aim of the study is to know the prevalence of psychosis and other psychiatric disorders in patients with Systemic Lupus Erythematosus and to correlate the severity of illness with psychosis and other psychiatric disorders in patients of systemic lupus erythematosus. Methodology: This is a case control study conducted at Government Rajaji Hospital, Madurai, a tertiary care centre for 3 months. A sample of 30 consecutive patients with an established diagnosis of systemic lupus erythematosus, attending the Rheumatology OP as well as Inpatients were selected for the study. A sample of 30 controls (Age, sex, marital status, place of living, Socioeconomic status matched controls) who attended Govt Rajaji Hospital OPD for minor physical ailments were enrolled in this study. Results: Among the sample of 30 patients with Systemic Lupus Erythematosus,17 patients (56.7%) have psychiatric disorders. Among the 17patients with psychiatric comorbidity, 7 patients suffer from Major depression, contributing to 23.3%second common, being dysthymia and Generalized Anxiety Disorder with a frequency of 3 patients (10.0%), psychotic disorder and social Anxiety Disorder (9.6%) and in 6.7% of patients. Among controls, 3 patients (10.0%) have psychiatric disorders. Among 3 patients with psychiatric disorders, one (3.3%) suffer from depression, one (3.3%) suffer from dysthymia and one (3.3%) suffer from Generalized Anxiety Disorder. Conclusion: Psychiatric disorders are highly prevalent in patients with Systemic Lupus Erythematosus. Major depressive disorder is the most common Psychiatric disorder associated with Systemic Lupus Erythematosus. The risk of developing Psychiatric illnesses (Depression and psychotic disorder) increases with increasing severity of systemic lupus erythematosus. It is shown that Systemic Lupus Erythematosus patients have a high risk of Psychiatric illness and when emotional factors are not addressed adequately, the morbidity of these patients may increase.