Annaliese Tisseverasinghe1, Christine Peschken2,3, Carol Hitchon2. 1. Department of Internal Medicine, Section of Rheumatology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. atisseverasinghe@hsc.mb.ca. 2. Department of Internal Medicine, Section of Rheumatology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. 3. Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
Abstract
PURPOSE OF REVIEW: Optimal management of anxiety and mood disorders in patients with systemic lupus erythematosus (SLE) is limited by an incomplete understanding of their pathophysiology and a lack of treatment guidelines. This review aims to critically synthesize recent literature on these conditions in adults with SLE, focusing on their etiology, assessment, and management. RECENT FINDINGS: Along with psychosocial factors, there is growing evidence for a bidirectional interaction between inflammatory pathways and SLE-associated anxiety and mood disorders. Direct immune-mediated mechanisms via autoantibodies may also play a role in some cases. With a growing number of tools used in SLE for the assessment of these conditions, the search continues for the ideal instrument to use in all future investigations to allow comparisons across studies. There is data supporting psychological interventions, but a dearth of literature on pharmacotherapy for the treatment of anxiety and mood disorders in SLE. There is a clear need for further research in anxiety and mood disorders in SLE, particularly with respect to diagnostic tools and medications, which could inform much-needed updates to current guidelines.
PURPOSE OF REVIEW: Optimal management of anxiety and mood disorders in patients with systemic lupus erythematosus (SLE) is limited by an incomplete understanding of their pathophysiology and a lack of treatment guidelines. This review aims to critically synthesize recent literature on these conditions in adults with SLE, focusing on their etiology, assessment, and management. RECENT FINDINGS: Along with psychosocial factors, there is growing evidence for a bidirectional interaction between inflammatory pathways and SLE-associated anxiety and mood disorders. Direct immune-mediated mechanisms via autoantibodies may also play a role in some cases. With a growing number of tools used in SLE for the assessment of these conditions, the search continues for the ideal instrument to use in all future investigations to allow comparisons across studies. There is data supporting psychological interventions, but a dearth of literature on pharmacotherapy for the treatment of anxiety and mood disorders in SLE. There is a clear need for further research in anxiety and mood disorders in SLE, particularly with respect to diagnostic tools and medications, which could inform much-needed updates to current guidelines.
Authors: Margarida Figueiredo-Braga; Caleb Cornaby; Alice Cortez; Miguel Bernardes; Georgina Terroso; Marta Figueiredo; Cristina Dos Santos Mesquita; Lúcia Costa; Brian D Poole Journal: Medicine (Baltimore) Date: 2018-07 Impact factor: 1.889