Psychiatric symptoms in systemic lupus erythematosus: an update.

Twenty-one studies on the prevalence and type of psychiatric symptoms in systemic lupus erythematosus (SLE) are reviewed and evaluated. Substantial differences in prevalence of psychiatric symptoms in SLE-patients (from 17%-71%) have been reported. Of the investigated methodological aspects, differences in assessment techniques appeared to be the main source of the variability in findings. Although various types of psychiatric symptoms have been observed, depression is most frequently reported. There was no consistent relationship between the occurrence of psychiatric symptoms and other symptoms of SLE. However, the data suggest an association with (the patient's perception of) illness severity and with the experience of psychosocial stressors. Studies applying control groups (patients with other chronic diseases (e.g., rheumatoid arthritis) showed striking similarities between both patient groups with respect to prevalence and type of psychiatric symptoms. There is some evidence, however, indicating that a small proportion of the psychiatric symptomatology, in particular psychosis, is related to neurological dysfunction in SLE.