Advances in Psychiatric Treatment (2009) 15: 451-458. doi: 10.1192/apt.bp.108.005785
© 2009 The Royal College of Psychiatrists
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Clinical implications of neuropsychiatric systemic lupus erythematosus

Anselm Mak, Roger Chun Man Ho and Chak Sing Lau

Anselm Mak is Assistant Professor of Medicine and an associate consultant rheumatologist in the Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore. His research interest is lupus-related damage, especially NPSLE-related damage, and lupus nephritis. Roger Chun Man Ho is Assistant Professor of psychiatry and a specialist psychiatric registrar at the National University of Singapore. He has a special interest in psychoneuroimmunology. Chak Sing Lau is Professor of Medicine and a consultant rheumatologist at the Ninewells Hospital and Medical School, University of Dundee, Scotland. His research interests include immunogenetics, T and B cell functions, and apoptosis in SLE.

Correspondence: Correspondence Dr Roger Chun Man Ho, Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 110974. Email: pcmrhcm{at}nus.edu.sg

Systemic lupus erythematosus (SLE) is a disorder which can affect the central nervous system and result in a broad range of psychiatric syndromes such as psychosis, mood disorders, acute confusion and cognitive dysfunction. Despite the robust nomenclature of neuropsychiatric SLE (NPSLE), psychiatric syndromes in patients are often non-specific and may be secondary to concurrent non-SLE-related conditions and complications of medical therapies. Although the exact immunopathological mechanism for psychiatric presentation remains elusive, prompt exclusion of other factors contributing to the psychiatric symptoms coupled with effective assessment strategies and management with immunosuppression and psychiatric therapy are imperative. Psychiatrists and rheumatologists must work in close liaison to identify, treat and prognosticate patients with psychiatric syndromes in order to improve their quality of life, vocational aptitude and, ultimately, survival.