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. 2017 Oct;26(12):1252-1259.
doi: 10.1177/0961203317694262. Epub 2017 Feb 22.

Neuropsychiatric symptoms in systemic lupus erythematosus: impact on quality of life

R C Monahan  1 , L J J Beaart-van de Voorde  1 , G M Steup-Beekman  1 , C Magro-Checa  1 , T W J Huizinga  1 , J Hoekman  2 , A A Kaptein  3
Affiliations

Neuropsychiatric symptoms in systemic lupus erythematosus: impact on quality of life

R C Monahan et al. Lupus. 2017 Oct.

Abstract

Objective Assess quality of life in patients with systemic lupus erythematosus (SLE) presenting with neuropsychiatric symptoms (neuropsychiatric SLE, NPSLE). Methods Quality of life was assessed using the Short-Form 36 item Health Survey (SF-36) in patients visiting the Leiden NPSLE clinic at baseline and at follow-up. SF-36 subscales and summary scores were calculated and compared with quality of life of the general Dutch population and patients with other chronic diseases. Results At baseline, quality of life was assessed in 248 SLE patients, of whom 98 had NPSLE (39.7%). Follow-up data were available for 104 patients (42%), of whom 64 had NPSLE (61.5%). SLE patients presenting neuropsychiatric symptoms showed a significantly reduced quality of life in all subscales of the SF-36. Quality of life at follow-up showed a significant improvement in physical functioning role ( p = 0.001), social functioning ( p = 0.007), vitality ( p = 0.023), mental health ( p = 0.014) and mental component score ( p = 0.042) in patients with neuropsychiatric symptoms not attributed to SLE, but no significant improvement was seen in patients with NPSLE. Conclusion Quality of life is significantly reduced in patients with SLE presenting neuropsychiatric symptoms compared with the general population and patients with other chronic diseases. Quality of life remains considerably impaired at follow-up. Our results illustrate the need for biopsychosocial care in patients with SLE and neuropsychiatric symptoms.

Keywords: NPSLE; SF-36; SLE; neuropsychiatric symptoms; quality of life.

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Figures

Figure 1
Figure 1
(a) Health-related quality of life using the SF-36 in patients with SLE and neuropsychiatric symptoms compared with the general Dutch population. 0 = worst quality of life, 100 = best quality of life. * = p < 0.001. (b) * = p < 0.05. NPSLE: neuropsychiatric systemic lupus erythematosus; PF: physical functioning; RP: role functioning, physical; BP: bodily pain; GH: general health; V: vitality; SF: social functioning; RE: role functioning, emotional; MH: mental health; SF-36: Short-Form Health Survey; MCS: mental component score; PCS: physical component score
Figure 2
Figure 2
Health-related quality of life using the SF-36 in patients with SLE and NP symptoms, compared with patients with other (chronic) diseases in the Dutch population.– PF: physical functioning; RP: role functioning, physical; BP: bodily pain; GH: general health; V: vitality; SF: social functioning; RE: role functioning, emotional; MH: mental health; NPSLE: neuropsychiatric systemic lupus erythematosus; RA: rheumatoid arthritis; SF-36: Short-Form Health Survey
Figure 3
Figure 3
Health-related quality of life at baseline and follow-up of 104 patients that visited the NPSLE clinic. * = p < 0.05. NPSLE: neuropsychiatric systemic lupus erythematosus; PF: physical functioning; RP: role functioning, physical; BP: bodily pain; GH: general health; V: vitality; SF: social functioning; RE: role functioning, emotional; MH: mental health; MCS: mental component score; PCS: physical component score
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