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Psychiatric symptoms before systemic lupus erythematosus is diagnosed

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Abstract

Psychiatric symptoms are rarely reported as an initial feature of systemic lupus erythematosus (SLE). Nevertheless, many patients have the feeling that psychiatric symptoms occurred before they were diagnosed as having SLE. This feeling was confirmed by an enquiry among members of the Dutch Lupus Patients Society: half of them had experienced psychiatric complaints before SLE was diagnosed. Two-thirds of these patients searched for professional help for these complaints. This motivated us to study whether SLE patients were admitted into psychiatric hospitals without being diagnosed as having SLE. Sera from 2121 patients admitted to a psychiatric hospital and from 500 controls matched for sex and age were tested for the presence of antinuclear antibodies (ANA) and antibodies to DNA. ANA were found in 3% of patients, as well as controls. Anti-DNA antibodies were found in 1% of both patients and controls. Two out of 114 patients psychiatric patients with ANA and/or anti-DNA antibodies had SLE and/or Sjögren's syndrome. We concluded that SLE is not an important cause of admission to psychiatric hospitals. Routine tests for the determination of antinuclear and anti-DNA antibodies on admissions in these hospitals thus would not seem useful. To study whether patients with another chronic disease also had psychiatric complaints before being diagnosed, we performed the same enquiry among members of the Dutch Sarcoidosis Patients Society. The results were almost equal to those of the enquiry of the members of the Dutch Lupus Patients Society. Why members of both societies so often report psychiatric symptoms before their disease is diagnosed should be a subject of further studies.

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Authors and Affiliations

  1. Department of Autoimmune Diseases, Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, P.O. Box 9190, NL-1006 AD, Amsterdam, The Netherlands

    A. P. van Dam, J. de Jong, R. J. T. Smeenk & T. E. W. Feltkamp

  2. Psychiatric Centre Bavo, Noordwijkerhout, The Netherlands

    E. M. Wekking & J. A. C. Callewaert

  3. Psychiatric Centre Sancta Maria, Noordwijkerhout, The Netherlands

    A. J. M. Schipperijn

  4. Psychiatric Centre Vogelenzang, Bennebroek, The Netherlands

    H. A. P. C. Oomen

  5. Department of Rheumatology, Daniel den Hoed Clinic, Rotterdam, The Netherlands

    A. J. G. Swaak

Authors
  1. A. P. van Dam
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  2. E. M. Wekking
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  3. J. A. C. Callewaert
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  4. A. J. M. Schipperijn
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  5. H. A. P. C. Oomen
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  6. J. de Jong
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  7. A. J. G. Swaak
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  8. R. J. T. Smeenk
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  9. T. E. W. Feltkamp
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van Dam, A.P., Wekking, E.M., Callewaert, J.A.C. et al. Psychiatric symptoms before systemic lupus erythematosus is diagnosed. Rheumatol Int 14, 57–62 (1994). https://doi.org/10.1007/BF00300248

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  • DOI: https://doi.org/10.1007/BF00300248

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