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Prevalence of Neuropsychiatric Symptoms Up for Autoimmune Rheumatic Disease

More than 50 percent of those with systemic autoimmune rheumatic diseases had never/rarely reported mental health symptoms to clinicians

By Elana Gotkine HealthDay Reporter

TUESDAY, Aug. 1, 2023 (HealthDay News) — The prevalence of all self-reported neuropsychiatric symptoms is significantly higher in those with systemic autoimmune rheumatic diseases (SARDs) versus controls, according to a study published online July 27 in Rheumatology.

Melanie Sloan, Ph.D., from the University of Cambridge in the United Kingdom, and colleagues examined a wider range of potential neuropsychiatric symptoms in SARDs than have been reported previously using data from 1,853 SARD patients, 463 controls, and 289 clinicians as part of the INSPIRE research project. A total of 113 in-depth interviews were analyzed thematically. The means of survey items were compared between patients and controls, eight different SARD groups, and clinician specialties.

The researchers found that compared with controls, SARDs had higher self-reported prevalence rates of all 30 neuropsychiatric symptoms investigated, including cognitive, sensorimotor, and psychiatric. Of SARD patients, validated instruments revealed that 55 and 57 percent currently had depression or anxiety, respectively. Limits to knowledge, guidelines, objective tests, and interspecialty cooperation; subjectivity, invisibility, and believability of symptoms; and under-eliciting, under-reporting, and under-documenting were barriers to identifying neuropsychiatric symptoms. The proportion of clinicians who reported never/rarely asking patients about mental health symptoms was much lower than the percentage of patients who reported never/rarely being asked in clinic (4 versus 74 percent). More than 50 percent of SARD patients had never/rarely reported their mental health symptoms to clinicians, which was underestimated by clinicians at less than 10 percent.

“The low level of reporting we identified is a major concern as problems with mental health, fatigue, and cognition can be life-changing, and sometimes life-threatening,” Sloan said in a statement.

Several authors disclosed ties to the pharmaceutical industry.

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