Neuropsychiatric disorders more common in rheumatologic disease

Sundquist K, Li X, Hemminki K, Sundquist J, Karolinska Institute, Huddinge, Sweden, and German Cancer Research Center, Heidelberg. Subsequent risk of hospitalization for neuropsychiatric disorders in patients with rheumatic diseases: a nationwide study from Sweden.Arch Gen Psychiatry. 2008;65:501-507.

Neuropsychiatric disorders are more likely to develop in patients with a rheumatologic disease-rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or ankylosing spondylitis (AS)-than in the general population. Some subgroups with rheumatologic disease seem to be more vulnerable than others.

Sundquist and associates conducted a cohort study of hospitalizations in Sweden for RA, SLE, and AS and for subsequent affective, psychotic, neurotic, and personality disorders, as well as for dementia and delirium, for the entire Swedish population. Age-standardized incidence ratios (SIRs) were calculated for the whole follow-up period.

In most age groups, rates of psychiatric disorders were higher in persons who had rheumatologic diseases than in the general population.The highest risks were found in men and women with SLE (significant SIRs, 2.38 and 2.16, respectively); those with AS also were at higher risk than those with RA. The risk of severe depression was increased in women with SLE and those with RA. There was an increased risk of dementia and delirium in persons with SLE.

The authors noted that their study adds to the literature because it took a novel approach, studying an entire population to examine the association between rheumatologic diseases and neuropsychiatric disorders.