Psychiatric disturbances in rheumatoid arthritis

To study the pattern of psychiatric syndromes that may accompany Rheumatoid arthritis [RA] and their relationship to disease activity, severity, pain and disability. Also, to find out the impact of stressful life events on the same parameters of the disease. The study comprised forty RA patients and 20 apparently normal controls. They were subjected to thorough medical history taking, clinical examination, laboratory investigations, disease activity, spread severity index, functional assessment with the Health Assessment Questionnaire Score, the Social Readjustment Rating Scale [SRRS] and identification of psychiatric disorders using the International Classification of Diseases [ICD,-10] symptom checklist for mental disorders. The prevalence of psychiatric disorders was significantly higher in RA patients than in the control group [p<0.05]. Depressive disorders were the most prevalent of these disorders. The Social Readjustment Rating Scale was significantly higher in RA patients than in the control group [p<0.001]. Also RA patients with psychiatric disorders were found to have higher SRRS than those not suffering from psychiatric disorders [p<0.05]. The stressful life events were found to have a strong impact on disease activity and pain in RA patients. Depression was the most common psychological disturbance associated with RA. This study highlights the role that the rheumatologist can play in the early detection of psychiatric disorders and psychiatric consultation in the proper time. In addition, it should be emphasized that the psychosocial effects of RA should always be put in mind and treated as a part of the illness

Value of single-photon-emission computed tomography scan in the diagnosis of neuropsychiatric manifestations of systemic lupus erythematosus

The aim of this study was to predict CNS affection in SLE patients using SPECT and to study the previous parameter as prognostic tool for CNS affection in SLE patients. We studied 30 SLE patients diagnosed according to the American College of Rheumatology [ACR] criteria for the classification of SLE. Ten normal healthy subjects were also included as a control group. SLE patients were categorized into 3 groups: Group I: with major NPSLE [n=7]; Group II: with minor NPSLE [n=3] and Group III: without NPSLE [n=20] Abnormal SPECT scan was found in 83% in group I, 33% in group II, normal SPECT scan in 72% in group III and normal SPECT scan in 100% in the control group