{
  "abstract": "Objectives Beyond widespread somatic manifestations, mental health problems are a major concern for individuals with systemic lupus erythematosus (SLE). Although anxiety and depression are frequently reported, a systematic understanding of psychiatric morbidity in SLE remains limited. We aimed to describe the occurrence of psychiatric morbidity before and after SLE diagnosis and to examine its association with adverse long-term outcomes.Methods We conducted a nationwide, register-based matched cohort study in Sweden including 4,079 adults newly diagnosed with SLE between 2005–2021 and followed through February 2024, and 39,399 general population controls individually matched on age, sex, and residential location. Exposures were history and incidence of (i) any psychiatric disorder, and (ii) any psychiatric hospitalisation, both identified from specialist care. Outcomes included organ damage (Lupus Register-Based Organ Damage Index, modified to exclude psychosis) and all-cause mortality. Multivariable Poisson regression models with time-varying psychiatric diagnoses estimated incidence rates (IRs) and incidence rate ratios (IRRs) for organ damage and mortality, adjusting for demographics, socioeconomic status, and prior morbidity.Results At SLE diagnosis, 16.2% had a history of any psychiatric disorder and 4.7% of psychiatric hospitalisation, compared with 12.0% and 4.2% among controls ( table 1). The incidence of each psychiatric diagnosis was higher among SLE patients than controls, with the highest IRs (per 1,000 person-years) for anxiety disorders (7.0; 95%CI: 6.2–7.9), depression (6.6; 95%CI: 5.7–7.5), and substance use disorders (5.3; 95%CI: 4.6–6.1). Over a median follow-up of 4.8 years for organ damage and 8.9 years for mortality, 2,135 (52.3%) patients developed organ damage and 733 (18.0%) died (table 2). Psychiatric disorders were independently associated with increased risk of organ damage, ranging from 30% higher for any psychiatric disorder (IRR: 1.28; 95%CI: 1.15–1.42) to 50% higher for psychiatric hospitalisation (IRR: 1.47; 95%CI: 1.24–1.73). Both exposures were associated with an approximately two-fold increase in mortality risk.Abstract PO:03:091 Table 1–2Conclusions One in six patients with SLE had a history of specialist-treated psychiatric morbidity at diagnosis. Psychiatric disorders and hospitalisations were more frequent in patients with SLE than in the general population and were associated with higher risks of organ damage and mortality. These findings support the value of addressing mental health in SLE care.",
  "authors": [
    {
      "affiliations": [
        "Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"
      ],
      "name": "Alvaro Gomez"
    },
    {
      "affiliations": [
        "Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"
      ],
      "name": "Nurgul Batyrbekova"
    },
    {
      "affiliations": [
        "Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"
      ],
      "name": "Annica Dominicus"
    },
    {
      "affiliations": [
        "Division of Rheumatology, Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden",
        "Swedish Rheumatism Association, Stockholm, Sweden"
      ],
      "name": "Karin Blomkvist Sporre"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Institution for Clinical Sciences, Lund University, Lund, Sweden"
      ],
      "name": "Andreas Jönsen"
    },
    {
      "affiliations": [
        "Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"
      ],
      "name": "Johan Reutfors"
    },
    {
      "affiliations": [
        "Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"
      ],
      "name": "Elizabeth Arkema"
    }
  ],
  "title": "PO:03:091 Psychiatric morbidity and risk of adverse long-term outcomes in systemic lupus erythematosus",
  "uid": "673edbe6-4389-51c1-a6fa-1f171706854b"
}