دورية أكاديمية

Prevalence and identification of neuropsychiatric symptoms in systemic autoimmune rheumatic diseases: an international mixed methods study.

التفاصيل البيبلوغرافية
العنوان: Prevalence and identification of neuropsychiatric symptoms in systemic autoimmune rheumatic diseases: an international mixed methods study.
المؤلفون: Sloan M; Department of Public Health and Primary Care Unit, University of Cambridge, Cambridge, UK., Wincup C; Department of Rheumatology, King's College Hospital London, London, UK., Harwood R; Swansea University Medical School, Swansea University, Swansea, UK., Pollak TA; Institute of Psychiatry, Psychology and Neuroscience, King's College London, and SLAM NHS Foundation Trust, London, UK., Massou E; Department of Public Health and Primary Care Unit, University of Cambridge, Cambridge, UK., Bosley M; Patient Co-Investigators., Pitkanen M; Institute of Psychiatry, Psychology and Neuroscience, King's College London, and SLAM NHS Foundation Trust, London, UK., Zandi MS; Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK., Leschziner G; Department of Neurology, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK., Barrere C; Patient Co-Investigators., Ubhi M; Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Andreoli L; Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili, Brescia, Italy.; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy., Brimicombe J; Department of Public Health and Primary Care Unit, University of Cambridge, Cambridge, UK., Diment W; Patient Co-Investigators., Jayne D; Department of Medicine, University of Cambridge, Cambridge, UK., Gordon C; Rheumatology Research Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK., Naughton F; Behavioural and Implementation Science Group, School of Health Sciences, University of East Anglia, Norwich, UK., D'Cruz D; The Louise Coote Lupus Unit, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK.
المصدر: Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 May 02; Vol. 63 (5), pp. 1259-1272.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Oxford University Press Country of Publication: England NLM ID: 100883501 Publication Model: Print Cited Medium: Internet ISSN: 1462-0332 (Electronic) Linking ISSN: 14620324 NLM ISO Abbreviation: Rheumatology (Oxford) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford, UK : Avenel, N.J. : Oxford University Press ; Distributed by Mercury International, c1999-
مواضيع طبية MeSH: Rheumatic Diseases*/epidemiology , Rheumatic Diseases*/psychology , Autoimmune Diseases*/epidemiology , Autoimmune Diseases*/psychology , Self Report*, Humans ; Male ; Female ; Prevalence ; Middle Aged ; Adult ; Aged ; Case-Control Studies ; Depression/epidemiology ; Mental Disorders/epidemiology ; Anxiety/epidemiology
مستخلص: Objective: A limited range of neuropsychiatric symptoms have been reported in systemic autoimmune rheumatic diseases (SARDs), with varied symptom prevalence. This study aimed to investigate a wider range of potential symptoms than previous studies, compare patient self-reports with clinician estimates, and explore barriers to symptom identification.
Methods: Mixed methods were used. Data from SARDs patients (n = 1853) were compared with controls (n = 463) and clinicians (n = 289). In-depth interviews (n = 113) were analysed thematically. Statistical tests compared means of survey items between patients and controls, 8 different SARD groups, and clinician specialities.
Results: Self-reported lifetime prevalences of all 30 neuropsychiatric symptoms investigated (including cognitive, sensorimotor and psychiatric) were significantly higher in SARDs than controls. Validated instruments assessed 55% of SARDs patients as currently having depression and 57% anxiety. Barriers to identifying neuropsychiatric symptoms included: (i) limits to knowledge, guidelines, objective tests and inter-speciality cooperation; (ii) subjectivity, invisibility and believability of symptoms; and (iii) under-eliciting, under-reporting and under-documenting. A lower proportion of clinicians (4%) reported never/rarely asking patients about mental health symptoms than the 74% of patients who reported never/rarely being asked in clinic (P < 0.001). Over 50% of SARDs patients had never/rarely reported their mental health symptoms to clinicians, a proportion underestimated at <10% by clinicians (P < 0.001).
Conclusion: Neuropsychiatric symptom self-reported prevalences are significantly higher in SARDs than controls, and are greatly underestimated by most clinicians. Research relying on medical records and current guidelines is unlikely to accurately reflect patients' experiences of neuropsychiatric symptoms. Improved inter-speciality communication and greater patient involvement is needed in SARD care and research.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.)
References: Ann Rheum Dis. 2020 Mar;79(3):356-362. (PMID: 31915121)
Autoimmun Rev. 2019 Jan;18(1):93-106. (PMID: 30408582)
Arthritis Rheum. 1999 Apr;42(4):599-608. (PMID: 10211873)
Brain Sci. 2022 Jan 30;12(2):. (PMID: 35203955)
Autoimmun Rev. 2021 Apr;20(4):102780. (PMID: 33609799)
RMD Open. 2017 Jul 18;3(1):e000499. (PMID: 29152329)
Lancet Neurol. 2023 Apr;22(4):300. (PMID: 36828008)
BMJ Case Rep. 2014 May 23;2014:. (PMID: 24859541)
Rheumatology (Oxford). 2015 May;54(5):891-8. (PMID: 25339643)
Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: 17872937)
Patient. 2017 Aug;10(4):455-462. (PMID: 28229377)
Best Pract Res Clin Rheumatol. 2018 Aug;32(4):500-510. (PMID: 31174819)
Psychiatry Clin Neurosci. 2011 Oct;65(6):549-60. (PMID: 22003987)
Front Psychol. 2017 Jul 07;8:1134. (PMID: 28736541)
Reumatologia. 2020;58(6):381-389. (PMID: 33456081)
Arthritis Care Res (Hoboken). 2020 Oct;72(10):1481-1489. (PMID: 31350805)
Paediatr Perinat Epidemiol. 2011 Sep;25(5):402-12. (PMID: 21819422)
Arthritis Res Ther. 2020 Apr 15;22(1):78. (PMID: 32293528)
Trends Pharmacol Sci. 2022 Aug;43(8):615-628. (PMID: 35272861)
Semin Arthritis Rheum. 2011 Aug;41(1):1-11. (PMID: 20965549)
Medicine (Baltimore). 2018 Jul;97(28):e11376. (PMID: 29995777)
J Rheumatol. 2022 Sep;49(9):1058-1066. (PMID: 35365580)
Int J Mol Sci. 2018 Nov 13;19(11):. (PMID: 30428632)
Ann Rheum Dis. 2018 Mar;77(3):441-448. (PMID: 29259047)
Med Care. 2008 Mar;46(3):266-74. (PMID: 18388841)
Diagnosis (Berl). 2019 Aug 27;6(3):213-221. (PMID: 31039128)
Int J Mol Sci. 2021 Oct 19;22(20):. (PMID: 34681945)
Acad Med. 2020 Jun;95(6):846-850. (PMID: 31809294)
Rheumatology (Oxford). 2010 Aug;49(8):1540-9. (PMID: 20444860)
Rheumatology (Oxford). 2022 Aug 30;61(9):3723-3736. (PMID: 34995345)
Arthritis Rheum. 2008 May 15;59(5):721-9. (PMID: 18438902)
Nat Rev Rheumatol. 2019 Mar;15(3):137-152. (PMID: 30659245)
Lupus. 2016 Aug;25(9):997-1003. (PMID: 26846690)
Joint Bone Spine. 2021 Oct;88(5):105200. (PMID: 33932572)
Rheumatology (Oxford). 2017 May 1;56(5):856-857. (PMID: 28339930)
J Neurol Sci. 2022 Mar 15;434:120120. (PMID: 34992042)
Jpn J Psychiatry Neurol. 1991 Dec;45(4):855-60. (PMID: 1813680)
Arthritis Rheumatol. 2017 Jan;69(1):35-45. (PMID: 27785888)
Rheumatology (Oxford). 2017 Oct 1;56(10):e24-e48. (PMID: 28957550)
Rheumatology (Oxford). 2021 Dec 24;61(1):8-23. (PMID: 33788917)
Value Health. 2020 Jan;23(1):104-113. (PMID: 31952665)
Ann Rheum Dis. 2011 May;70(5):722-6. (PMID: 21257615)
Arthritis Rheumatol. 2019 Jan;71(1):33-42. (PMID: 29927108)
Rheumatol Adv Pract. 2020 Jul 22;4(2):rkaa037. (PMID: 32974426)
Front Immunol. 2018 Jun 06;9:1146. (PMID: 29928273)
BMJ Open. 2017 Dec 14;7(12):e017434. (PMID: 29247087)
معلومات مُعتمدة: 21992 United Kingdom VAC_ Versus Arthritis
فهرسة مساهمة: Keywords: depression; mental health; neuropsychiatric; patient–clinician relationships; rheumatology; symptom identification; systemic autoimmune rheumatic diseases; under-reporting
تواريخ الأحداث: Date Created: 20230726 Date Completed: 20240502 Latest Revision: 20240504
رمز التحديث: 20240504
مُعرف محوري في PubMed: PMC11065444
DOI: 10.1093/rheumatology/kead369
PMID: 37491699
قاعدة البيانات: MEDLINE
الوصف
تدمد:1462-0332
DOI:10.1093/rheumatology/kead369