Appendix A: Case Definitions for Neuropsychiatric Syndromes in Systemic Lupus Erythematosus
Psychosis
Definition:
Severe disturbance in the perception of reality characterized by delusions and/or hallucinations
Diagnostic criteria:
All of the following:
A. At least one of the following
- Delusions
- Hallucinations without insight
B. The disturbance causes clinical distress or impairment in social, occupational, or other relevant areas of functioning.
C. The disturbance does not occur exclusively during the course of a delirium.
D. The disturbance is not better accounted for by another mental disorder (e.g., mania).
Exclusions:
- Primary psychotic disorder unrelated to SLE (e.g., schizophrenia)
- Substance- or drug-induced psychotic disorder (including NSAIDs, antimalarials)
- Psychologically mediated reaction to SLE (brief reactive psychosis with major stressor)
Associations:
- Marked psychosocial stress
- Corticosteroids
Ascertainment:
History (from patient and others)
Record:
- Basic descriptors
- Type (hallucinations, delusions)
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