Non-organic non-psychotic psychopathology (NONPP) in patients with systemic lupus erythematosus

C ENTRAL NERVOUS SYSTEM (CNS) abnormalities occur frequently in patients with systemic lupus erythematosus (SLE)‘-” with a reported incidence ranging from 25%3 and 37%5 to 75%8 in retrospective clinical reviews. These abnormalities include psychiatric and neurologic dysfunction. Organic brain syndromes, overt psychoses, seizures, peripheral and cranial neuropathies, stroke, cerebellar signs and vascular headaches are among the more prominent findings in CNS-SLE.3-5,” Less severe psychiatric abnormalities which cannot be readily explained on the basis of a structural lesion may also occur. These findings, which we have termed non-organic, nonpsychotic psychopathology (NONPP), are often not mentioned or dismissed with the vague term “functional.” This may in part be attributed to the difficulty in assessing such psychopathology in a chronic disease state.‘* Standardized psychiatric testing has not previously been employed to evaluate psychopathology in SLE. Correlation of NONPP with other disease manifestations such as organic CNS disease, clinical activity or serologic abnormalities has rarely been attempted.‘9’3 The present study assesses these milder psychiatric findings in patients with SLE and attempts to place them in perspective. To accom-