Neuropsychiatric symptoms in lupus

Patients with lupus experience a high burden of neuropsychiatric symptoms. While some patients have frank neurological complications, this represents a minority. Most neuropsychiatric symptoms are chronic and not associated with brain imaging abnormalities, for example, fatigue, ‘brain fog’ and altered mood. Factors which contribute to these symptoms may include medications, infections, the psychological burden of chronic unpredictable disease, and the direct effects of inflammation on the brain. This article summarizes our current understanding of psychological symptoms in lupus, and how this informs our approach to management.