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The association between systemic lupus erythematosus and bipolar disorder – a big data analysis

Published online by Cambridge University Press:  23 March 2020

S. Tiosano ,
Z. Nir ,
O. Gendelman ,
D. Comaneshter ,
H. Amital ,
A.D. Cohen  and
D. Amital
S. Tiosano
Affiliation:
Department of Medicine ‘B’, Sheba Medical Center, 52621Tel-Hashomer, Israel Sackler Faculty of Medicine, Tel-Aviv University, 6997801Tel-Aviv, Israel
Z. Nir
Affiliation:
Ness-Ziona/Beer-Yaakov Mental Health Center, 70300Beer-Yaakov, Israel
O. Gendelman
Affiliation:
Department of Medicine ‘B’, Sheba Medical Center, 52621Tel-Hashomer, Israel Sackler Faculty of Medicine, Tel-Aviv University, 6997801Tel-Aviv, Israel
D. Comaneshter
Affiliation:
Chief Physician's Office, Clalit Health Services, 6209804Tel-Aviv, Israel
H. Amital*
Affiliation:
Department of Medicine ‘B’, Sheba Medical Center, 52621Tel-Hashomer, Israel Sackler Faculty of Medicine, Tel-Aviv University, 6997801Tel-Aviv, Israel
A.D. Cohen
Affiliation:
Chief Physician's Office, Clalit Health Services, 6209804Tel-Aviv, Israel Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, 84105 Beer Sheva, Israel
D. Amital
Affiliation:
Ness-Ziona/Beer-Yaakov Mental Health Center, 70300Beer-Yaakov, Israel
*
*Corresponding author. Department of Medicine ’B’, Sheba Medical Center, 52621 Tel.:-Hashomer, Israel. Tel.: +972 3 530 2652; fax: +972 3 535 4796. E-mail address:howard.amital@sheba.health.gov.il
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Abstract

Background:

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disease that has a wide variety of physical manifestations, including neuropsychiatric features. Bipolar disorder (BD) is a chronic, episodic illness, that may present as depression or as mania. The objective of this study was to investigate the association between SLE and BD using big data analysis methods.

Methods:

Patients with SLE were compared with age- and sex-matched controls regarding the prevalence of BD in a cross-sectional study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis, adjusting for confounders. The study was performed utilizing the chronic disease registry of Clalit Health Services medical database.

Results:

The study included 5018 SLE patients and 25,090 matched controls. BD was found in a higher prevalence among SLE patients compared to controls (0.62% vs. 0.26%, respectively, P < 0.001). BD patients had a greater prevalence of smokers compared to non-BD patients (62.5% vs 23.5%, respectively, P < 0.001). In a multivariate analysis, smoking and SLE were both found to be significantly associated with BD.

Conclusions:

SLE was found to be independently associated with BD. These findings may imply that an autoimmune process affecting the central nervous system among SLE patients facilitates the expression of concomitant BD.

Keywords

SLEBipolar disorderPsychosisAutoimmune diseasesComorbidity
Type
Original article
Information
European Psychiatry , Volume 43 , June 2017 , pp. 116 - 119
Copyright
Copyright © European Psychiatric Association 2017

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