Psychiatric disorders in systemic lupus erythematosus (SLE): a serious SLE-related crime

Introduction: Systemic lupus erythematosus (SLE) is associated with CNS disorders in 50-90% of all cases. Thus far 19 neuropsychiatric syndromes have been reported in association with SLE, and many others will be added to this list in the future. Long-term observation and use of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (Text Revision) is the solution for a correct diagnosis.
Case report: The patient was an 18-year-old woman who had been charged with the attempted murder of an elderly woman in the latter's home. According to the victim's testimony, the young woman had entered the victim's home under pretence and suddently attacked her with a hammer. The young woman denied all knowledge of the event. A few days after her arrest the patient was hospitalized for attempted suicide. The work-up that began with this hospitalization led to the diagnosis of an intermittent explosive disorder secondary to SLE. The authors analyze this case from the psychiatric, medical, and legal points of view.
Conclusions: This is the first report of this type of disorder is a patient with SLE. The authors suggest that intermittent explosive disorder should be added to the list of neuropsychiatric syndromes associated with this disease.