全身性紅斑狼瘡合併雙相情感障礙症造成之臨床診斷與處置之困難：一病例報告

全身性紅斑狠瘡(systemic lupus erythematosus; SLE)為一慢性全身性的自體免疫疾患，隨著病情的復發及緩解，對於神經系統的完整及心理方面的功能都可能有原發性及續發性的影響，但因臨床表現多樣化而難以診斷，且致病機轉複雜，而不易給予適當的精神相關治療。本文報告一位22歲女性患者，本身亦有精神疾病之家族史，在15歲時即被診斷罹患SLE，並出現情緒不穩，社交退縮情形，卻未能及時積極處理，或轉介精神科做正確診斷及處置，造成7年來臨床處理的困擾，也使患者生活功能與品質受到影響。協助SLE病患的調適、留心思者的精神狀態、及早發現個案與及時轉介適當評估和治療，是臨床醫師不可忽視的責任。

關鍵字

全身性紅斑狼瘡；雙相情感障礙症；精神症狀的處置

並列摘要

Systemic lupus erythematosus (SLE) is a chronic relapsing/remitting autoimmune disease with primary and secondary effects on both neurological integrity and psychological function. However, owing to the various and complex clinical manifestations and pathogenesis, prompt psychiatric treatment remains challenging. We report a 22-year-old female patient, also with a positive family history of psychiatric disorders, first diagnosed SLE at the age of 15. Affective instability with social isolation was presented, but she didn't receive any form of psychiatric evaluation or management until 7 years later, and resulted in various clinical difficulties. Helping patients with SLE to adjust and resolve psychological distress is crucial for both symptom control and improvement in quality of life, and is all clinicians' responsibility. We should monitor patients' mental status carefully to see if adequate management or referral is indicated.

並列關鍵字

Systemic lupus erythematosus ； Bipolar affective disorder ； Psychiatric management

國際替代計量

全身性紅斑狼瘡合併雙相情感障礙症造成之臨床診斷與處置之困難：一病例報告

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