{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:08:01Z","timestamp":1777928881096,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T00:00:00Z","timestamp":1635465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Lupus fog is ill-defined. We aimed to study whether lupus fog is the result of dissociation by studying the prevalence of dissociation and dissociative fog in patients with SLE and neuropsychiatric manifestations of inflammatory and non-inflammatory origin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients visiting the tertiary referral center for neuropsychiatric systemic lupus erythematosus (NPSLE) of the LUMC between 2007\u20132019 were included. Patients were classified as having neuropsychiatric symptoms of inflammatory or non-inflammatory origin. Dissociation was studied using the Dissociative Experience Scale-II (DES), in which the presence of 28 dissociative symptoms is rated (0\u2013100% of the time), of which one question assesses the presence of a dissociative fog directly. Average scores are calculated and scores \u2265 25 are considered indicative of a dissociative disorder. A score of \u2265 30 on question 28 (dissociative fog) was considered indicative for the presence of a fog. Summary scores in the general adult population range from 4.4 to 14. Multiple regression analysis (MRA) was performed to study the association between inflammatory neuropsychiatric symptoms and dissociation. DES results are presented as median (range) and MRA as B and 95% confidence interval (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DES questionnaires were available for 337 patients, of which 69 had an inflammatory NPSLE phenotype (20%). Mean age in the total study population was 43 \u00b1 14\u00a0years and the majority was female (87%). The median dissociation score was 7.1 (0\u201375) and did not differ between patients with neuropsychiatric symptoms of inflammatory or non-inflammatory origin (B: \u22120.04 (95% CI: \u22120.17; 0.09)). 35 patients (10%) had a score indicative of a dissociative disorder. The most common type of dissociation was absorption\/imagination. 43 patients (13%) reported a dissociative fog.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In most patients with SLE and neuropsychiatric symptoms, dissociative symptoms are within normal range, regardless of underlying etiology. Dissociative fog is present, but uncommon. Lupus fog is most likely not associated with dissociation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033211050347","type":"journal-article","created":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T02:21:16Z","timestamp":1635560476000},"page":"2151-2156","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Dissociation in SLE: A part of lupus fog?"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2561-7085","authenticated-orcid":false,"given":"Rory C","family":"Monahan","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne ME","family":"Blonk","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Leiden University Medical Center, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Baptist","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Haaglanden Medical Center, the Hague, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huub AM","family":"Middelkoop","sequence":"additional","affiliation":[{"name":"Department of Neurology Leiden University Medical Center, the Netherlands"},{"name":"Department of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margreet","family":"Kloppenburg","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, the Netherlands"},{"name":"Department of Clinical Epidemiology, Leiden University Medical Center, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom WJ","family":"Huizinga","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nic J","family":"van der Wee","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Leiden University Medical Center, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerda M","family":"Steup-Beekman","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, the Netherlands"},{"name":"Department of Rheumatology, Haaglanden Medical Center, the Hague, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,10,29]]},"reference":[{"key":"bibr1-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1007\/s12026-015-8716-3"},{"key":"bibr2-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13816"},{"key":"bibr3-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"bibr4-09612033211050347","first-page":"151","volume":"3","author":"Frischholz EJ","year":"1990","journal-title":"Dissociation: Prog Dissociative Disord"},{"key":"bibr5-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1191\/0961203305lu2094oa"},{"key":"bibr6-09612033211050347","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.170233"},{"key":"bibr7-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.7028"},{"key":"bibr8-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1002\/art.40222"},{"key":"bibr9-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-020-2432-9"},{"key":"bibr10-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2019.06.007"},{"key":"bibr11-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2017.17010025"},{"key":"bibr12-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropsychologia.2016.07.017"},{"key":"bibr13-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1177\/0961203320963815"},{"key":"bibr14-09612033211050347","first-page":"697","volume":"46","author":"Sno HN","year":"2004","journal-title":"Tijdschrift Voor Psychiatrie"},{"key":"bibr15-09612033211050347","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.150.7.1030"},{"key":"bibr16-09612033211050347","volume-title":"The case for the study of \u2018normal\u2019 dissociation processes","author":"Dalenberg CJ","year":"2009"},{"key":"bibr17-09612033211050347","first-page":"347","volume":"151","author":"Giovannelli L","year":"2016","journal-title":"G Ital Dermatol 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