indicates that a significant portion of these patients infrequently or never disclose their mental health concerns to medical professionals. Additionally, the spectrum of potential mental and neurological symptoms is broader than previously thought.
55% of SARD patients were experiencing depression, 57% experiencing anxiety, 89% had experienced severe fatigue and 70% had experienced cognitive dysfunction, for example. The overall prevalence of symptoms was significantly higher than previously thought, and much higher than in a control group of healthy volunteers.
However, other clinicians felt that these symptoms were underestimated because patients were rarely asked about them in the clinic. One rheumatology nurse interviewed said: “Doctors don’t go looking for it [hallucinations], so if we don’t ask we don’t think it exists much.” The study showed that patients were often reticent to report to clinicians mental health problems they might be having, sometimes feeling that they might be stigmatized. Patients frequently said that even when they did share their mental health symptoms with clinicians, they were often not commented on or not documented accurately or at all.
The research team suggests that though they found neurological and psychiatric symptoms to be under-elicited in clinic, under-identified in research, and under-represented in clinical guidelines, they described almost all clinicians as highly motivated to improve care. Rapidly evolving knowledge – including the behavioral and cognitive impacts of chronic inflammation and a widening range of potential biomarkers – means that there are grounds for optimism.
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