Neuropsychiatric systemic lupus erythematosus age and the neurodevelopmental model: Evidence in support of the Weinberger hypothesis

We set out to describe neurologic and psychiatric syndromes secondary to systemic lupus erythematosus (NPSLE) in terms of age of onset and to compare such findings to those predicted by Weinberger's "windows of vulnerability" hypothesis of the neurodevelopmental pathogenesis of mental disorders. A search of the literature provided 767 NPSLE diagnoses in 511 patients. The particular NPSLE diagnoses and the age at which they occurred were compiled. We then determined ranges medians and means of age of onset of the various syndromes. We compared these to the ranges and means of age of onset of psychiatric disorders postulated in the "windows" model. The type of NPSLE varied with age and the most striking finding was an 11.3-year difference between the mean onset of psychosis (30.4) and depressed mood (41.1). The mean ages of onset and the ranges were similar to those proposed by Weinberger both absolutely and in temporal relation to each other We conclude that NPSLE syndromes vary in age of onset in a manner consistent with and in support of the "windows of vulnerability" neurodevelopmental model of mental disorders.