The autoimmune disorder known as mixed connective tissue disease is frequently associated with the onset of psychiatric symptoms. In a group of 20 patients with the disease, followed up for 5 years, there was a 55 percent incidence of psychiatric symptoms. The culprit was an aseptic syndrome resembling meningitis. Fortunately, these symptoms were very responsive to corticosteroid therapy. Others exhibited peripheral neuropathy, cerebellar ataxia, trigeminal neuropathy, psychosis and convulsions. Among the patients exhibiting such symptoms, 5 of them were found to have abnormal cerebrospinal fluid, with mild pleocytosis and heightened protein content being the main abnormalities.
Another report, summarizing the results of this study, said:
“This case is unique in several ways. Major depression in MCTD is rarely documented whereas psychosis and seizures do tend to occur. In a study of 20 patients with MCTD conducted by Bennett et al., over a span of 5 years, showed that 11 had neurological and psychiatric symptoms. Psychosis was seen in 3 patients, one patient also had a progressive stupor while severely ill with polymyositis very similar to this patient.6 Depression however, was not documented but can occur due to steroid use. Both depression and psychosis can occur because of steroid use but the dose is generally high about 40 mg and these symptoms occur early on after starting treatment and gradually disappear as the dose is tapered.7 This patient was not on steroids at the time of presentation or 3 months prior to admission and when she was given steroids in the past it was in a low dose (10 mg) and that too on irregular basis because of her diagnosis of RA. Secondly, the symptoms of depression improved with steroids, thus negating that steroids could be the cause of her illness.”
