Abstract
The manifestation of lupus psychosis is characterized by the lack of 'rapport', i. e. sympathetic relationship, based on depression. As Sir William Osler once described the patient with lupus psychosis as 'the patient who imagines all sorts of things', the signs and symptoms of lupus psychosis can be a psychological state full of imagination often accompanied by innocent illusion or hallucination. The time of the onset of lupus psychosis can also be characteristic : it emerges so often after the peak of systemic disease activity when the patient resumed to recover. The pathological studies done in the patients who died in the era before institution of any modern interventions revealed no remarkable pathognomonic changes that can explain the patients' diffuse psychological manifestation. We show that interferon α (IFNα) is significantly increased in the cerebrospinal fluids of patients in a disease-specific fashion. It subsequently decreases to disappear after the resolution of lupus psychosis. Further, studies have shown that the signs and symptoms akin to lupus psychosis were raised in the patients with viral hepatitis or cancer after therapeutic administration of IFNα, and they disappeared after cessation of IFNα therapy. Thus, the findings indicate that IFNα now fulfills the triad of Koch, i. e., the cause can be found in the lesion, the cause can be extracted from the lesion, and the cause can induce same manifestation when administered again, and that IFNα causes lupus psychosis.
