In rare cases, neuropsychiatric systemic lupus erythematosus (NPSLE) manifests as psychosis. As there are no guidelines recommending the use of antinuclear antibody (ANA) testing in the assessment of patients with psychosis, researchers herein examined NPSLE prevalence in patients with psychosis who were positive for ANAs.

• From the mental health service of 2 metropolitan tertiary referral centers, researchers retrieved data of 10,205 mental health admissions with diagnoses of psychosis representing 4,766 individual patients.

• ANAs tests were conducted in 911 patients (19%), 135 (15%) of these returned a positive result with a titer of ≥ 1:160.

• In patients with psychosis who were positive for ANAs, there was a low prevalence of NPSLE, at 1.5%.

• Routine testing for ANAs is not supported in patients with psychosis given the low rate of clinically significant positive results.