BACKGROUND Stiff-person syndrome (SPS) is a rare autoimmune neurologic disease characterized by painful rigidity and muscle spasms. Patients with SPS may present with psychiatric symptoms, and little is known about the presence of psychiatric comorbidities. OBJECTIVE The objective of this study was to provide an overview of the association between SPS and psychiatric illnesses. METHODS The protocol is registered in PROSPERO (Registration ID CRD42020159354). Peer-reviewed articles on adults with SPS and psychiatric comorbidities published before May 26, 2020, were selected by 2 independent reviewers. Qualitative summary data and relative risk of psychiatric disorders in patients with SPS compared with the general population and multiple sclerosis were calculated. RESULTS After screening 909 articles, 52 full texts were assessed for eligibility and 27 were ultimately included, 5 of which were selected for quantitative analysis. Although limited by small sample sizes leading to large confidence intervals, the relative risk of any psychiatric comorbidity in SPS was higher than that of the general population, ranging from estimates of 6.09 (95% confidence interval: 4.09, 9.08) to 11.25 (95% confidence interval: 3.27, 38.66). There was no statistically significant difference in the risk of any psychiatric comorbidity between SPS and multiple sclerosis. The review also highlighted delays in SPS diagnosis, often related to misattribution of symptoms as being solely secondary to a psychiatric cause. CONCLUSIONS The higher risk of psychiatric comorbidities emphasizes the important role of psychiatrists in recognizing the symptoms of SPS to reach timely diagnosis and treatment. The presence of psychiatric symptoms should support rather than delay the diagnosis of SPS.

中文翻译：

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僵硬的人综合征和精神疾病：系统评价

背景僵硬人综合征（SPS）是一种罕见的自身免疫性神经系统疾病，其特征是疼痛的僵硬和肌肉痉挛。SPS 患者可能会出现精神症状，而对精神共病的存在知之甚少。目的 本研究的目的是概述 SPS 与精神疾病之间的关联。方法 该协议在 PROSPERO 中注册（注册 ID CRD42020159354）。2020 年 5 月 26 日之前发表的关于患有 SPS 和精神疾病的成人的同行评审文章由 2 位独立评审员选择。与一般人群和多发性硬化症相比，计算了 SPS 患者精神疾病的定性汇总数据和相对风险。结果 筛选 909 篇文章后，对 52 篇全文进行了资格评估，最终收录了 27 篇，其中 5 篇被选中进行定量分析。尽管受样本量小导致置信区间大的限制，但 SPS 中任何精神科合并症的相对风险高于一般人群，范围从估计值 6.09（95% 置信区间：4.09、9.08）到 11.25（95%置信区间：3.27、38.66）。SPS 和多发性硬化症之间的任何精神共病风险在统计学上没有显着差异。该审查还强调了 SPS 诊断的延误，这通常与将症状错误归因于仅继发于精神疾病有关。结论 精神科合并症的较高风险强调了精神科医生在识别 SPS 症状以达到及时诊断和治疗方面的重要作用。精神症状的存在应该支持而不是延迟 SPS 的诊断。