Glucocorticoid exposure and social support deficits as longitudinal predictors of long-term neuropsychiatric damage in SLE: insights from the LUMINA cohort (LXXXIII).

92 patients (14.0%) had organic and 197 (30.0%) had any neuropsychiatric damage; models were trained on incident events (48 and 90, respectively).

Random survival forests achieved C-indices of 0.738 (organic) and 0.775 (all neuropsychiatric damage) outperforming Cox regression.

Tangible material support deficits specifically dominated the social support signal.

For the secondary outcome, physician global assessment, fatigue and pain ranked highest, suggesting distinct predictor profiles for cognitive versus organic outcomes.