Giant cell arteritis

Page most recently updated 7 September 2026

This page focuses on the reported psychiatric associations, which may be the initial presenting manifestation, and on other clinical features that may assist the psychiatrist or primary care physician in identifying the underlying diagnosis, considered through the lenses of the diagnostic lenses framework.

Giant cell arteritis is a systemic vasculitis.

It can present with psychiatric features such as depression, anxiety, behavioural change, mood disturbance, cognitive dysfunction, and, less commonly, psychosis.

Other characteristic features include new-onset headache (typically in adults aged >50 years), scalp tenderness, jaw claudication, visual disturbance (including transient visual loss or diplopia), constitutional symptoms, and polymyalgia rheumatica. Neurological complications may include ischaemic optic neuropathy, stroke, and, less commonly, cranial neuropathies.

From a multisystemic lens perspective, clinical features in other body systems include (but are not limited to):

  • Cardiovascular: large-vessel vasculitis may involve the aorta and its major branches, with an increased risk of aortic aneurysm and dissection.

  • Hematologic: elevated inflammatory markers (erythrocyte sedimentation rate and C-reactive protein) and thrombocytosis are common.

  • Musculoskeletal: polymyalgia rheumatica, characterized by pain and stiffness affecting the shoulders, neck, and hips, commonly coexists.

Early diagnosis is important to enable prompt corticosteroid therapy, prevent irreversible visual loss and other ischaemic complications, reduce the risk of large-vessel complications including aortic aneurysm and dissection, and improve long-term outcomes and quality of life.

Selected references and further reading — Multisystemic lens

Cardinal RN, Bullmore ET. The diagnosis of psychosis. Cambridge: Cambridge University Press; 2011.

Sachdev PS, Keshavan MS, editors. Secondary schizophrenia. Cambridge: Cambridge University Press; 2010.

Levenson JL, editor. The American Psychiatric Association Publishing textbook of psychosomatic medicine and consultation-liaison psychiatry. 3rd ed. Washington (DC): American Psychiatric Association Publishing; 2019.

Stern TA, Beach SR, Smith FA, Freudenreich O, Vranceau AM, Fava M, editors. Massachusetts General Hospital handbook of general hospital psychiatry. 8th ed. Philadelphia: Elsevier; 2025.

Arciniegas DB, Yudofsky SC, Hales RE, editors. The American Psychiatric Association Publishing textbook of neuropsychiatry and clinical neurosciences. 6th ed. Washington (DC): American Psychiatric Association Publishing; 2018.

Agrawal N, Faruqui R, Bodani M, editors. Oxford textbook of neuropsychiatry. Oxford: Oxford University Press; 2020.

Boland R, Verduin M, editors. Kaplan and Sadock's comprehensive textbook of psychiatry. 11th ed. Philadelphia: Wolters Kluwer; 2024.

Loscalzo J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Harrison's principles of internal medicine. 22nd ed. New York: McGraw Hill; 2025.