Saygin Caner, Uzunaslan Didem, Hatemi Gulen, Hamuryudan Vedat
Behçet's Syndrome Research Centre, Istanbul University, Istanbul, Turkey.
Clin Exp Rheumatol. 2015 Nov-Dec;33(6 Suppl 94):S30-5. Epub 2015 Mar 23.
To evaluate the frequency of suicidal ideation among Behçet's syndrome (BS) patients compared to healthy and diseased controls and to delineate possible factors predicting an increase in suicidal ideation.
We included consecutive BS patients attending our outpatient clinic, patients with ankylosing spondylitis (AS) and healthy hospital staff as controls. Suicidal ideation was assessed by a standard questionnaire. Linear regression was used to identify the factors associated with suicidal ideation, such as demographic and clinical features, drugs, disease activity assessed using the Behçet's disease current activity form (BDCAF) for BS patients and BASDAI for AS patients, Behçet's disease quality of life (BDQoL) and Beck depression inventory (BDI) score.
We surveyed 303 BS patients, 52 AS patients and 106 healthy controls. Suicidal thoughts, as reflected by a positive response to the first three items of the questionnaire, were higher among BS patients with major organ involvement (42%) than those with mucocutaneous involvement (35%) and the control groups. There were significantly more BS patients with active major organ involvement who had thought to terminate their lives without plans within the last year (25.5%) compared to those with active mucocutaneous involvement (8.7%) and active AS patients (10%) (p=0.012). Patient-reported joint pain (β=-0.155, p=0.046), BDQoL (β=0.176, p=0.032), and BDI (β=0.017, p<0.0001) scores, suicidal thoughts before the onset of BS (β=-0.124, p=0.043), neurologic involvement (β=0.119, p=0.047) and past prednisone use (β=0.212, p=0.005) were independent predictors of suicidal thoughts.
BS patients with major organ involvement have increased thoughts of suicide during the active stages of their disease. A number of risk factors could help physicians to identify patients with increased suicidal thoughts.
评估白塞病（BS）患者与健康对照及患病对照相比自杀意念的发生率，并确定可能预测自杀意念增加的因素。
我们纳入了连续就诊于我们门诊的BS患者、强直性脊柱炎（AS）患者以及作为对照的健康医院工作人员。通过标准问卷评估自杀意念。采用线性回归来确定与自杀意念相关的因素，如人口统计学和临床特征、药物、使用白塞病患者的白塞病当前活动形式（BDCAF）和AS患者的巴斯强直性脊柱炎疾病活动指数（BASDAI）评估的疾病活动度、白塞病生活质量（BDQoL）和贝克抑郁量表（BDI）评分。
我们调查了303例BS患者、52例AS患者和106例健康对照。问卷前三项回答呈阳性所反映的自杀想法，在有主要器官受累的BS患者中（42%）高于有黏膜皮肤受累的患者（35%）及对照组。与有活动性黏膜皮肤受累的患者（8.7%）和活动性AS患者（10%）相比，有活动性主要器官受累且在过去一年中曾想过无计划地结束生命的BS患者明显更多（25.5%）（p = 0.012）。患者报告的关节疼痛（β = -0.155，p = 0.046）、BDQoL（β = 0.176，p = 0.032）和BDI（β = 0.017，p < 0.0001）评分、BS发病前的自杀想法（β = -0.124，p = 0.043）、神经受累（β = 0.119，p = 0.047）以及过去使用泼尼松（β = 0.212，p = 0.005）是自杀想法的独立预测因素。
有主要器官受累的BS患者在疾病活动期自杀想法增加。一些危险因素可帮助医生识别自杀想法增加的患者。
