No abstract

Backgroundthe cognitive disorders (CD) is a special psychopathological problem for Behçet's Disease (BD) patients. The causes of CD aren't enough investigated. Anxiety/depressive disorders and primary neural parenchymal lesions due to BD usually related to CD in these patients.Objectivesto determine the prevalence of CD in BD patients and its associations with some clinical and magnetic resonance imaging (MRI) scan features.Methodsthe investigation has been realized in accordance with the interdisciplinary program “Stress factors and mental disorders in immune-mediated inflammatory rheumatic diseases”.106 BD patients were enrolled in the study. The majority of patients were men (72,6%), natives of the North Caucasus (51,9%), with mean age (M±m) 33,3±0,98 years. All the patients met the criteria of the International Study Group for BD (1990) classification. The disease activity was assessed by scoring system BDCAF.CD were diagnosed with psychology and neuropsychology methods. Mental disorders (MD) were diagnosed by psychiatrist in accordance with the ICD-10 in semi-structured interview. The severity of depression and anxiety was evaluated by Montgomery–Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A).Brain MRI including T1- weighted images, T2- weighted images and fluid-attenuated inversion-recovery images (FLAIR) was done in 44 (41,5%) BD patients.ResultsCD of mild to moderate severity were diagnosed in 82 (77,4%) of BD patients. The mechanical memory (50%) and attention deficit (80,5%) were the most frequent manifestations of CD, impairment of associative memory (31,7%) and logical thinking (36,6%) were less frequent. The presence of CD didn't depend on BD activity, severity and duration, as on patient's ethnicity, use of prednisone and immunosupressive agents. The frequency of neurological manifestations (headache, seizures, myelopathy, ataxia) did not differ significantly in patients with and without CD (28% vs 32%, p=0,44). The patients with CD were older (34,3±1,07 vs 29,0±2,14, p=0,006), more often had chronic/recurrent depressive disorders (84,1% vs 50,0%, p=0,001) of moderate severity (MADRS 16,1±0,74 vs 12,2±1,06, p=0,005), chronic stressful life events (91,5% vs 62,5%, p=0,001) and multifocal subcortical parenchymal MRI changes (57,6% vs 9%, p=0,005).Conclusionsthe results have shown high rates of different CD in BD patients. CD were not associated with BD activity and presence of neurological symptoms. CD were related to the diagnoses of stress-related mild to moderate chronic depressive disorders and minor brain multifocal subcortical parenchymal MRI lesions.Disclosure of InterestNone declared

BackgroundPsychiatric disorders (PD) of anxiety-depressive spectrum occur in Behcet's Disease (BD) patients quite often. The multifactorial genesis of PD in BD have not been clarified yetObjectivesTo analyze the occurrence rate of PD and their associations with BD clinical featuresMethods75 patients with BD were enrolled in the study. All the patients met the criteria of the International Study Group for BD (1990). 57 (76%) patients were men and 18 (24%) – women, with a mean age of 33,4±1,15 (M±m) and mean disease duration of 150,8±11,9 months. Most of BD patients (46 (61,3%)) were the inhabitants of the North Caucasus and parts of Western Asia: 24 (32%) were the natives of Daghestan, 10 (13,3%) – the Chechens, 8 (10,7%) - the Armenians, 4 (5,3%) - the Azerbaijanians. 13 (17,3%) were Russians. The disease activity was assessed by scoring system BDCAF. 73% of BD patients had a moderate and high activity of disease (BDCAF>3). 67 (75%) patients were taking prednisone in mean dose 9,4±0,68 mg/day (M±m), 66 (88%) - cytotoxic drugs. PD were diagnosed by psychiatrist in accordance with the ICD-10 in semi-structured interview. Psychiatric and psychological scales and methods used: Hospital Anxiety and Depression Scale for screening, Hamilton Anxiety Rating Scale, Montgomery-Asberg Depression Rating Scale (MADRS) and projective psychological methods for evaluation of cognitive functions. The severity of fatigue was evaluated with the Fatigue Severity Scale (FSS)ResultsAnxiety-depressive disorders were diagnosed in 63 (84%) BD patients. Chronic depression prevailed - dysthymia was found in 22 (29,3%) and recurrent depressive disorder - in 21 (28%) of BD patients. Single depressive episode had 9 (12%) patients, adjustment disorder - 7 (9,3%), generalized anxiety disorder - 4 (5,3%). Mild and moderate cognitive disorders were found in 62 (83%) BD patients. 61 (81,3%) patients had acute stress events one year before the BD onset. The chronic psychosocial stress had 67 (89,3%) BD patients. Early traumatic childhood experiences revealed in 46 (61,3%) BD patients. The patients with anxiety-depressive spectrum disorders did not differ significantly on the age, duration of BD, gender, disease activity (BDCAF score) and BD clinical features from the patients without PD. The patients with major depressive disorder (MDD) had the high hsCRP level (>10 mg/l) two times more frequent (33,3% vs 16,6%) than the patients without PD. We found significant (p<0,05) positive correlation between cognitive impairments and BD duration (r=0,233), BDCAF score (r=0,258), fibrinogen level (r=0,481), anxiety-depressive spectrum disorders (r=0,280) and chronic stress (r=0,233), depression (MADRS score) (r=0,304) and fatigue (FSS score) (r=0,320) severityConclusionsThe results showed high occurrence rate of anxiety-depressive spectrum disorders and cognitive impairments in BD patients. The stress events preceded the BD onset and accompanied BD in majority of patients. MDD was associated with high hsCRP level, cognitive impairments - with BD activity and d...

No abstract

BackgroundMental disorders (MD), especially depressive, have high rates in rheumatic disorders (RD)–Behçet's Disease (BD) and Rheumatoid Arthritis (RA). Depressive and cognitive disorders have close pathogenesis interrelations with RD.ObjectiveTo compare the variants of MD in BD and RA-patients.MethodsTwo hundred and twenty-five (100 BD and 125 RA) inpatients were enrolled in the study. In BD patients prevailed men (70%) in RA–women (77%). MD were diagnosed in accordance with the ICD-10 in semi-structured interview. For evaluation of severity and the variants of cognitive disorders psychology and neuropsychological methods were used.ResultsMD were diagnosed in the majority of patients (86%), significantly more often (P < 0001) in RA (94%) versus (vs) BD (79%) patients. The depressive disorders dominated (BD–100%, RA–93%). The chronic and recurrent depressive disorders prevailed in both groups : in RA more often than in BD patients (58.4% vs 39.2%, P = 0.003). Cognitive disorders of different severity were diagnosed in most patients with BD and RA (73% vs 66.4%, n/s). The mechanical memory (63%) and attention deficit (72%) in BD and impairment of associative memory (90%) and logical thinking (71%) in RA were the most frequent manifestations of cognitive disorders.ConclusionThe results have shown high rates of MD, especially chronic depression and cognitive disorders in BD and RA patients. The necessity of interdisciplinary strategy implementation for the improvement of individualized treatment approaches in RD has been confirmed.Disclosure of interestThe authors have not supplied their declaration of competing interest.