Behçet’s disease (BD) can affect the genital system and is more common in Middle Eastern countries and Asia but also occurs in Caucasian people. Aim of this study was to evaluate the prevalence of sexual dysfunction (SD) and depression in patients with BD compared to a healthy control group (HCG). In addition, differences with regard to depression and patients’ origin were evaluated. This prospective, monocentric study included 106 consecutive patients from our specialized BD outpatient clinic. Patients were asked to fill out the paper based standardized and validated questionnaires International Index of Erectile Function (IIEF), the Female Sexual Function Index (FSFI) and the Beck Depression Inventory (BDI). In addition, 206 healthy controls were asked to fill out the questionnaires. 106 patients with BD were evaluated and 206 participants in the HCG. The mean age in BD group was 40.5 years as compared to 44.4 years in the HCG. Half of the patients had Middle Eastern and half Caucasian origin. SD was found in 24.5% of all subjects. Only 6.9% of male patients showed signs of SD, while half of the women’s group was suffering from SD. The prevalence for SD was significantly higher in women with Middle Eastern ethnic origin compared to women with Caucasian origin (75 vs. 33.3%, p = 0.024). Erectile Dysfunction occurred in 55% of all male patients which was not statistical different from the HCG. Genital ulcers affected 73.6% of all patients. Depression was found in 36.7% of all subjects as compared to 6.25% in the HCG (p < 0.001). Both, SD and depression correlated positively in males (p = 0.017) and females (p = 0.013). SD and depression are very common problems in BD and should be addressed by the treating physician. Both manifestations are intensifying each other. Depression especially is more prevalent compared to the healthy population.

Objective. Women are more frequently affected by connective tissue diseases like systemic sclerosis (SSc). Therefore, few studies exist on male-specific complaints. This study aimed to investigate the prevalence and associated factors of erectile dysfunction (ED) in SSc compared with other connective tissue diseases (CTD) and healthy controls. Methods. 64 patients were analysed and compared with 123 age-matched HC. The 15-item International Index for Erectile Function (IIEF) questionnaire was used to assess sexual function. The prevalence of depression was quantified by using the validated Beck Depression Inventory (BDI). Results. Mean age was 52.3 years (SD 10.75) for SSc, 52.9 years (SD 11.01) for patients with other CTD and 52.6 (SD 12.37) for HC. Mean IIEF-15 score was 13.6 for SSc, 11.7 for other CTD and 23.6 for HC. ED was significantly more frequent in patients with SSc (55.0%) and other CTD (54.4%) than in HC (12.7%) (p<0.001) and correlated with diseases severity. The mean BDI score was 10.8 for SSc/CTD and 5.4 for HC (p<0.001). With 36.6%, SSc patients suffered more often from a depression than patients with other CTD (17.4%) and HC (6.3%). We found a significant correlation between the IIEF-15 and depression classified by p<0.001). Conclusion. This is the first study to show increased prevalence of ED, especially severe ED, in men with SSc compared to other CTD and age-matched HC. Physicians should be aware of this influence on sexual health and its correlation to depression and disease severity.

Objective Interstitial lung disease (ILD) is the leading cause of morbidity/mortality in systemic sclerosis (SSc). We aimed to study investigate the impact of sex on SSc-ILD. Methods EUSTAR SSc patients with radiological-confirmed ILD and available %predicted forced vital capacity(%pFVC) were included. Demographics and disease features were recorded. Change in %pFVC over 12±6 months (cohort 1) was classified into stable (≤4%), mild (5-9%) and large progression (≥10%). In those with 2-year longitudinal %pFVC (cohort 2), %pFVC change at each 12±6 months interval was calculated. Logistic regression analyses (OR and 95%CI) and Cox proportional hazards models adjusted for age and %pFVC were applied. Results 1136 male and 5253 female SSc-ILD patients were identified. Males were significantly younger, had a shorter disease duration, higher prevalence of CRP elevation, were had frequently a diffuse cutaneous involvement. In cohort 1(1655 females and 390 males), a higher percentage of males had stable ILD (74.4% versus 69.4%, p = 0.056). In multivariable analysis, disease duration and %pFVC(OR 0.99,0.98–0.99; 0.97,0.95–0.99) in males and age, %pFVC and anti-centromere(OR 1.02,1.00–1.04; 0.97,0.96–0.98; 0.39,0.245–0.63) in females were associated with large progression. The 1-year mortality rate was higher in males (5.1% versus 2.5%, p = 0.013). In cohort 2(849 females and 209 males), a higher percentage of females showed periods of large progression (11.7% versus 7.7%, p = 0.023), the percentage of patients with 0, 1 or 2 periods of worsening was not different. The overall death rate was 30.9% for males and 20.4% in females (p &lt; 0.001). At survival analysis, male sex was a predictor of mortality (OR 1.95, 1.66–2.28). Conclusions Male SSc-ILD patients have a poorer prognosis and sex-specific predictors exist in SSc-ILD.

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