title: Suicidal ideation among patients with Behçet's syndrome.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Behçet's Syndrome Research Centre, Istanbul University, Istanbul, Turkey.
authors: Caner
authors: C
authors: Saygin
authors: Behçet's Syndrome Research Centre, Istanbul University, Istanbul, Turkey.
authors: Didem
authors: D
authors: Uzunaslan
authors: Behçet's Syndrome Research Centre, Istanbul University, Istanbul, Turkey.
authors: Gulen
authors: G
authors: Hatemi
authors: Behçet's Syndrome Research Centre, Istanbul University, Istanbul, Turkey. vhamuryudan@yahoo.com.
authors: Vedat
authors: V
authors: Hamuryudan
mesh_terms: D000328:Adult; D017668:Age of Onset; D001528:Behcet Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult