title: Fatigue in patients with Behçet's syndrome: relationship with quality of life, depression, anxiety, disability and disease activity.
abstract: OBJECTIVE
  Fatigue is a common symptom of chronic inflammatory diseases. The objective of this study was to investigate fatigue in patients with Behçet's syndrome (BS) and to examine the relationship between fatigue and disease activity, quality of life, anxiety and depression.
  
  
  METHODS
  This is a cross-sectional study of 123 BS patients and 71 healthy controls in Turkey. All subjects completed the Multidimensional Assessment of Fatigue (MAF) questionnaire, Short form-36 (SF-36), Hospital Anxiety and Depression (HADS) scale and Health Assessment Questionnaire (HAQ). Disease activity among BS patients was assessed using the Behçet Syndrome Activity Scale (BSAS) and the physician's global assessment (PGA).
  
  
  RESULTS
  BS patients had significantly higher MAF, HADS-depression (HADS-D) and HADS-anxiety (HADS-A) scores than the healthy controls (P < 0.001). Both the physical and mental components of the SF-36 scale were impaired in BS patients (P = 0.0001). BS patients with active disease, depression and anxiety had significantly higher MAF scores compared to BS patients without active disease, depression and anxiety (P = 0.0001). MAF scores showed positive correlations with HADS-A, HADS-D, HAQ scores and negative correlations with SF-36 mental and physical components. In regression analyses, depression, anxiety and physical dysfunction were significantly associated with fatigue, after adjusting for age, sex, SF-36 physical and mental scores, HAQ, HADS-A, HADS-D and BSAS scores (P < 0.05). Decreases in SF-36 physical and mental scores were significant predictive factors for high MAF score in healthy controls (P < 0.05).
  
  
  CONCLUSIONS
  Fatigue is common in clinically active BS patients compared with healthy controls and inactive BS patients. Depression, anxiety and physical dysfunction were significantly associated with fatigue.
authors.affiliation: Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Birkan
authors.initials: B
authors.lastname: Ilhan
authors.affiliation: Department of Rheumatology, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey.
authors.forename: Meryem
authors.initials: M
authors.lastname: Can
authors.affiliation: Department of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Alibaz-Oner
authors.affiliation: Department of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Yilmaz-Oner
authors.affiliation: Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Ozge
authors.initials: O
authors.lastname: Polat-Korkmaz
authors.affiliation: Department of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Gulsen
authors.initials: G
authors.lastname: Ozen
authors.affiliation: Faculty of Health Sciences, Marmara University, Istanbul, Turkey.
authors.forename: Gonca
authors.initials: G
authors.lastname: Mumcu
authors.affiliation: Department of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Hilal
authors.initials: H
authors.lastname: Maradit Kremers
authors.affiliation: Department of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Haner
authors.initials: H
authors.lastname: Direskeneli
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D001528:Behcet Syndrome / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D004185:Disability Evaluation; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000073222:Patient Health Questionnaire; D011237:Predictive Value of Tests; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D014421:Turkey
keywords: miscellaneous topics; vasculitides