Depression and Anxiety in Iranian Patients with Behcet's Disease: A Single Center Experience

  • Mohammad Mehdi Fani Department of Oral Medicine, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz
  • Elham Aflaki Department of Rheumatology, Shiraz University of Medical Sciences, Shiraz
  • Hooman Ebrahimi Department of Oral Medicine, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz
  • Anahita Safari Department of Prosthodontics, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz
  • Sina Ghanizadeh Department of Psychiatry, Shiraz University of Medical Sciences, Shiraz
  • Maryam Ranjbar Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz
  • Alireza Manafi Student Research Committee, Fasa University of Medical Sciences, Fasa
  • Afshin Borhanihaghighi Associate Professor, Department of Neurology, Shiraz University of Medical Sciences, Shiraz
Keywords: Behcet`s Disease Anxiety, Stress, Depression, Iran


Background: This study was designed to determine and compare the stress, anxiety and depression levels in Behcet’s disease (BD) patients and a control group of normal individuals.Materials and Methods: One-hundred and six patients with BD were selected as cases and controls were 106 age- and sex-matched participants referred to the Shiraz Dental school clinics due to dental problems. We collected the information with 3 validated Farsi questionnaires: Perceived Stress Scale (PSS) for stress, Beck Anxiety Index (BDI) for depression and Beck Depression Index (BAI) for anxiety.Results: Stress, depression and anxiety levels were significantly higher in patients with BD in comparison with the control group (p<0.001).Conclusions: A high level of stress and depression in BD patients is frequent and PSS, BDI and BAI are useful for determining these variations. Finally, we suggest a psychiatrist consultation in all periods of disease treatment.


Saleh Al Musawi Z, Madan W, Fareed E. Pediatric-onset Behçet Disease in Bahrain: Report of Nine Cases and Literature Review. Arch Iran Med. 2012; 15(8): 485-7.

Saadoun D, Cassoux N, Wechsler B, Boutin D, Terrada C, Lehoang P, Bodaghi B, Cacoub P. Ocular manifestations of Behcet's disease. Rev Med Interne. 2010; 31(8): 545-50.

Saadoun D, Wechsler B, Terrada C, Hajage D, Le Thi Huong D, Resche-Rigon M, Cassoux N, Le Hoang P, Amoura Z, Bodaghi B, Cacoub P. Azathioprine in severe uveitis of Behcet's disease. Arthritis Care Res (Hoboken). 2010; 62(12): 1733-38.

Gur A, Sarac AJ, Burkan YK, Nas K, Cevik R. Arthropathy Behcet’s disease: relationship between arthritis and these factors. Clin Rheumatol. 2006;25(4):524-31.

Geri G, Wechsler B, Thi Huong Du L, Isnard R, Piette JC, Amoura Z, Resche-Rigon M, Cacoub P, Saadoun D. Spectrum of cardiac lesions in behcet disease: a series of 52 patients and review of the literature. Medicine (Baltimore). 2012; 91(1): 25-34.

Epstein RS, Cummings NA, Sherwood EB, Bergsma DR. Psychiatric aspects of Behcet`s syndrome. J Psychosom Res. 1970; 14: 161-172.

Kopragel G, Tuncer O, Enbityogiu G, Bayramoglu Z. A psychosomatic investigation of Behcet`s disease. Psychotherpsychosome. 1983; 40: 263-71.

Karlidag R, Unal S, Evereklioglu C, Sipahe B, ER H, Yologlu S. Stressful life events, anxiety, depression and coping mechanisms in patients with Behcet`s disease. J Eur Academy of Dermatology and venereology. 2003; 17: 670-75

Taner E, Coşar B, Burhanoğlu S, Calikoğlu E, Onder M, Arikan Z. Depression and anxiety in patients with Behçet's disease compared with that in patients with psoriasis. Int J Dermatol. 2007 Nov;46(11):1118-24

Karlidag R, Unal S, Evereklioglu C, Sipahi B, Er H, Yologlu S. Stressful life events, anxiety, depression and coping mechanisms in patients with Behçet's disease. J Eur Acad Dermatol Venereol. 2003 Nov;17(6):670-5

Calikoglu E. Onder M, Cosar B, Candansayar S. Depression , anxiety levels and general psychological profile in Behcet`s disease. Dermatology. 2001; 203: 240-88.

BorhaniHaghighi A, Purmand R, Nikseresht Ar. NeuroBehcet`s disease. A review. Neurologist 2005;11:80-89.

Tunç R, Uluhan A, Melikoglu M, Ozyazgan Y, Özdogan H, Yazic H. A reassessment of the International Study Group criteria for the diagnosis (classification) of Behcet’s syndrome. Clinical and Experimental Rheumatology 2001; 19 (Suppl. 24): 45-47.

Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory, Second edition: BDI-II-PERSIAN. Depress Anxiety. 2005;21(4):185-92

Bang D, Lee J, Lee E, Lee S, Choi JS, Kim YK, Cho BK et al (2001) Epidemiologic and clinical survey of Behcet’s disease in Korea: the first multicenter study. J Korean Med Sci 16:615–18.

Pande I, Uppal S, Kailash S, Kumar A, Malaviya AN. Behcet’s disease in India: a clinical, immunological, immunogenetic and outcome study. Br J Rheumatol. 1995; 34:825–30.

Gurler A, Boyvat A, Tursen U. Clinical manifestations of Behcet’s disease: an analysis of 2,147 patients. Yonsei Med J. 1997; 38:423–27.

Tanner E. Anxiety and depression in Behcet`s disease patients compared to psoriasis patients. Psychiatry in Turkey, 2006; 8(1): 27-29.

Cohen Sh, Kamark T, Mermel Stein R. A global measure of Perceived Stress. Journal of Health and Behavior. 1983; 24: 385-96.

Huyser B, Parker J. Stress and rheumatoid arthritis: an integrative review. Arthr Care Res. 1998; 11:135–45.

Melzack R. Pain: past, present and future. Can J Exp Psychol. 1993; 47:615–29.

Schwartz L, Slater MA, Birchler GR. Interpersonal stress and pain behaviors in patients with chronic pain. J Consult Clin Psychol. 1994; 62:861–64.

Melikoglu MA, Melikoglu M. The relationship between disease activity and depression in patients Behcet`s disease and rheumatoid arthritis. Rheumatol Int. 2010; 30: 941-46.

Kim WH, Cho YS, Yoo HM, Park Si, Park CE, Lim Jg. Quality of life in Korean patients with inflammatory bowel diseases: ulcerative colitis, Crohn's disease and intestinal Behçet's disease. Int J Colorectal Dis. 1999; 14(1):52-7.

Ugaz F, Dursum R, Kaya N, Savascilli A. Quality of life in patients with Behcet`s disease. The impact of major depression. J General Hospital psychiatry.2007; 29: 21-2.

How to Cite
Fani, M. M., Aflaki, E., Ebrahimi, H., Safari, A., Ghanizadeh, S., Ranjbar, M., Manafi, A., & Borhanihaghighi, A. (2013). Depression and Anxiety in Iranian Patients with Behcet’s Disease: A Single Center Experience. Galen Medical Journal, 2(3), 100-105.
Original Article