Behçet's syndrome and psychiatric involvement: is it a primary or secondary feature of the disease?

The primary aim of the study was to determine the frequency of psychiatric disorders in Behçet's syndrome (BS) patients, both with and without neurological involvement. The secondary aims were: to investigate a possible association between disease activity/organ involvement/demographic data and psychiatric profile in BS patients, and to compare the distribution of psychiatric disorders in BS patients compared to patients with other chronic diseases.

One hundred and sixteen BS patients were studied; in addition, two groups of patients affected by systemic lupus erythematosus and chronic arterial hypertension were included in the study as disease control groups. The end-point was represented by the assessment of disease activity, performed by the evaluation of: the presence/absence of manifestations, BDCAF and clinician's overall perception of disease activity. Psychiatric comorbidity was evaluated according to the DSMIV-TR criteria.

The frequency of bipolar disorders resulted significantly higher in BS than in disease controls. The presence of bipolar disorders in BS patients does not seem to be related to the presence of neurological involvement in the history of the disease. Notably, a significant correlation was found between BS disease activity and mood disorders, also in the follow-up.

The study demonstrated a high frequency of psychiatric disorders in BS patients, peculiarly represented by bipolar disorders. The presence of this involvement, independently from the organ involvement, and strictly related to the disease activity, seems to suggest that neuro-psycho-BS may represent an intrinsic aspect of BS.