Behçet Hastalığı Olanlarda Uyku Kalitesinin ve Uyku Kalitesi ile Hastalık Aktivitesi Arasındaki İlişkinin Değerlendirilmesi

Giriş:Behçet hastalığı vaskülit ile seyreden kronik otoimmün bir hastalıktır. Hastalık yineleme (relaps) ve iyilik dönemleri (remisyon) ile seyretmektedir ve tüm organları tutabilmektedir. Behçet hastalığında aynı zamanda psikiyatrik belirtilerin de sık gözlendiği çalışmalarda ortaya konmuştur ve psikiyatrik belirtilerin hastalık şiddeti ile ilişkili olduğu gösterilmiştir. Çalışmamızın amacı Behçet Hastalığı olanlarda uyku kalitesinin değerlendirilmesi ve uyku kalitesi ile hastalık aktivitesi arasındaki ilişkinin araştırılmasıdır. Yöntem: Ankara Üniversitesi Tıp Fakültesi Mulidisipliner Behçet polikliniğine başvuran 49 hastaya Sosyodemografik veri formu, Pittsburgh Uyku Kalitesi Ölçeği (PUKÖ), Hastane Anksiyete Depresyon (HAD) ve Behçet Hastalığı Aktivite Formu (BHAF) verilmiştir. Tanımlayıcı analizler, korelasyon analizleri ve Students t-testi yapılmıştır. Bulgular:  PUKÖ ortalaması 4,76±2,52, BHAF puanı ortalaması 4,4±2,43 ve HAD ortalaması 16,71±6,6 olarak belirlenmiştir. BHAF ve HAD’den yüksek puan almak sırası ile hastalık aktivitesi ve depresyon ile anksiyete belirtilerinin daha fazla olduğuna işaret etmektedir. PUKÖ puanları değerlendirildiğinde hastaların %32,7’si (n=16) eşik puan olan 5’in üzerinde puan almıştır. PUKÖ ile BDCAF arasında anlamlı bir korelasyon saptanmamıştır (r=.068, p=0.641).Her üç Behçet hastasının birinin uyku kalitesinin bozuk olduğu gösterilmiş olup hastalık aktivitesi ve uyku kalitesi arasında anlamlı bir ilişki bulunmamıştır. 

Sleep Quality in Behcet Disease and The Relationship Between Sleep Quality and Disease Activity

Introduction: Behcet disease is an autoimmune disease that presents vasculitis. It is relapsing and remmitting disease and effects every organs. Nevertheless it was shown that psychiatric findings were common in the disease and there was a relationship between disease activity and these findings. In this paper we aimed to evaluate relationship between sleep quality and disease activity. Method:Sociodemographic dataset, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale and Behcet Disease Current Activity Form were applied to patients that refered to Ankara University MEdical Faculty Multidiscipliner Behcet Clinic. Descriptive, correlation analysis and Mann-Whitney U were carried out. Results: Mean of BDCAF, HAD depression subscale, anxiety subscale and PSQI were respectively 4,4 ± 2,43, 8,69±3,19, 8,10 ± 4,36 and 4,76±2,52. %32,7 (n=16) of patients had over 5 point in PSQI; which cut off point of this scale is 5 point. Both BDCAF and HAD higher scores mean increased disease activity and more intense depression and anxiety findings. There was no correlation between PSQI and BDCAF(r=.068, p=0.641). Conclusion: In our study it was shown that one of three patients with Behcet disease had poor sleep quality but there was no relationship between sleep quality and disease activity

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  • Ağargün, M. Y., Kara, H., & Anlar, Ö. (1996). The validity and reliability of the Pittsburgh Sleep Quality Index. Turk Psikiyatri Derg, 7(2), 107-15.
  • Aydemir, Ö., Güvenir, T., Küey, L., & Kültür, S. (1997). Hastane anksiyete ve depresyon ölçeği Türkçe formunun geçerlilik ve güvenilirliği. Türk Psikiyatri Dergisi, 8(4), 280-7.
  • Bagheri, F., Mani, A., Tadayyoni, A., Firozi, F., & Nazarinia, M. A. (2013). The prevalence of psychiatric symptoms in the patients with Behcet's disease in Shiraz, Southwest of Iran. Journal of Mood Disorders, 3(1), 28.
  • Bhakta, B. B., Brennan, P., James, T. E., Chamberlain, M. A., Noble, B. A., & Silman, A. J. (1999). Behcet's disease: evaluation of a new instrument to measure clinical activity. Rheumatology, 38(8), 728-733
  • Buysse, D. J., Reynolds III, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry research, 28(2), 193-213.
  • Erberk,Ö. N., Birol, A., Boratav, C., & Kocak, M. (2006). Executive dysfunctions and depression in Behçet’s disease without explicit neurological involvement. Psychiatry and clinical neurosciences, 60(4), 465-472.
  • Epstein, R. S., Cummings, N. A., Sherwood, E. B., & Bergsma, D. R. (1970). Psychiatric aspects of Behçet's syndrome. Journal of psychosomatic research, 14(2), 161-172
  • Hamuryudan, V., Fresko, I., Direskeneli, H., Tenant, M. J., Yurdakul, S., Akoglu, T., & Yazıcı, H. (1999). Evaluation of the Turkish translation of a disease activity form for Behçet's syndrome. Rheumatology, 38(8), 734-736.
  • Herdi, O., Şahin, B., Barı, B., Boyvat, A., & Cankorur, V. Ş. BEHÇET HASTALARINDA DEPRESYON ANKSİYETE BELİRTİLERİ SIKLIĞI VE BEHÇET HASTALIĞI AKTİVİTESİ İLE İLİŞKİSİ.
  • Jeong HJ, Lee TH, Lee JM, et al. Sleep disturbances in Korean patients with ankylosing spondylitis are associated with increased disease activity. J Rheum Dis 2014;21:241247.
  • Kaklamani VG, Vaiopoulos G, Kaklamanis G (1998) Behcet’s disease. Semin Arthritis Rheum 27:197–217
  • Karlidag, R., Unal, S., Evereklioglu, C., Sipahi, B., Er, H., & Yologlu, S. (2003). Stressful life events, anxiety, depression and coping mechanisms in patients with Behçet's disease. Journal of the European Academy of Dermatology and Venereology, 17(6), 670-675.
  • Koca, I., Savas, E., Ozturk, Z. A., Tutoglu, A., Boyaci, A., Alkan, S., ... & Onat, A. M. (2015). The relationship between disease activity and depression and sleep quality in Behçet’s disease patients. Clinical rheumatology, 34(7), 1259-1263.
  • Kontogiannis, V., & Powell, R. J. (2000). Behcet's disease. Postgraduate medical journal, 76(900), 629-637.
  • Lee, J., Kim, S. S., Jeong, H. J., Son, C. N., Kim, J. M., Cho, Y. W., & Kim, S. H. (2017). Association of sleep quality in Behcet disease with disease activity, depression, and quality of life in Korean population. The Korean journal of internal medicine, 32(2), 352.
  • MarshallSE(2004)Behçet’sdisease.BestPractResClinRheumatol 18:291–311
  • Melikoglu, M. A., & Melikoglu, M. (2010). The relationship between disease activity and depression in patients with Behcet disease and rheumatoid arthritis. Rheumatology international, 30(7), 941-946.
  • Monastero, R., Camarda, C., Pipia, C., Lopez, G., Camarda, L. K., Baiamonte, V., ... & Camarda, R. (2004). Cognitive impairment in Behçet's disease patients without overt neurological involvement. Journal of the neurological sciences, 220(1), 99-104.
  • Özdemir, D. F., Özsoylar, G., Candansayar, S., Coşar, B., & Önder, M. (2004). Psychiatric findings related to neurological complications in Behcet's disease: A short review and a case presentation. International journal of psychiatry in clinical practice, 8(3), 185-190.
  • Son CN, Choi G, Lee SY, et al. Sleep quality in rheumatoid arthritis, and its association with disease activity in a Korean population. Korean J Intern Med 2015;30:384-390.
  • Tanrıverdi, N., Dürü, Ç., Özdal, P., Ortaç, S., & Fırat, E. (2003). Health-related quality of life in Behcet patients with ocular involvement. Japanese journal of ophthalmology, 47(1), 85-92.
  • Tascilar, N. F., Tekin, N. S., Ankarali, H., Sezer, T., Atik, L., Emre, U., ... & Cinar, F. (2012). Sleep disorders in Behçet’s disease, and their relationship with fatigue and quality of life. Journal of sleep research, 21(3), 281-288.
  • Yazmalar, L., Batmaz, İ., Sarıyıldız, M. A., Yıldız, M., Uçmak, D., Türkçü, F., ... & Çevik, R. (2017). Sleep quality in patients with Behçet's disease. International journal of rheumatic diseases, 20(12), 2062-2069.
  • Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta psychiatrica scandinavica, 67(6), 361-370.