THU0559 PSYCHOLOGICAL EFFECTS OF A BEHÇET’S DIAGNOSIS ON DISEASE ACTIVITY PERCEPTION- A PROSPECTIVE OBSERVATIONAL STUDY
Authors: Casandra Buzatu, Hannah Nicholson, Roisin Cunningham, Robert J Moots
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> There is a pressing need to understand more about the psychological experience in patients with Behçet's Disease (BD). The presence of poor wellbeing, low mood and anxiety may affect the ability to both manage and cope with this complex disorder and also impact upon the perception and experience of disease activity<sup>1,2,3</sup>. <h3>Objectives:</h3> Our aim was to investigate the relationship between patient rating of disease activity and their psychological experience (anxiety, low mood, illness perception and coping style) in a UK Centre of Excellence for BD. <h3>Methods:</h3> This study had full UK research ethics approval. A 12-month prospective observational study of a cohort of patients diagnosed with BD according to the International Criteria for BD(ICBD) under surveillance in the BD Centre of Excellence Liverpool, UK. All patients that agreed to a psychological evaluation were included. Participants were described for demographics and clinical presentation. BD Current Activity Form 2006 and a clinician's and patient's visual analogue scale (VAS) were recorded. Participants completed validated self-reported measures: Brief COPE, IPQ-R, PHQ-9, GAD-7 and WEMWBS. Spearman Rank correlations, multivariate regression analysis and mediation analysis were used to investigate the relationship between patient perception of disease activity, coping mechanisms and mood. For data analysis Excel and SPSS were used. <h3>Results:</h3> 86 patients were selected (24 males, 68 females; mean age at time of evaluation 43.58 years ±11.8 SD; mean disease duration 9.76years ±10.01). The correlation between Clinician's VAS and Patient's VAS was strong 0.754 (p&lt;0.005). Strong correlations were also observed between Patient's VAS and low mood (PHQ-9) r=0.533 (p&lt;0.005), anxiety (GAD-7) r=0.433(p&lt;0.05), illness perception- emotional representation (IPQ-R) r=0.377 (p&lt;0.05) and emotion-focused coping (COPE) r=0.320 (p&lt;0.05). The results of the mediation analysis indicated that patient's perception of disease activity was a significant predictor for Dysfunctional Coping Strategies (b=1.5,se=0.57, p&lt;0.05). Dysfunctional Coping Strategies had a mediating impact on the relationship between patient perception of disease activity (VAS) and mood 0.645(CE: 0.68-1.389). <h3>Conclusion:</h3> Psychological experience plays an important part in the patient evaluation and experience of disease activity. Patient coping strategies and psychological representation of illness experience influence their perception of disease activity and their mood. This highlights the need of patients for psychological support and for improving coping mechanisms in order to obtain a better disease control and a higher quality of life. <h3>References:</h3> [1] RJ Moots, S Campbell, Is Psychological Status Related to Symptom Experience in Behçet's Syndrome? 2014 ACR/ARHP Annual Meeting [2] IM Atay,I Erturan, A Demirdas, GB Yaman, VA Yürekli The impact of personality on quality of life and disease activity in patients with Behcet's disease: a pilot study Compr Psychiatry. 2014 Apr;55(3):511-7 [3] MA Melikoglu,M Melikoglu The relationship between disease activity and depression in patients with Behcet disease and rheumatoid arthritis. Rheumatol Int. 2010 May;30(7):941-6 <h3>Disclosure of Interests:</h3> Casandra Buzatu: None declared, Hannah Nicholson: None declared, Roisin Cunningham: None declared, Robert J Moots Grant/research support from: Biogen, Bristol-Myers Squibb, Chugai, Novartis, Pfizer Inc, Roche, Sandoz, and UCB, Consultant for: Biogen, Bristol-Myers Squibb, Chugai, Novartis, Pfizer Inc, Roche, Sandoz, and UCB, Speakers bureau: Biogen, Bristol-Myers Squibb, Chugai, Novartis, Pfizer Inc, Roche, Sandoz, and UCB