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01-08-2019 | IM - ORIGINAL

Does illness perception associate with disease symptoms in Behçet’s disease?

Authors: Gonca Mumcu, Fedayi Yağar, Fatma Alibaz-Öner, Nevsun İnanç, Haner Direskeneli, Tulin Ergun

Published in: Internal and Emergency Medicine | Issue 5/2019

Abstract

This study aims to assess the relationship between illness perception and disease course and symptoms in Behçet disease (BD). One hundred ten consecutive BD patients (F/M 50/60, mean age 38.5 ± 9.88 years) and 57 patients with Psoriasis as a disease control group (F/M 28/29, mean age 48.12 ± 15.52) are included in this cross-sectional study. Illness perception is evaluated using a revised version of the Illness Perception Questionnaire (IPQ-R). In IPQ-R, the identity score reflecting the number of symptoms is higher in BD patients with musculoskeletal involvement than the others (6.77 ± 2.91 vs. 5.08 ± 3.3, respectively, p = 0.007). The consequences score for musculoskeletal involvement (19.52 ± 7.03) and timeline (acute/chronic) score for eye involvement (26.67 ± 4.32) are also higher compared to patients without them (16.37 ± 5.82 and 22.09 ± 8.68) (p = 0.011 and p = 0.038), reflecting negative beliefs about the illness. The score of psychological attribution is higher in patients with psoriasis than BD (p = 0.039), whereas the other subgroup scores are lower in patients with psoriasis compared to those of BD (p < 0.05). This study provides a patient’s perspective in the disease management process of BD using the IPQ-R questionnaire. A patient’s own personal beliefs and emotional responses to their symptoms might affect the outcome measures, especially with musculoskeletal symptoms and eye involvement in BD. However, psychological attribution is found to be a prominent issue in psoriasis.

Grayson PC, Amudala NA, McAlear CA, Leduc RL, Shereff D, Richesson R, Fraenkel L, Merkel PA (2014) Causal attributions about disease onset and relapse in patients with systemic vasculitis. J Rheumatol 41(5):923–930. https://doi.org/10.3899/jrheum.131096 CrossRefPubMedPubMedCentral

Brzoska P, Yilmaz-Aslan Y, Sultanoglu E, Sultanoglu B, Razum O (2012) The factor structure of the Turkish version of the Revised Illness Perception Questionnaire (IPQ-R) in patients with diabetes and cardiovascular disease. BMC Public Health 12:852. https://doi.org/10.1186/1471-2458-12-852 CrossRefPubMedPubMedCentral

Weinman J, Petrie KJ, Moss-Morris R, Horne R (1996) The Illness Perception Questionnaire: a new method for assessing the cognitive representation of illness. Psychol Health 11(3):431–445CrossRef

Figueiras MJ, Cortes MA, Marcelino D, Weinman J (2010) Lay views about medicines: the influence of the illness label for the use of generic versus brand. Psychol Health 25(9):1121–1128. https://doi.org/10.1080/08870440903137170 CrossRefPubMed

Leventhal H, Brissette I, Leventhal EA (2003) The common-sense model of self-regulation of health and illness. Self-regulation Health Illn Behav 1:42–65

Moss-Morris R, Weinman J, Petrie K, Horne R, Cameron L, Buick D (2002) The Revised Illness Perception Questionnaire (IPQ-R). Psychol Health 17(1):1–16CrossRef

Ziarko M, Mojs E, Piasecki B, Samborski W (2014) The mediating role of dysfunctional coping in the relationship between beliefs about the disease and the level of depression in patients with rheumatoid arthritis. Sci World J 2014:585063. https://doi.org/10.1155/2014/585063 CrossRef

Leysen M, Nijs J, Meeus M, Paul van Wilgen C, Struyf F, Vermandel A, Kuppens K, Roussel NA (2015) Clinimetric properties of Illness Perception Questionnaire Revised (IPQ-R) and Brief Illness Perception Questionnaire (Brief IPQ) in patients with musculoskeletal disorders: a systematic review. Man Ther 20(1):10–17. https://doi.org/10.1016/j.math.2014.05.001 CrossRefPubMed

Daleboudt GM, Broadbent E, Berger SP, Kaptein AA (2011) Illness perceptions in patients with systemic lupus erythematosus and proliferative lupus nephritis. Lupus 20(3):290–298. https://doi.org/10.1177/0961203310385552 CrossRefPubMed

10.

Barbasio C, Vagelli R, Marengo D, Querci F, Settanni M, Tani C, Mosca M, Granieri A (2015) Illness perception in systemic lupus erythematosus patients: the roles of alexithymia and depression. Compr Psychiatry 63:88–95. https://doi.org/10.1016/j.comppsych.2015.09.004 CrossRefPubMed

11.

Grayson PC, Amudala NA, McAlear CA, Leduc RL, Shereff D, Richesson R, Fraenkel L, Merkel PA (2013) Illness perceptions and fatigue in systemic vasculitis. Arthritis Care Res 65(11):1835–1843. https://doi.org/10.1002/acr.22069 CrossRef

12.

Alibaz-Oner F, Karadeniz A, Ylmaz S, Balkarl A, Kimyon G, Yazc A, Cnar M, Ylmaz S, Yldz F, Bilge SY, Bilgin E, Coskun BN, Omma A, Cetin GY, Cagatay Y, Karaaslan Y, Sayarlioglu M, Pehlivan Y, Kalyoncu U, Karadag O, Kasifoglu T, Erken E, Pay S, Cefle A, Kisacik B, Onat AM, Cobankara V, Direskeneli H (2015) Behcet disease with vascular involvement: effects of different therapeutic regimens on the incidence of new relapses. Medicine 94(6):e494. https://doi.org/10.1097/MD.0000000000000494 CrossRefPubMedPubMedCentral

13.

Alibaz-Oner F, Mumcu G, Kubilay Z, Ozen G, Celik G, Karadeniz A, Can M, Oner SY, Inanc N, Atagunduz P, Ergun T, Direskeneli H (2014) Unmet need in Behcet’s disease: most patients in routine follow-up continue to have oral ulcers. Clin Rheumatol 33(12):1773–1776. https://doi.org/10.1007/s10067-014-2585-3 CrossRefPubMed

14.

Merkel PA, Aydin SZ, Boers M, Cornell C, Direskeneli H, Gebhart D, Hatemi G, Luqmani R, Matteson EL, Milman N, Robson J, Seo P, Tomasson G (2014) Current status of outcome measure development in vasculitis. J Rheumatol 41(3):593–598. https://doi.org/10.3899/jrheum.131248 CrossRefPubMedPubMedCentral

15.

Hatemi G, Merkel PA, Hamuryudan V, Boers M, Direskeneli H, Aydin SZ, Yazici H (2014) Outcome measures used in clinical trials for Behcet syndrome: a systematic review. J Rheumatol 41(3):599–612. https://doi.org/10.3899/jrheum.131249 CrossRefPubMedPubMedCentral

16.

Mumcu G, Inanc N, Taze A, Ergun T, Direskeneli H (2014) A new Mucocutaneous Activity Index for Behcet’s disease. Clin Exp Rheumatol 32(4 Suppl 84):S80–S86PubMed

17.

Hatemi G, Ozguler Y, Direskeneli H, Mahr A, Gul A, Levi V, Aydin SZ, Mumcu G, Sertel-Berk O, Stevens RM, Yazici H, Merkel PA (2015) Current Status, Goals, and Research Agenda for Outcome Measures Development in Behcet syndrome: report from OMERACT 2014. J Rheumatol 42(12):2436–2441. https://doi.org/10.3899/jrheum.141147 CrossRefPubMedPubMedCentral

18.

Emmi G, Silvestri E, Squatrito D, D’Elios MM, Ciucciarelli L, Prisco D, Emmi L (2014) Behcet’s syndrome pathophysiology and potential therapeutic targets. Intern Emerg Med 9(3):257–265. https://doi.org/10.1007/s11739-013-1036-5 CrossRefPubMed

19.

Ilhan B, Can M, Alibaz-Oner F, Yilmaz-Oner S, Polat-Korkmaz O, Ozen G, Mumcu G, Maradit Kremers H, Direskeneli H (2016) Fatigue in patients with Behcet’s syndrome: relationship with quality of life, depression, anxiety, disability and disease activity. Int J Rheum Dis. https://doi.org/10.1111/1756-185x.12839 CrossRefPubMed

20.

Basavaraj KH, Navya MA, Rashmi R (2011) Stress and quality of life in psoriasis: an update. Int J Dermatol 50(7):783–792. https://doi.org/10.1111/j.1365-4632.2010.04844.x CrossRefPubMed

21.

Sampogna F, Tabolli S, Abeni D, investigators IDIMPRoVE (2012) Living with psoriasis: prevalence of shame, anger, worry, and problems in daily activities and social life. Acta Derm Venereol 92(3):299–303. https://doi.org/10.2340/00015555-1273 CrossRefPubMed

22.

Hayes J, Koo J (2010) Psoriasis: depression, anxiety, smoking, and drinking habits. Dermatol Ther 23(2):174–180. https://doi.org/10.1111/j.1529-8019.2010.01312.x CrossRefPubMed

23.

Tula E, Ergun T, Seckin D, Ozgen Z, Avsar E (2017) Psoriasis and the liver: problems, causes and course. Australas J Dermatol 58(3):194–199. https://doi.org/10.1111/ajd.12460 CrossRefPubMed

24.

Lin TY, See LC, Shen YM, Liang CY, Chang HN, Lin YK (2011) Quality of life in patients with psoriasis in northern Taiwan. Chang Gung Med J 34(2):186–196PubMed

25.

Tang MM, Chang CC, Chan LC, Heng A (2013) Quality of life and cost of illness in patients with psoriasis in Malaysia: a multicenter study. Int J Dermatol 52(3):314–322. https://doi.org/10.1111/j.1365-4632.2011.05340.x CrossRefPubMed

26.

Alpsoy E, Polat M, FettahlioGlu-Karaman B, Karadag AS, Kartal-Durmazlar P, YalCin B, Emre S, Didar-Balci D, Bilgic-Temel A, Arca E, Koca R, Gunduz K, Borlu M, Ergun T, Dogruk-Kacar S, Cordan-Yazici A, Dursun P, Bilgi CO, Gunes-Bilgili S, Sendur N, Baysal O, Halil-Yavuz I, Yagcioglu G, Yilmaz E, Kavuzlu U, Senol Y (2017) Internalized stigma in psoriasis: a multicenter study. J Dermatol 44(8):885–891. https://doi.org/10.1111/1346-8138.13841 CrossRefPubMed

27.

International Study Group for Behcet’s Disease (1990) Criteria for diagnosis of Behcet’s disease. Lancet 335(8697):1078–1080

28.

Krause I, Mader R, Sulkes J, Paul M, Uziel Y, Adawi M, Weinberger A (2001) Behcet’s disease in Israel: the influence of ethnic origin on disease expression and severity. J Rheumatol 28(5):1033–1036PubMed

29.

Kocaman N, Özkan M, Armay Z, Özkan S (2007) Hastalik Algisi Ölçeginin Türkçe uyarlamasinin geçerlilik ve güvenilirlik çalismasi [Reliability and validity study of the Turkish adaptation of the revised Illness Perception Questionnaire]. Anadolu Psikiyatri Dergisi 8:271–280

30.

http://www.uib.no/ipq/. Accessed 10 Oct 2018

31.

Ashley L, Smith AB, Keding A, Jones H, Velikova G, Wright P (2013) Psychometric evaluation of the revised Illness Perception Questionnaire (IPQ-R) in cancer patients: confirmatory factor analysis and Rasch analysis. J Psychosom Res 75(6):556–562. https://doi.org/10.1016/j.jpsychores.2013.08.005 CrossRefPubMed

32.

Buyuktas D, Hatemi G, Yuksel-Findikoglu S, Ugurlu S, Yazici H, Yurdakul S (2015) Fatigue is correlated with disease activity but not with the type of organ involvement in Behcet’s syndrome: a comparative clinical survey. Clin Exp Rheumatol 33(6 Suppl 94):S107–S112PubMed

33.

Melikoglu M, Melikoglu MA (2014) What affects the quality of life in patients with Behcet’s disease? Acta Reumatol Port 39(1):46–53PubMed

34.

Backman CL, Kennedy SM, Chalmers A, Singer J (2004) Participation in paid and unpaid work by adults with rheumatoid arthritis. J Rheumatol 31(1):47–56PubMed

35.

Hatemi G, Seyahi E, Fresko I, Talarico R, Hamuryudan V (2015) Behcet’s syndrome: a critical digest of the 2014-2015 literature. Clin Exp Rheumatol 33(6 Suppl 94):S3–S14PubMed

36.

Tanriverdi N, Taskintuna Duru C, Ozdal P, Ortac S, Firat E (2003) Health-related quality of life in Behcet patients with ocular involvement. Jpn J Ophthalmol 47(1):85–92CrossRefPubMed

37.

Trovato GM, Pace P, Cangemi E, Martines GF, Trovato FM, Catalano D (2012) Gender, lifestyles, illness perception and stress in stable atrial fibrillation. Clin Ter 163(4):281–286PubMed

38.

Fabiani C, Vitale A, Orlando I, Sota J, Capozzoli M, Franceschini R, Galeazzi M, Tosi GM, Frediani B, Cantarini L (2017) Quality of life impairment in Behcet’s disease and relationship with disease activity: a prospective study. Intern Emerg Med 12(7):947–955. https://doi.org/10.1007/s11739-017-1691-z CrossRefPubMed

39.

Karacayli U, Mumcu G, Simsek I, Pay S, Kose O, Erdem H, Direskeneli H, Gunaydin Y, Dinc A (2009) The close association between dental and periodontal treatments and oral ulcer course in behcet’s disease: a prospective clinical study. J Oral Pathol Med 38(5):410–415. https://doi.org/10.1111/j.1600-0714.2009.00765.x CrossRefPubMed

40.

Mumcu G, Ergun T, Inanc N, Fresko I, Atalay T, Hayran O, Direskeneli H (2004) Oral health is impaired in Behcet’s disease and is associated with disease severity. Rheumatology (Oxford) 43(8):1028–1033. https://doi.org/10.1093/rheumatology/keh236 CrossRef

41.

Mumcu G, Inanc N, Aydin SZ, Ergun T, Direskeneli H (2009) Association of salivary S. mutans colonisation and mannose-binding lectin deficiency with gender in Behcet’s disease. Clin Exp Rheumatol 27(2 Suppl 53):S32–36PubMed

42.

Kaneko F, Oyama N, Nishibu A (1997) Streptococcal infection in the pathogenesis of Behcet’s disease and clinical effects of minocycline on the disease symptoms. Yonsei Med J 38(6):444–454CrossRefPubMed

43.

Kaneko F, Oyama N, Yanagihori H, Isogai E, Yokota K, Oguma K (2008) The role of streptococcal hypersensitivity in the pathogenesis of Behcet’s disease. Eur J Dermatol 18(5):489–498. https://doi.org/10.1684/ejd.2008.0484 CrossRefPubMed

44.

Ognenovski M, Renauer P, Gensterblum E, Kotter I, Xenitidis T, Henes JC, Casali B, Salvarani C, Direskeneli H, Kaufman KM, Sawalha AH (2015) Whole exome sequencing identifies rare protein-coding variants in Behcet’s disease. Arthritis Rheumatol. 1:2–5. https://doi.org/10.1002/art.39545 CrossRef

45.

Hughes T, Ture-Ozdemir F, Alibaz-Oner F, Coit P, Direskeneli H, Sawalha AH (2014) Epigenome-wide scan identifies a treatment-responsive pattern of altered DNA methylation among cytoskeletal remodeling genes in monocytes and CD4 + T cells from patients with Behcet’s disease. Arthritis Rheumatol 66(6):1648–1658. https://doi.org/10.1002/art.38409 CrossRefPubMedPubMedCentral

46.

Direskeneli H, Mumcu G (2010) A possible decline in the incidence and severity of Behcet’s disease: implications for an infectious etiology and oral health. Clin Exp Rheumatol 28(4 Suppl 60):S86–S90PubMed

47.

Mumcu G, Lehimci F, Fidan O, Guk H, Alpar U, Unal AU, Erturk Z, Alibaz Oner F, Inanc GN, Ergun SAT, Direskeneli RH (2017) The assessment of work productivity and activity impairment in Behcet’s disease. Turk J Med Sci 47(2):535–541. https://doi.org/10.3906/sag-1603-161 CrossRefPubMed

48.

Mumcu G, Alibaz-Oner F, Oner SY, Ozen G, Atagunduz P, Inanc N, Koksal L, Ergun T, Direskeneli H (2017) Oral ulcer activity in Behcet’s disease: poor medication adherence is an underestimated risk factor. Eur J Rheumatol 4(2):109–112. https://doi.org/10.5152/eurjrheum.2017.160094 CrossRefPubMedPubMedCentral

49.

Yilmaz-Oner S, Ilhan B, Can M, Alibaz-Oner F, Polat-Korkmaz O, Ozen G, Mumcu G, Kremers HM, Tuglular S, Direskeneli H (2017) Fatigue in systemic lupus erythematosus: association with disease activity, quality of life and psychosocial factors. Z Rheumatol 76(10):913–919. https://doi.org/10.1007/s00393-016-0185-0 CrossRefPubMed

50.

Sreih AG, Alibaz-Oner F, Easley E, Davis T, Mumcu G, Milman N, Robson J, Direskeneli H, Merkel PA, Cronholm P (2018) Health-related outcomes of importance to patients with Takayasu’s arteritis. Clin Exp Rheumatol 36(111 Suppl 2):51–57PubMed

51.

Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A (2001) Improving chronic illness care: translating evidence into action. Health Aff (Millwood) 20(6):64–78. https://doi.org/10.1377/hlthaff.20.6.64 CrossRef

52.

Wagner EH, Davis C, Schaefer J, Von Korff M, Austin B (1999) A survey of leading chronic disease management programs: are they consistent with the literature? Manag Care Q 7(3):56–66PubMed

Title: Does illness perception associate with disease symptoms in Behçet’s disease?
Authors: Gonca Mumcu
Fedayi Yağar
Fatma Alibaz-Öner
Nevsun İnanç
Haner Direskeneli
Tulin Ergun
Publication date: 01-08-2019
Publisher: Springer International Publishing
Published in: Internal and Emergency Medicine / Issue 5/2019
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-018-1983-y

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