Assessment of socioeconomic status in Behçet's syndrome: A cross-sectional controlled study

Background and Objectives: The etiopathogenesis of Behçet syndrome (BS) has not been elucidated. This study aimed to compare the socioeconomic status (SES) of BS patients with other inflammatory diseases and the general population (GP) and to identify associated factors. Materials and Methods: In our study, the In-Charge Financial Distress/Financial Well-being (IFDFW) and Socioeconomic Level-Composite (SES-C) scales, validated for Turkish, were used to assess SES. Face-to-face questionnaires were implemented to 499 (295M/204F) patients with BS, 137 (80M/57F) with ankylosing spondylitis, 105 (44M/61F) with psoriatic arthritis, and 134 (79M/55F) with inflammatory bowel disease (IBD) who consecutively admitted to our outpatient clinics, and to 324 (168M/156F) volunteers of similar age and gender to the BS patients without any known inflammatory disease. In BS patients, the severity of damage was assessed using the BODI, and disease activity was assessed using the BDCAF. Results: BS patients had the lowest socioeconomic status (p<0.001). Among all participants, having BS or IBD diagnoses, being male, having a high body mass index, being single, smoking, being unemployed, and having difficulty accessing healthcare were independent predictors of lower SES. Among BS patients, when assessed with any scale in univariate analysis, parenchymal neurological involvement, pulmonary artery involvement, low visual acuity, BODI, and BDCAF scores were identified as significant clinical factors associated with low SES. In multivariate analysis, only BDCAF score remained an independent parameter significantly associated with SES [OR: 0.818, 95% CI (0.716-0.934), p=0.003]. Conclusion: BS patients have been shown to have the lowest SES compared to other inflammatory diseases and GP. This association with disease activity suggests that the microbiome and environmental factors may play a role in etiopathogenesis. Furthermore, disease activity may restrain labor force participation. Therefore, low SES can be considered both a potential trigger and a consequence of the disease. Keywords: Behçet's syndrome, BDCAF score, Etiopathogenesis, Damage indexes, Disease activity, Socioeconomic status