Perception-Driven Determinants of Pandemic-Related Anxiety in Familial Mediterranean Fever and Behçet’s Disease

Infectious outbreaks impose substantial psychological burden beyond their biomedical impact. Patients with chronic inflammatory diseases may be particularly vulnerable due to perceived infection risk and treatment-related concerns. This study aimed to compare coronavirus-related anxiety levels in patients with Familial Mediterranean Fever (FMF) and Behçet’s disease (BD) and to identify independent determinants of anxiety. In this cross-sectional study, 61 patients (FMF n=30; BD n=31) were consecutively recruited from a tertiary rheumatology clinic. Anxiety was assessed using the validated Turkish version of the Coronavirus Anxiety Scale (CAS). Demographic, clinical, and contextual variables were recorded. Group comparisons were performed using appropriate parametric and non-parametric tests. Multivariable linear regression was used to examine factors independently associated with anxiety. FMF patients had higher CAS scores than BD patients (2.97±3.05 vs 1.60±2.91; p=0.019; Cohen’s d=0.46). In multivariable analysis, female sex (B=1.80; 95% CI 0.14–3.46; p=0.034) and environmental COVID-19 exposure (defined as the presence of a confirmed case in the close surroundings) (B=2.71; 95% CI 0.89–4.54; p=0.004) were independently associated with higher anxiety scores. Neither exploratory analyses nor multivariable modeling demonstrated significant associations between anxiety scores and FMF diagnosis, age, disease duration, self-rated COVID-19 illness severity, comorbidity status, biologic therapy, or corticosteroid exposure. The model explained 26.1% of the variance in anxiety scores (R²=0.261). Pandemic-related anxiety in patients with FMF and BD appeared to be more closely associated with environmental COVID-19 exposure and female sex than with the disease-related variables evaluated in this study. These findings highlight the potential importance of psychosocial assessment and risk communication strategies during infectious outbreaks.