Children and adolescents with FMF had significantly higher levels of depressive symptoms and sleep disturbances than controls.
Key Findings
Results
Children and adolescents with FMF had significantly higher median SDSC and BDI scores than healthy controls.
Prospective case-control study conducted at a secondary hospital in Istanbul between July 2024 and January 2025.
Patient group: n = 97; control group: n = 90.
Median SDSC and BDI scores were significantly higher in the patient group than in the control group (p < 0.05).
Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC); depressive symptoms were evaluated using the Beck Depression Inventory (BDI).
Results
FMF patients experienced difficulties across multiple specific sleep disturbance domains compared to controls.
Significant differences were found in sleep initiation and maintenance, sleep-related breathing problems, hyperhidrosis, arousal disturbances, sleep-wake transitions, and excessive daytime somnolence (all p < 0.05).
All six SDSC subscales showed statistically significant differences between the patient and control groups.
These findings were identified through analysis of SDSC subscale scores.
Results
MEFV gene mutation subtype did not significantly influence depression or sleep disturbance outcomes in FMF patients.
No significant differences were found between patient subgroups categorized by MEFV gene mutations in total BDI scores, total SDSC scores, all SDSC subscale scores, or depression severity classes (p > 0.05).
This suggests that the specific genetic mutation variant did not modify the psychological or sleep burden of FMF in this cohort.
Results
No significant correlation was found between depressive symptoms and sleep disturbances within the FMF patient group.
No significant correlations were observed between total BDI scores and total SDSC scores or any of the SDSC subscale scores (p > 0.05).
This indicates that while both depression and sleep disturbances were elevated in FMF patients, they did not significantly co-vary with each other within the patient group.
Results
The patient group was significantly older on average than the control group.
Mean age of the patient group was 10.6 ± 2.9 years versus 9.3 ± 2.4 years in the control group (p < 0.001).
This age difference was a statistically significant baseline characteristic difference between the two groups.
Patient group: n = 97; control group: n = 90.
What This Means
This research suggests that children and adolescents living with Familial Mediterranean Fever (FMF) — a genetic condition causing repeated episodes of fever and inflammation — experience significantly more sleep problems and depressive symptoms than healthy children of similar ages. The study compared 97 young FMF patients to 90 healthy controls in Istanbul and found that FMF patients had higher scores on standardized measures of both sleep disturbance and depression. The sleep problems covered a wide range of issues including trouble falling or staying asleep, breathing difficulties during sleep, night sweats, abnormal arousals, disruptions in sleep-wake transitions, and excessive daytime sleepiness.
Interestingly, the type of genetic mutation (MEFV gene variant) that caused the FMF did not appear to make a difference — patients with different mutation types had similar levels of depression and sleep disturbance. Additionally, although both depression and sleep problems were more common in FMF patients, the two issues did not appear to be directly linked to each other within the patient group, meaning that having worse sleep did not necessarily predict worse depression scores, and vice versa.
This research suggests that the mental health and sleep health of young FMF patients deserve clinical attention beyond just managing the physical symptoms of the disease. Pediatric rheumatology care for FMF may benefit from routine screening for both depression and sleep disturbances, as these issues appear to be a meaningful part of how FMF affects children's overall wellbeing.
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Doğantan &, Bahadur E, Yücel B, Bekece E. (2026). Depression and sleep disturbances in children and adolescents with familial Mediterranean fever: a prospective case-control study.. Sao Paulo medical journal = Revista paulista de medicina. https://doi.org/10.1590/1516-3180.2025.3355.13052026