Psychiatric Burden in Adult Patients with Common Variable Immunodeficiency: A Single-Center Cross-Sectional Study

Abstract

ABSTRACT Aim: Common Variable Immunodeficiency (CVID) is characterized by recurrent infections and chronic complications. While the infectious burden of CVID has been extensively studied, psychiatric comorbidities remain underrecognized. This study aimed to evaluate psychiatric symptom burden and associated factors in adult CVID patients receiving immunoglobulin replacement therapy. Methods: Sixteen adult patients with CVID were included in this cross-sectional study. Demographic and clinical data were collected retrospectively. Anxiety and depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Psychiatric diagnoses were classified according to DSM-5 criteria. Infection frequency before and after immunoglobulin replacement therapy was compared using the Wilcoxon signed-rank test. Associations between clinical variables and HADS scores were analyzed using nonparametric tests. Results: The mean age of the patients was 43.2 ± 14.9 years, and 50% were female. Immunoglobulin replacement therapy was associated with significant reductions in annual pneumonia (p=0.001), sinusitis (p=0.003), and antibiotic use (p=0.001). Clinically significant anxiety (HADS-A ≥11) was observed in 50% of patients, and depressive symptoms (HADS-D ≥11) in 56.3%. Eight patients (50%) met DSM-5 criteria for at least one psychiatric disorder. Anxiety and depressive scores were strongly correlated (ρ=0.939, p<0.001). Social support was significantly associated with both anxiety (p=0.014) and depressive symptoms (p=0.049), whereas diagnostic delay and immunoglobulin replacement therapy delay were not. Conclusion: Despite effective control of infectious complications with immunoglobulin replacement therapy, psychiatric symptom burden remains high in adult CVID patients. Perceived social support appears to be an important determinant of psychological well-being in this population. Keywords: Common Variable Immunodeficiency; Primary Immunodeficiency; Anxiety; Depression; Immunoglobulin Replacement Therapy

Keywords

• Common Variable Immunodeficiency
• Primary Immunodeficiency
• Anxiety
• Depression
• Immunoglobulin Replacement Therapy

Supporting Institution

No financial support was received for this study.

Ethical Statement

Ethics approval for this study was obtained from the Marmara University Faculty of Medicine Non-Drug and Non-Medical Device Research Ethics Committee (Protocol code: 09.2026.26-0149; approval date: 20.02.2026; decision date: 06.03.2026). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Thanks

None

Yaygın Değişken İmmün Yetmezliği Olan Erişkin Hastalarda Psikiyatrik Yük: Tek Merkezli Kesitsel Bir Çalışma

Abstract

ÖZET Amaç: Common Variable Immunodeficiency (CVID), tekrarlayan enfeksiyonlar ve kronik komplikasyonlarla karakterize bir primer immün yetmezliktir. CVID’de enfeksiyon yükü ayrıntılı olarak incelenmiş olmasına rağmen psikiyatrik eş tanılar yeterince değerlendirilmemiştir. Bu çalışmada, immünoglobulin replasman tedavisi alan erişkin CVID hastalarında psikiyatrik semptom yükü ve ilişkili faktörlerin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya 16 erişkin CVID hastası dahil edildi. Demografik ve klinik veriler retrospektif olarak toplandı. Anksiyete ve depresif semptomlar Hastane Anksiyete ve Depresyon Ölçeği (HADS) ile değerlendirildi. Psikiyatrik tanılar DSM-5 kriterlerine göre sınıflandırıldı. İmmünoglobulin replasman tedavisi öncesi ve sonrası enfeksiyon sıklığı Wilcoxon işaretli sıralar testi ile karşılaştırıldı. HADS skorları ile klinik değişkenler arasındaki ilişkiler nonparametrik testlerle analiz edildi. Bulgular: Hastaların yaş ortalaması 43.2 ± 14.9 yıl olup, %50’si kadındı. İmmünoglobulin replasman tedavisi sonrası yıllık pnömoni (p=0.001), sinüzit (p=0.003) ve antibiyotik kullanımında (p=0.001) anlamlı azalma saptandı. Klinik olarak anlamlı anksiyete (HADS-A ≥11) hastaların %50’sinde, depresif semptomlar (HADS-D ≥11) ise %56.3’ünde görüldü. Hastaların %50’si DSM-5’e göre en az bir psikiyatrik tanı almaktaydı. Anksiyete ve depresyon skorları arasında güçlü bir korelasyon bulundu (ρ=0.939, p<0.001). Sosyal destek varlığı hem anksiyete (p=0.014) hem de depresyon skorları (p=0.049) ile anlamlı ilişkili bulundu; tanı gecikmesi ve immünoglobulin replasman tedavisi gecikmesi ile anlamlı ilişki saptanmadı. Sonuç: İmmünoglobulin replasman tedavisi enfeksiyon sıklığını belirgin şekilde azaltmasına rağmen, erişkin CVID hastalarında psikiyatrik semptom yükü yüksek düzeyde seyretmektedir. Algılanan sosyal destek, psikolojik iyilik halinin önemli belirleyicilerinden biri olabilir. Anahtar Kelimeler: Yaygın Değişken İmmün Yetmezlik; Primer İmmün Yetmezlikler; Anksiyete; Depresyon; İmmünoglobulin Replasman Tedavisi

Keywords

• Yaygın Değişken İmmün Yetmezlik
• Primer İmmün Yetmezlik
• Anksiyete
• Depresyon
• İmmünoglobulin Replasman Tedavisi

Supporting Institution

Bu çalışma için herhangi bir kurum veya kuruluştan finansal destek alınmamıştır.

Ethical Statement

Bu çalışma için Marmara Üniversitesi Tıp Fakültesi İlaç ve Tıbbi Cihaz Dışı Araştırmalar Etik Kurulu’ndan onay alınmıştır. Etik kurul onay tarihi 20.02.2026, karar tarihi 06.03.2026, protokol kodu 09.2026.26-0149’dur. Çalışma Helsinki Deklarasyonu ilkelerine uygun olarak yürütülmüştür.

Thanks

Teşekkür beyanı bulunmamaktadır.

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