Frequency of depression and anxiety in patients with inborn errors of immunity: a cross-sectional study

BACKGROUND: Inborn errors of immunity are chronic, genetically caused disorders that impair immune function and often increase susceptibility to infection. Many patients self-isolate because of infection-related concerns, which may increase the risk of mental health problems. This study evaluated symptoms of depression and anxiety and the need to address mental health in primary care. METHODS: In this cross-sectional study in Germany, fatigue, pain and quality of life were assessed using visual analogue scales. Routine clinical data including diagnosis, psychiatric comorbidities and susceptibility to infections were collected. Symptoms of depression and anxiety were evaluated using the PHQ-9 and GAD-7 questionnaires. Statistical analyses were performed to examine differences in self-isolation frequency and its association with pre-existing mental illness. RESULTS: A total of 143 patients (88 women and 55 men, mean age 45.4 years, range 21-85) were included. The median PHQ-9 score was 5 (IQR 8) and the median GAD-7 score was 5 (IQR 7). Eleven of 140 patients with PHQ-9 scores of at least 10 had no psychiatric diagnosis. Overall, 26% of patients with relevant symptoms had not received a diagnosis or treatment. Patients who self-isolated because of infection concerns had significantly higher PHQ-9 (Spearman's ρ = 0.52, p < 0.001) and GAD-7 scores (Spearman's ρ = 0.48, p < 0.001). CONCLUSIONS: Self-isolation was associated with more severe symptoms of depression and anxiety, including in patients without known psychiatric disease. These findings highlight the need for greater awareness of mental health issues and multidisciplinary care in patients with inborn errors of immunity.