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Depressive mood disorders in relation to T cell abnormalities in a cohort of common variable immune deficiency patients
EP30919
Poster Title: Depressive mood disorders in relation to T cell abnormalities in a cohort of common variable immune deficiency patients
Submitted on 05 Nov 2019
Author(s): Olivia Manusama, Hemmo Drexhage, Martin van Hagen, Maksym Ahiyevets, Tom Birkenhäger, Virgil Dalm
Affiliations: Erasmus University Medical Center
This poster was presented at International Primary Immunodeficiencies Congress (IPIC) 2019
Poster Views: 61
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Poster Information
Abstract: Objective

Depressive mood disorders belong to the leading causes of disability and high burden of disease worldwide. While our knowledge of the diverse clinical manifestations of Common Variable Immune Deficiency (CVID) increases, not much is known on the association between CVID and mental illness. Recently, it was shown in 304 CVID patients that 46% were at risk for anxiety and depressive mood disorders. It is hypothesized that mental illness results from the psychological burden of chronic illness. However, extending evidence supports that inborn immune defects, especially in the T lymphocyte compartment, could contribute to the development of mood disorders. This study investigated the prevalence of depressive disorders in patients with CVID. Additionally, we aimed to examine the frequency and nature of T cell aberrancies and to correlate depressive mood disorders to T cell subset aberrancies.

Design and Method

Patients with CVID from the department of clinical immunology were enrolled and screened for depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). When a patient scored 6 points or higher, structural diagnostic interview was performed using the Schedule for Affective Disorders and Schizophrenia (SADS) and the Hamilton Depression Rating Scale (HAMD). Blood samples were collected for B/T cell counts and material was stored for additional T cell subset analyses.

Results and conclusions

Forty patients were evaluated, 21 showed a PHQ-9 score of 6 or higher, suggesting a depressive mood disorder. Upon further examination, 10 patients had a depressive disorder (HAMD > 7 with depressed mood and/or anhedonia), including 5 patients with severe depression. Preliminary data reveal that out of 33 patients from whom current T cell counts were available, total T cells, CD4+ and CD8+ T cells were increased in 2 patients and decreased in 4 patients. Total T cells and CD8+ T cells were increased in 4 patients. Total T cells and CD4+ T cells were decreased in 2 patients. Four of 33 patients had both a depressive mood disorder and abnormal T cell counts (decreased in 1 patient and increased in 3 patients). Further analyses will be performed to evaluate whether potential abnormalities in regulatory T cell and/or helper T cell numbers are associated with depressive mood disorders in CVID. Altogether, current study confirms that depressive mood disorders are common in CVID patients. Further in depth studies are required to evaluate whether T cell abnormalities are associated with these depressive mood disorders. Mental health assessment should be considered in CVID patients.

Summary: Depressive symptoms are common in adult CVID patients and may be associated with T cell (subset) abnormalities
References:
1. Azizi et al. T-Cell Abnormalities in Common Variable Immunodeficiency. J Investig Allergol Clin Immunol. 2016;26(4):233-43.
2. Grosse et al. Deficiencies of the T and natural killer cell system in major depressive disorder: T regulatory cell defects are associated with inflammatory monocyte activation. Brain Behav Immun. 2016;54:38-44.
3. Kroenke et al. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13.
4. Endicott et al. A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry. 35 (7): 837–43.
5. Hamilton M, Rating depressive patients. Jounal of Clinical Psychiatry 1980; 41: 21-24 - Dutch version: Bech, P, Kastrup, M, & Rafaelsen, O.J. (1989). Mini-compendium van beoordelingsschalen in de psychiatrie. (H.A.H. D’haenen, & W.M.A. Verhoeven, Vertalers). Brussel: VUB-Press.
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