Immunobiological model for diagnosing the course of adjustment disorder in women

Immunobiological model for diagnosing the course of adjustment disorder in women

 

Authors

 

V.B. Nikitina

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation

M.F. Belokrylova

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation; Federal State Budgetary Educational Institution of Higher Education “Siberian State Medical University” of the Ministry of Health of the Russian Federation, Tomsk, Russian Federation

V.A. Rudnitsky

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation

O.E. Perchatkina

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation

T.P. Vetlugina

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation

N.A. Bokhan

Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russian Federation; Federal State Budgetary Educational Institution of Higher Education “Siberian State Medical University” of the Ministry of Health of the Russian Federation, Tomsk, Russian Federation

 

https://doi.org/10.26617/1810-3111-2025-1(126)-5-14

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2025; 1 (126):  5-14.

 

Abstract

Background. Adjustment disorders are extremely variable and polymorphic in their clinical manifestations. Certain difficulties are presented by differential diagnostics of the leading syndromic component of this disorder, characterized by the predominance of anxiety or asthenic symptoms. The presence of mixed complaints that can relate to both syndromes, to a certain extent complicates the qualification of adjustment disorder by the main syndrome and creates difficulties in choosing the adequate therapy. Nowadays, mathematical modeling methods are actively used in the diagnostics of many diseases, including mental disorders. This approach allows formalizing the process of mental health assessment, integrating the results of clinical-psychopathological, psychological and immunobiological examination of patients into certain algorithms. Objective: to construct a mathematical model for diagnosing the course of adjustment disorder based on immunobiological parameters and anxiety levels in women. Material and Methods. A comprehensive (clinical-psychopathological, psychological and immunobiological) examination was conducted among 102 women aged 35-60 years with the diagnosis: Reaction to severe stress and adjustment disorders (ICD-10 code F43). Two groups were formed from the total sample depending on the prevalence of anxiety or asthenic syndrome: Group 1 (n=57) – Mixed anxiety and depressive reaction due to adjustment disorder (F43.22), adjustment disorder (adaptive reactions) (F43.25, F43.28); Group 2 (n=45) – adjustment disorder with predominant disturbance of other emotions (F43.23), adjustment disorder with predominant disturbance of conduct (F43.24). The anxiety level was assessed using the Spielberger-Khanin scale. The laboratory study included phenotyping of immunocompetent cells by differentiation clusters using flow cytometry and determination of cortisol concentration using enzyme immunoassay. The obtained data were statistically processed. Results.To build a diagnostic model of adjustment disorder by the leading syndrome, linear regression analysis was used, which allowed predicting the value of the dependent variable based on the known values of the predictor variables. The model included the level of personal anxiety, the number of T-lymphocytes, the number of lymphocytes with apoptosis readiness receptors, and the level of cortisol in the blood serum. A criterion variable was calculated; when its value was ≥1.76, adjustment disorder with the leading anxiety syndrome was diagnosed, and when the value was <1.76, adjustment disorder with a predominance of asthenic syndrome was diagnosed. The sensitivity of the mathematical model for diagnosing the course of adjustment disorder was 87.7%, and the specificity was 80.0%. Conclusion. A mathematical model has been proposed that provides the possibility of increasing the accuracy of differential diagnosis of adjustment disorder in women based on the underlying syndrome. Timely adequate diagnosis is aimed at the optimal choice of complex therapy tactics.

 

Keywords: adjustment disorder, anxiety, asthenia, immunity, lymphocytes, apoptosis, cortisol, regression analysis, women.

 

Article (pdf)

 

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Materials  

For citation: Nikitina V.B., Belokrylova M.F., Rudnitsky V.A., Perchatkina O.E., Vetlugina T.P., Bokhan N.A. Immunobiological model for diagnosing the course of adjustment disorder in women. Siberian Herald of Psychiatry and Addiction Psychiatry.2025; 1 (126): 5-14. https://doi.org/10.26617/1810-3111-2025-1(126)-5-14

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