Immunobiological model of differential diagnosis of adjustment disorder and organic emotionally labile disorder

Immunobiological model of differential diagnosis of adjustment disorder and organic emotionally labile disorder

 

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; Federal State Budgetary Educational Institution of Higher Education “Tomsk State Pedagogical University”, 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

M.M. Axenov

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/10.26617/1810-3111-2023-4(121)-5-14

 

Journal:Siberian Herald of Psychiatry and Addiction Psychiatry. 2023; 4 (121): 5-14.

 

Abstract

The relevance of the differential diagnosis of adjustment disorder and organic emotionally labile disorder is determined by the similarity of the clinical manifestations of these mental pathologies. In clinical practice, the emotional instability of patients in the organic register differs little from the emotional disturbances of patients with neurotic, stress-related disorders. These psychopathological conditions are combined with each other often, but in the interests of adequate therapeutic tactics, it is important to separate the main mental disorder and the cooccuring one. Research has accumulated on the interaction of the nervous and immune systemsto date, showing the significant role of their close relationship in adjustment disorder and organic non-psychotic disorders. The search for additional biological criteria for the diagnostic delimitation of these disorders is a relevant scientific and clinical task. Objective: to construct a model for the differential diagnosis of adjustment disorder and organic emotionally labile disorder based on immunobiological indicators. Material and Methods. We examined 137 women aged 45-65 years who were undergoing inpatient treatment at the clinic of Mental Health Research Institute of Tomsk National Research Medical Center.All patients were divided into two groups depending on the nosological forms of the diseases: group 1 (n=40) – adjustment disorder (ICD-10 headings F43.23 and F43.25), group 2 (n=60) – organic mental disorders (F06.61 and F06.68). The laboratory study included phenotyping of immunocompetent cells according to differentiation clusters using flow cytometry. Cortisol concentration was determined by ELISA. The obtained data were statistically processed. Results. Statistically significant differences were identified, namely an increase in the relative number of lymphocytes (p=0.020027) and cytotoxic T lymphocytes (p=0.028499), a decrease in the content of lymphocytes with apoptosis readiness receptors (p=0.000019) and an increase in cortisol levels (p=0.004195) for adjustment disorder compared with organic emotionally labile disorder. To build a model for the differential diagnosis of these disorders, linear regression analysis was used, which made it possible to predict the value of the dependent variable based on the known values of the predictor variables. If, when solving an equation, the value of the dependent variable was less than 1, then an adjustment disorder was diagnosed, and if the values of the dependent variable were greater than or equal to 1, an organic emotionally labile disorder was diagnosed. The sensitivity of the model was 85.0%, and the specificity was 83.3%. Conclusion. A model has been proposed that made it possible to increase the accuracy of differential diagnosis of adjustment disorder and organic emotionally labile disorder by determining the number of specialized lymphocytes and cortisol levels in the blood and carrying out differential diagnosis using a mathematical apparatus.

 

Keywords: adjustment disorder, organic emotionally labile disorder, cytotoxic T-lymphocytes, apoptosis, immunity, cortisol, regression analysis.

 

Article (pdf)

 

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Materials

For citation: Nikitina V.B., Belokrylova M.F., Rudnitsky V.A., Perchatkina O.E., Vetlugina T.P., Aksenov M.M., Bokhan N.A. Immunobiological model of differential diagnosis of adjustment disorder and organic emotionally labile disorder. Siberian Herald of Psychiatry and Addiction Psychiatry. 2023; 4 (121): 5-14. https://doi.org/10.26617/1810-3111-2023-4(121)-5-14

 

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