1014 – Clinical-immunological Criteria Of Prognosis Of Protracted Course Of Adjustment Disorders

Abstract

Various adverse factors and stressful situations result on one side in imbalance of immune system and weakening of mechanisms of immune protection, in formation of secondary immune deficiency and somatic pathology, on another - in stabilization of mental functions of the organism and adjustment disorder.

Material and methods

We have conducted clinical-immunological examination of 90 patients with adjustment disorder (F 43.2).

Results

From positions of clinical-dynamic approach, adjustment disorders have been differentiated depending on stage of development of disease: neurotic reactions (breakdown of mental adaptation), neurotic states (clinical full-blown states with sufficiently persistent neurotic symptoms and completion of formation of leading syndrome) and protracted states (developments, characterizing transition of the disease into chronic course).

Diagnosis of clinical manifestations of secondary immune deficiency has shown increase of incidence rate of allergic and autoimmune syndromes in persons with adjustment disorder with protracted states as compared with previous stages of development of the illness. At this stage, we have more frequently observed combination of several syndromes of immune deficiency.

Comparative analysis of immune and hormonal statuses has revealed the most informative indices, which characterize stages of development of adjustment disorders, and namely: total number of T-lymphocytes (CD2⁺-phenotype), level of serum IgM, indices of spontaneous and stimulated variants of NBT-test, level of cortisol and free thyroxin (T4).

Conclusions

Totality of alterations of revealed immunobiological indices is typical for every stage of disease that alongside with clinical signs of immune deficiency allows considering of them as an additional criterion in differential diagnostics of adjustment disorders.