Biological markers of the prognosis of the formation, course and effectiveness of therapy for mental disorders and alcohol addiction

Psychiatry as a science is at the stage of understanding the biological markers of mental pathology. Over the past decades, a large number of genetic, neuroimaging and neurophysiological studies have been carried out to search for them. At present, a priority scientific direction of research on the establishment of peripheral laboratory biomarkers of mental disorders is developing rapidly. Compared to subjectively assessed clinical and psychopathological signs and syndromes, biomarkers are more valid and reliable indicators. Objective: to summarize the results of research by the staff of the Laboratory of Clinical Psychoneuroimmunology and Neurobiology on the search for biological markers and their role in the formation, course and effectiveness of the treatment of mental disorders and alcohol dependence. Material and Methods. A clinical-psychopathological, psychological and immunobiological examination of patients undergoing inpatient treatment at the clinic of Mental Health Research Institute of Tomsk National Research Medical Center was carried out. Diagnostic evaluation was carried out according to the main clinical criteria of ICD-10. The survey sample included patients with adjustment disorder (F43.2) - n=50, panic disorder (F41.0) - n=40, schizophrenia (F20.00, F20.01, F20.02, F20.6) - n=156, mental and behavioral disorders due to alcohol use (addiction syndrome - F10.21 and withdrawal syndrome - F10.30) - n=54. The level of reactive and personal anxiety, the severity of psychopathological symptoms according to the PANSS scale, and the dynamics of mental state improvement according to the CGI scale were assessed. Laboratory research included phenotyping of immunocompetent cells by differentiation clusters by flow cytometry, hormone determination by ELISA. The obtained data were statistically processed using STATISTICA for Windows (version 12.0). Comparison of independent samples was performed using the Mann-Whitney U-test. Results. A method is proposed for predicting the risk of developing a panic disorder at an early stage of the disease - at the stage of adjustment disorder - by assessing the level of reactive and personal anxiety in patients with adjustment disorder, determining the concentration of cortisol and natural killer cells in the blood. A complex of clinical-psychopathological and peripheral biomarkers was revealed to predict the effectiveness of therapy in patients with schizophrenia. The levels of free thyroxine, carbonylated proteins, and TBA-reactive products can be used as biological markers for predicting the duration of remission after anti-alcohol therapy in order to identify a cohort of patients with unstable therapeutic remission. Conclusion. Informative biomarkers have been found to predict the formation of panic disorder at an early stage of the disease, the effectiveness of therapy in patients with schizophrenia, and the duration of remission after therapy in patients with unstable remission in alcohol dependence.