Clinical and immunological features in hysterical disorders that form in the structure of endogenous diseases of affective and schizophrenic spectrum

The study was performed based on the Laboratory of Neuroimmunology and the Department for the Study of Endogenous Mental Disorders and Affective States of the Federal State Budgetary Institution “Mental Health Research Centre”. Objective: to study the clinical and biological relationships between immunological blood parameters and the characteristics of the mental state of patients with hysterical disorders associated with endogenous mental illnesses of affective and schizophrenic spectrum. Material and Methods: the study included 34 patients (24 women and 10 men) aged 18 to 53 years (mean age 30.3±10.6 years) with hysterical disorders that develop within the framework of endogenous mental disorders of affective and schizophrenic spectrum (diagnosis codes according to ICD-10: F20, F21, F25, F31, F32, F33). All patients were examined for the severity of the manifestation of psychopathological symptoms during hospitalization in the clinic. Psychometric examination of patients was performed using the Hamilton Scale (HDRS) and the Positive and Negative Syndromes Scale (PANSS). Immunological examination included the determination of the activity of inflammatory markers - leukocyte elastase (LE) and α1-proteinase inhibitor (a1-PI), as well as the level of autoantibodies to the S-100B protein and myelin basic protein (MBP). Based on the totality of indicators, the overall level of activation of the immune system was assessed. Statistical processing of the results was carried out in the IBM SPSS Statistics 26 software package. Results. Patients with hysterical disorders demonstrate not only high clinical, but also immune heterogeneity, from a moderate increase in only inflammatory markers with the development of conversion symptoms to a pronounced increase in the activity of both inflammatory and autoimmune markers in patients with combined dissociative-conversion symptoms. Along with an increase in inflammatory markers, more than half of the examined patients are characterized by the presence of an autoimmune component to neuroantigens. The level of activation of the immune system, determined by the combination of inflammatory markers and the level of antibodies, reflects the severity of the mental state of patients with hysterical symptoms associated with both affective diseases and schizophrenia spectrum disorders. Accession of an autoimmune component is associated with the most severe intractable conditions.