Immunity indicators, anxiety and somatic pathology as factors in the formation of a protracted course of panic disorder

Panic disorder is one of the most common non-psychotic mental disorders; in its clinical picture, the leading role is played by the periodic occurrence of panic attacks of varying intensity, fear and anxiety of expecting new attacks with various vegetative symptoms, and a high probability of the formation of restrictive behavior. In the absence of timely treatment, panic disorder acquires a protracted course, which leads to social de-adaptation. Objective. To iden-tify immunological and clinical and psychological predictors of a protracted course of panic disorder. Material and Methods. A comprehensive clinical-psychopathological, psychological and immunological examination of 48 pa-tients with panic disorder (according to ICD-10 F41.0) was carried out. According to the course and duration of the disease, two clinical groups were formed: group 1 (23 people) ‒ a moderate course of panic disorder with a disease duration of less than 3 years; group 2 (25 people) ‒ a protracted course of panic disorder with a disease duration of more than 3 years. All patients were examined by a general practitioner to identify somatic pathology. The level of personal and reactive anxiety was assessed. The laboratory study included phenotyping of immunocompetent cells by clusters of differentiation by flow cytometry. All data were statistically processed. Results. On the basis of a clinical and immunological approach, a method has been developed for predicting a protracted course of panic disorder. If patients with a moderate course of panic disorder have somatic diseases, a level of personal anxiety of more than 53 points and the content of activated T-lymphocytes (CD3+HLA-DR+) in the blood, more than 13% predict a protracted course of panic disorder with a disease duration of more than 3 years. Conclusion. The proposed method can be widely used in medicine and health care to predict a protracted course of panic disorder, which will optimize psycho-therapeutic and pharmacological measures.