Predicting the risk of the formation of mixed anxiety and depressive disorders in women

Background. In case of unfavorable dynamics of events and/or untimely treatment; adjustment disorders may develop into more severe conditions with aggravated clinical manifestations. The reaction to stress becomes prolonged and goes beyond the adjustment disorders; leading to the formation of stable psychopathological disorders with a predominance of vegetative symptoms. A mixed anxiety and depressive reaction due to adjustment disorders may transform into a clinically formalized mixed anxiety and depressive disorder.

The aim. Construction of a mathematical model for predicting the risk of developing the mixed anxiety and depressive disorder in women with mixed anxiety and depressive reaction due to adjustment disorders; using hormonal parameters.

Materials and methods. Two groups of women were examined: group 1 (n = 53) with the diagnosis of “Adjustment disorders: mixed anxiety and depressive reaction” (F43.22); group 2 (n = 48) – “Mixed anxiety and depressive disorder” (F41.2). The level of anxiety was determined using the Spielberger – Khanin Personality and Reactive Anxiety subscale. Anxiety and depression levels were assessed using the Hospital Anxiety and Depression Scale (HADS). The body mass index (BMI) was calculated. The laboratory study included the determination of hormonal parameters using the ELISA method. All data were processed statistically.

Results. A model for predicting the risk of developing mixed anxiety and depressive disorder in women with mixed anxiety and depressive reaction due to adjustment disorder had been developed. The model included the level of cortisol; prolactin; and BMI. The criterion variable was calculated; and if its value was ≥ 1.5; the risk of developing mixed anxiety and depressive disorder was predicted; and if the value was < 1.5; a favorable course of adjustment disorder was predicted with 83.0 % sensitivity – 81.3 % specificity.

Conclusion. We propose a mathematical model that provides the possibility of early recognition of conditions with a high risk of developing mixed anxiety and depressive disorder. This will allow timely carrying out the preventive and therapeutic activities aimed at increasing the stress resistance and restoring the normal neuroendocrine regulation.

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