Psychoemotional disorders associated with pulmonary pathology in children, the role of serotonin, GABA and vitamin D in the pathogenesis of these disorders

Abstract

Annotation. The present work aims to study psychoemotional disorders and somatoform autonomic dysfunction of the respiratory system in children-patients of the pulmonology department and to understand how serotonin, GABA, and vitamin D metabolism disorders contribute to their onset. The study involved 90 children with bronchial asthma (BA), community-acquired pneumonia, and somatoform autonomic dysfunction of the respiratory system (SADRS) aged 11,6±3,3 years, and 30 healthy children of the control group. The children’s depression inventory of M. Kovacs and Spielberger-Khanin was used to diagnose depression and anxiety. ELISA method was used to test blood serum for serotonin and vitamin D, and high-performance liquid chromatography to measure GABA levels. Probability was estimated using the t-test and construction of a 95% confidence interval (CI) for the difference in means, as well as correlation and regression analysis methods. In general, the level of serotonin in patients was lower compared to the control group (95% CI, 0,27 – 0,73 μmol/l, p<0,0001). The lowest level of serotonin was found in patients with BA (95% CI, 0,40 – 0,93 μmol/l, p<0,0001) and SADRS (95% CI, 0,32 – 0,82 μmol/l, p<0,0001) compared to the control group (95% CI, 0,2 – 8,0 ng/ml, p<0,04). Overall, a moderate and inverse correlation between serotonin levels and the severity of depression was found on the M.Kovacs scale where r -0,50 (р<0,0001), a strong and inverse correlation in patients with BA r -0,77 (р<0,022), and a moderate and inverse correlation r -0,55 (р<0,001) in patients with SADRS. A weak and inverse correlation was found between GABA levels and reactive anxiety on the Spielberger-Khanin scale, where r -0,25 (р<0,012) and a moderate and inverse correlation in patients with SADRS, where r -0,42 (p<0,01). Serotonin can play a key role in the development of anxiety and depressive disorders in children with respiratory pathologies. A low level of vitamin D in patients with SADRS may contribute to the development of the pathology. The correlation between the levels of GABA and the severity of reactive anxiety in general and in patients with SADRS, in particular, may suggest the indirect involvement of GABA in the development of anxiety.