Clinical and Laboratory Features of Infectious Complications in Patients with Mental and Behavioral Disorders
A. A. Anderzhanova,
V. A. Mazus,
S. V. Yakovlev,
Yu. A. Meleshkina,
M. I. Tsarev,
M. V. Lukina,
M. A. Balalaeva https://doi.org/10.30629/2618-6667-2026-24-2-38-49
Abstract
Background: the issues of diagnosis and prevalence of infectious complications (ICs) in patients with mental disorders remain insufficiently studied. Diagnosing ICs in this population is challenging due to poor patient cooperation, atypical presentation of infections, and masking of symptoms by the underlying psychiatric illness. Classical markers of infection are often non-specific or lack sensitivity, highlighting the need for more reliable diagnostic and prognostic criteria.
The aim of study was to investigate the incidence and clinical-laboratory features of ICs in psychiatric patients to develop specialized algorithms for early diagnosis and treatment.
Patients and Methods: a retrospective, non-interventional study was conducted based on the analysis of the “CLIOPS” database. The study included 727 patients (385 men and 342 women; mean age 62 ys), divided into two groups: without IC (n = 360) and with IC (n = 367). Anthropometric, demographic, clinical, and laboratory data were analyzed.
Results: the most vulnerable group were patients with organic mental disorders (52.9% of all patients with ICs). The leading ICs were pneumonia (59.7%) and urinary tract infections (13.9%). Patients with IC had significantly more frequently: longer hospitalization, higher Waterlow scale scores, elevated CRP levels (99.2% vs 0.8%), leukocytosis (82.6% vs 55.8%), and changes in psychotic status (9.3% vs 1.7%). Fever was absent in 35.6% of patients with ICs. The strongest predictors of IC were: elevated CRP (OR = 50.2), fever > 38 °C (OR = 40.9), and altered mental status (OR = 6.02).
Conclusion: diagnosing IC in patients with mental disorders requires a comprehensive approach due to the frequent absence of classic symptoms. The most significant markers of IC are elevated CRP and sudden decompensation of mental state. The lack of productive communication with the patient is a key factor complicating diagnosis. It is necessary to implement targeted screening algorithms for at-risk groups (patients with organic mental disorders), mandatorily including CRP testing and thorough assessment of mental state for early infection detection and therapy initiation.
About the Authors
A. A. Anderzhanova
City Clinical Hospital No. 1 named after N.I. Pirogov of the Moscow Department of Health
Russian Federation
Russian Federation
Anastasia A. Anderzhanova, Cand. Sci. (Med.), Head of Department, Clinical Pharmacology Department
Moscow
V. A. Mazus
City Clinical Hospital No. 1 named after N.I. Pirogov of the Moscow Department of Health
Russian Federation
Russian Federation
Veronika A. Mazus, Head of the Psychiatric Department for Patients with Comorbid Somatic and Mental Pathology
Moscow
S. V. Yakovlev
Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russia;
City Clinical Hospital named after S.S. Yudin of the Moscow Department of Health
Russian Federation
Russian Federation
Sergey V. Yakovlev, Dr. Sci. (Med.), Professor, Department of Clinical Pharmacology and Therapy named after Academician B.E. Votchal, Russian Medical Academy of Continuous Professional Education, Clinical Pharmacologist, City Clinical Hospital named after S.S. Yudin
Moscow
Yu. A. Meleshkina
City Clinical Hospital No. 1 named after N.I. Pirogov of the Moscow Department of Health
Russian Federation
Russian Federation
Yulia A. Meleshkina, Clinical Pharmacologist, Clinical Pharmacology Department
Moscow
M. I. Tsarev
City Clinical Hospital No. 1 named after N.I. Pirogov of the Moscow Department of Health
Russian Federation
Russian Federation
Mikhail I. Tsarev, Dr. Sci. (Med.), Deputy Chief Medical Officer for Medical Affairs
Moscow
M. V. Lukina
City Clinical Hospital No. 1 named after N.I. Pirogov of the Moscow Department of Health
Russian Federation
Russian Federation
Maria V. Lukina, Cand. Sci. (Med.), Clinical Pharmacologist, Clinical Pharmacology Department
Moscow
M. A. Balalaeva
City Clinical Hospital No. 1 named after N.I. Pirogov of the Moscow Department of Health;
Russian Scientific Center for Surgery named after academician B.V. Petrovsky
Russian Federation
Russian Federation
Maria A. Balalaeva, Cand. Sci. (Med.), Senior Researcher, Centralized Clinical Pharmacology Department, Russian Research Centre of Surgery named after academician B.V. Petrovsky; Clinical Pharmacologist, Clinical Pharmacology Department, City Clinical Hospital No. 1 named after N.I. Pirogov
Moscow
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For citations:
Anderzhanova A.A., Mazus V.A., Yakovlev S.V., Meleshkina Yu.A., Tsarev M.I., Lukina M.V., Balalaeva M.A. Clinical and Laboratory Features of Infectious Complications in Patients with Mental and Behavioral Disorders. Psychiatry (Moscow) (Psikhiatriya). 2026;24(2):38-49. (In Russ.) https://doi.org/10.30629/2618-6667-2026-24-2-38-49
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