The aim: To determine the anxiety disorders in children suffering from organic diseases and functional disorders of the respiratory tract in the clinical settings of the pulmonology department, as well as to assess their impact on disease course and quality of life. Materials and methods: 131 pediatric patients aged 6-17 years old have been studied. The patients were divided into three groups: the children with somatoform respiratory disorders (SRD) – 33,6 % (n = 44), those with bronchial asthma (BA) – 34,3 % (n = 45) and those with pneumonia - 32,1 % (n = 42). Spielberger-Khanin test questionnaire was used to study anxiety, and Nijmegen questionnaire was used to diagnose hyperventilation syndrome (HVS). Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q) was used to determine the quality of life. Results: Severe trait anxiety was observed more often in the subgroup of children with SRD (65,9 %) than in those with asthma (40,0 %) and pneumonia (21,5 %). HVS occurred in 19.1% of patients. Direct moderate correlations were found between Spielberger scale (trait anxiety, r = 0,426; p<0,0001), (state anxiety, r = 0,393; p<0,0001) and Nijmegen HVS questionnaire, as well as inverse moderate correlations between Spielberger scale (state anxiety, r = -0,321; p<0.0001), (trait anxiety, r = -0.429; p<0,0001) and Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Conclusions: Severe trait and state anxiety was found in 42,8 % and 19,1 % of children, respectively. Severe state and trait anxiety was observed more often in patients with SRD (65,9 % and 27,3 %, respectively), being twice as common in girls as in boys (57,6 % versus 32,1 % for trait anxiety and 24,8 % versus 12,6 % for state anxiety, respectively). Anxiety disorders are supposed to be the basis for HVS development and the cause of low satisfaction with the quality of life in patients with pulmonary diseases.

Цель. Установление взаимосвязи полиморфизма 5-HTTLPR (короткий S- и долгий L-аллель), включая однонуклеотидный полиморфизм rs25531 (A/G) полиморфной области L-аллеля, с риском развития соматоформного расстройства (СР) у детей.Материалы и методы. Обследовано 94 ребенка, у которых было диагностировано СР. Средний возраст детей составлял 13,4±2,1 года. Контрольную группу составили 32 обследованных ребенка. Определение в сыворотке крови серотонина проводили биохимическим методом. Определение генетического полиморфизма проводили методом ПЦР.Результаты. У детей с СР-полиморфизм S/S («аллель риска») 5-HTTLPR встречался в 1,5 раза чаще, а полиморфизм S/L встречается в 1,9 раза реже по сравнению с детьми без СР. Средний уровень серотонина у детей с СР составлял 1,16±0,37 мкмоль/л, у детей без СР – 1,35±0,34 мкмоль/л (95% ДИ, 0,04–0,33; p<0,012). Уровень серотонина у детей с СР и наличием S/S-аллели составлял 1,15±0,39 мкмоль/л и был ниже по сравнению с детьми без СР (95% ДИ, 0,04–0,36; p<0,014). Уровень серотонина у детей с СР и наличием S/L составлял 1,24±0,34 мкмоль/л. Высокоэкспрессирующий 5-HTT rs25531 (A/G) полиморфизм LA/LA у детей с СР в 2,9 раза встречалсяреже по сравнению с детьми, которые не болели СР, а среднеэкспрессирующий 5-HTT поли-морфизм S/LA в 1,7 раза реже.Выводы. Риск развития СР с наличием S/S-аллели увеличивается в 2,96 раза (отношение шан-сов – ОШ 2,96±0,42, где 95% ДИ 1,29–6,78). Риск развития СР с наличием S/L-аллели уменьшается в 0,37±0,43 раза (ОШ 0,37±0,43, где 95% ДИ 0,16–0,86). Наличие аллели S/S может быть фактором нарушения обмена серотонина и, соответственно, увеличивать риски развития как СР, так и коморбидных с ним депрессии и тревоги. The purpose of the study is to reveal the association of 5-HTTLPR polymorphism, including the single nucleotide polymorphism rs25531 (A/G) of the polymorphic region of the L-allele, with the risk of development of somatoform disorder (SD) in children.Materials and methods. There were examined 94 children with SD. The average age of children was 13.4±2.1 years. The control group consisted of 32 children. Serum serotonin was determined with a biochemical method. Genetic polymorphism was determined with PCR.Results. In children with SD, the S/S 5-HTTLPR polymorphism is 1.5 times more common and the S/L polymorphism is 1.9 times less frequent than in children without SD. The average serotonin level in children with SD was 1.16±0.37 μmol/l, in children without SD – 1.35±0.34 μmol/l (p<0.012). The level of serotonin in children with SD and the presence of S/S allele was 1.15±0.39 μmol/l, and it was lower, if compared to children without SD (p<0,014). Serotonin levels in children with SD and S/L were 1.24±0.34 μmol/l. High-expressing 5-HTT rs25531 (A/G) polymorphism of LA/LA in children withSD was 2.9 times less frequent, if compared with children, who did not have SD; and the average-expressing 5-HTT polymorphism S/LA – 1.7 times less frequent.Conclusion. The risk of development of SD with the presence of S/S allele increases by 2.96 times(odds ratio – OR 2.96±0.42, where 95% CI, 1.29–6.78). The risk of development of SD with the presence of S/L allele decreases by 0.37 times (OR 0.37±0.43; 95% CI, 0.16–0.86). The presence of the S/S allele may be a factor of impaired serotonin metabolism and, accordingly, increase the risk of SD and comorbid depression and anxiety.