zdmeЗдоровье мегаполисаCity Healthcare2713-2617ГБУ «НИИОЗММ ДЗМ»10.47619/2713-2617.zm.2026.v.7i2;100-112zdme-376Research ArticleОБЗОРЫREVIEWSРасстройства адаптации в структуре постстрессовых нарушений: социальный и клинический аспектыThe Adjustment Disorders in the Structure of Post-Stress Disorders: Social and Clinical Aspectshttps://orcid.org/0009-0004-8513-6245ЛупаносоваО. А.LupanosovaO. A.

Лупаносова Ольга Андреевна – младший научный сотрудник отделения социально-стрессовых расстройств Отдела интегративной психиатрии.

107076, Москва, ул. Потешная, д. 3, к. 10

Olga A. Lupanosova – Junior Researcher of the Department of Social Stress Disorders of the Department of Integrative Psychiatry of the Moscow Research Institute of Psychiatry – branch of Serbsky National Medical Research Centre of Psychiatry and Narcology of the Ministry of Health of the Russian Federation.

3 bldg. 10 Poteshnaya ul., Moscow, 107076

lupanosova.o@serbsky.ruhttps://orcid.org/0000-0002-2335-5846ГригороваО. В.GrigorovaO. V.

Григорова Оксана Валерьевна – канд. мед. наук, старший научный сотрудник отделения социально-стрессовых расстройств Отдела интегративной психиатрии.

107076, Москва, ул. Потешная, д. 3, к. 10

Oksana V. Grigorova – Cand.Sci. in Medicine, Senior Researcher of the Department of Social and Stress Disorders of the Department of Integrative Psychiatry of the Moscow Research Institute of Psychiatry – branch of Serbsky National Medical Research Centre of Psychiatry and Narcology of the Ministry of Health of the Russian Federation.

3 bldg. 10 Poteshnaya ul., Moscow, 107076

grigorova.o@serbsky.ruМосковский научно-исследовательский институт психиатрии – филиал ФГБУ «Национальный медицинский исследовательский центр психиатрии и наркологии им. В.П. Сербского» Минздрава РоссииMoscow Research Institute of Psychiatry – branch of Serbsky National Medical Research Centre for Psychiatry and Narcology20263006202672100112Copyright © Лупаносова О.А., Григорова О.В., 20262026Лупаносова О.А., Григорова О.В.Lupanosova O.A., Grigorova O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.city-healthcare.com/jour/article/view/376

Введение. Расстройства адаптации (РА) занимают существенную, но малоизученную нишу в спектре социально-стрессовых расстройств. Несмотря на высокую распространенность, их клиническая значимость долгое время недооценивалась в связи с размытостью диагностических критериев. Цель. Обобщение современных данных о РА с акцентом на диагностическую эволюцию, эпидемиологию, социальную значимость, механизмы формирования и терапевтические стратегии. Материалы и методы. Проведен анализ публикаций в базах eLibrary.ru, PubMed, Scopus, РИНЦ (2010–2025). В обзор включено 59 источников. Результаты. В МКБ-11 РА операционализированы через симптомы «озабоченности стрессором» и «неспособности адаптироваться» с временным критерием один месяц. На территории Российской Федерации с 2022 г. приостановлено действие приказа о внедрении МКБ-11, однако ее диагностические подходы сохраняют научную ценность. В амбулаторной практике доля РА составляет 5–21%, в группах социального риска – 15–35%, у военнослужащих, эвакуированных из зоны боевых действий, – 37,6%. В качестве этиологического фактора отечественными исследователями доказана роль нейроиммуноэндокринных нарушений. В плане терапевтического воздействия наиболее эффективна когнитивно-поведенческая психотерапия; фармакотерапия вспомогательна, но на практике широко используется. Суицидальный риск при РА высок: риск попыток повышен в 4,7 раза, завершенного суицида – в 6 раз. Выводы. РА – самостоятельная клиническая категория, требующая персонализированного подхода и пристального внимания врачей, особенно в условиях социальных изменений.

Introduction. Adjustment disorders (AD) occupy a vast but poorly understood niche in the spectrum of social stress disorders. Despite their high prevalence, their clinical significance has long been underestimated due to blurred diagnostic criteria. Objective. To summarize current data on AD with a focus on diagnostic evolution, epidemiology, social significance, mechanisms of formation, and therapeutic strategies. Material and methods. Publications indexed in eLibrary.ru, PubMed, Scopus, and RSCI (2010–2025) were analyzed. The review includes 59 sources. Results. In ICD11, AD is operationalized through the symptoms of “preoccupation with the stressor” and “failure to adapt” with a time criterion of one month. In outpatient practice, AD accounts for 5–21%; in social risk groups – 15–35%; among military personnel evacuated from combat zones – 37.6%. Russian researchers have confirmed the role of neuroimmunoendocrine disturbances as an etiological factor. Cognitive behavioral therapy is most effective; pharmacotherapy is adjunctive but widely used in practice. Suicidal risk in AD is high: the risk of suicide attempts is increased 4.7fold, and the risk of completed suicide – 6fold. Conclusions. AD is an independent clinical category requiring a personalized approach and close attention from clinicians, especially in the context of social changes.

расстройство адаптациисоциально-стрессовые расстройстванейроиммуноэндокринные взаимодействиякогнитивно-поведенческая терапияобзорadjustment disordersocial stress disordersneuroimmunoendocrine interactionscognitive-behavioral therapyreviewРабота проводилась в рамках выполнения государственного задания «Разработка медицинского изделия в виде специального программного обеспечения, предназначенного для помощи в принятии решений по скринингу, комплексной дифференцированной диагностике и лечению социально-стрессовых расстройств в разные возрастные периоды». Регистрационный номер 1240208000601.The work was carried out as part of the implementation of the state task “Development of a medical device in the form of special software designed to assist in making decisions on screening, comprehensive differentiated diagnosis, and treatment of socio-stress disorders at different age periods”. Registration number 1240208000601.ReferencesАлександровский Ю.А. 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The authors declare that there are no conflicts of interest present.