AccScience Publishing / JCBP / Online First / DOI: 10.36922/jcbp.2758
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ORIGINAL RESEARCH ARTICLE

Allostatic overload in the medically ill patients: Results from an observational study

Giovanni Mansueto1,2 ,  Sara Romanazzo1 ,  Caterina Romaniello3 ,  Serena Guiducci3 ,  Sara Galimberti4 ,  Fiammetta Cosci1,5*
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1 Department of Health Sciences, University of Florence, Florence, Italy
2 School of Applied Sciences, London South Bank University, London, United Kingdom
3 Division of Rheumatology, Scleroderma Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
4 Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
5 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
JCBP 2024, 2(2), 2758 https://doi.org/10.36922/jcbp.2758
Submitted: 16 January 2024 | Accepted: 7 March 2024 | Published: 26 March 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

The present study aimed at evaluating the prevalence of allostatic overload (AO) among subjects with different medical diseases and explore whether medically ill patients with or without AO differ for specific clinical features (i.e., co-occurring mental or psychosomatic disorders). An observational cross-sectional study was carried out. Outpatients with a diagnosis of blood cancer, systemic sclerosis, or migraine received a clinical assessment which included the Mini International Neuropsychiatric Interview or the Structured Clinical Interview for DSM-5 and the Diagnostic Criteria for Psychosomatic Research-Revised Semi-Structured Interview (DCPR-R SSI). Four hundred and thirty-nine outpatients were enrolled. Among them, 39 (8.9%) had a diagnosis of blood cancer, 200 (45.5%) had a diagnosis of systemic sclerosis, and 200 (45.5%) had a diagnosis of migraine. A total of 104 (23.7%) patients had a DCPR-R diagnosis of AO. Patients with a diagnosis of blood cancer, migraine, or systemic sclerosis did not differ for DCPR-R AO prevalence (P = 0.082). Based on multiple regression analysis, medically ill patients with DCPR-R AO were more likely to satisfy the diagnosis of DCPR-R illness denial (odds ratio [OR] = 2.99, 95% confidence interval [CI] = 1.04 – 8.58), conversion symptoms (OR = 5.32, 95% CI = 1.16 – 24.38), or demoralization (OR = 2.57, 95% CI = 1.08 – 6.11) and a DSM-5 diagnosis of major depressive episode/disorder (OR = 1.90, 95% CI = 1.03 – 3.50), if compared to those without DCPR-R AO. DCPR-R AO is a clinically useful transdiagnostic feature potentially associated with other psychosomatic syndromes and mental disorders that may contribute to the disease burden and the poor global health conditions of medically ill patients.

Keywords
Stress
Medical disease
Cancer
Migraine
Systemic sclerosis
Funding
None.
Conflict of interest
The authors declare they have no competing interests.
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Journal of Clinical and Basic Psychosomatics, Electronic ISSN: 2972-4414 Print ISSN: 3060-8562, Published by AccScience Publishing
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