Allostatic load is associated with psychotic symptoms and decreases with antipsychotic treatment in patients with schizophrenia and first-episode psychosis
Allostatic load is associated with psychotic symptoms and decreases with antipsychotic treatment in patients with schizophrenia and first-episode psychosis
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DOI：
10.1016/j.psyneuen.2018.02.001
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发表时间：
2018-04-01
影响因子：
3.7
通讯作者：
Sarnyai, Zoltan
中科院分区：
文献类型：
--
作者：
Berger, Maximus;Juster, Robert-Paul;Sarnyai, Zoltan
目前精神分裂症的病理生理学模型表明，压力有助于该疾病的病因和发展轨迹。我们调查了精神分裂症 (SCZ) 和首发精神病 (FEP) 患者的变稳态负荷 (AL) 是否升高，AL 是对慢性应激反应的神经内分泌、免疫和代谢失调的综合指数，并且与精神病症状以及社会和职业功能相关。此外，我们还评估了 AL 对第二代抗精神病药物治疗的反应的时间动态。采用纵向设计对 SCZ 患者 (n = 28)、FEP (n = 28) 和健康对照组 (n = 53) 在基线以及开始抗精神病药物治疗后 6 周和 12 周时的 AL、精神病症状和心理社会功能进行评估。相对于对照组，SCZ 和 FEP 患者的基线 AL 较高，但 SCZ 和 FEP 患者之间没有差异。调整年龄和吸烟情况后，我们发现阳性症状与 AL 呈正相关，心理社会功能与 AL 在趋势水平上呈负相关。线性混合模型分析表明，在基线评估以及 6 周和 12 周随访期间，SCZ 和 FEP 患者开始治疗后 AL 有所下降。 AL 不能预测治疗反应或症状缓解。我们的数据提供了 SCZ 和 FEP 患者累积的生理失调的证据，这与当前阳性精神病症状的经历有关。 AL 可能是监测与精神分裂症慢性压力和不健康行为相关的生物特征的有用工具。
Current pathophysiological models of schizophrenia suggest that stress contributes to the etiology and trajectory of the disorder. We investigated if allostatic load (AL), an integrative index of neuroendocrine, immune and metabolic dysregulation in response to chronic stress, is elevated in patients with schizophrenia (SCZ) and first episode psychosis (FEP) and related to psychotic symptoms and social and occupational functioning. Additionally, we assessed the temporal dynamics of AL in response to treatment with second-generation anti psychotics. AL, psychotic symptoms and psychosocial functioning were assessed in a longitudinal design in patients with SCZ (n = 28), FEP (n = 28), and healthy controls (n = 53) at baseline and 6 and 12 weeks after commencement of antipsychotic therapy. AL at baseline was higher in patients with SCZ and FEP relative to controls, but not different between patients with SCZ and FEP. Adjusting for age and smoking, we found that positive symptoms were positively correlated with AL and psychosocial functioning was negatively correlated with AL at trend level. Linear mixed model analysis demonstrated that AL decreased after treatment was commenced in patients with SCZ and FEP between the baseline assessment and the 6 and 12-week follow-up. AL was not predictive of treatment response or symptomatic remission. Our data provide evidence for cumulative physiological dysregulation in patients with SCZ and FEP that is linked to the experience of current positive psychotic symptoms. AL could be a useful tool to monitor biological signatures related to chronic stress and unhealthy behaviors in schizophrenia.