Page 15 - JCBP-2-2

Journal of Clinical and

Basic Psychosomatics

ORIGINAL RESEARCH ARTICLE
Allostatic overload in the medically ill

patients: Results from an observational study

1,2
Giovanni Mansueto , Sara Romanazzo , Caterina Romaniello ,
3
1
3
Serena Guiducci , Sara Galimberti , and Fiammetta Cosci *
1,5
4
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

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
*Corresponding author: Diagnostic Criteria for Psychosomatic Research-Revised Semi-Structured Interview
Fiammetta Cosci
(fiammetta.cosci@unifi.it) (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
Citation: Mansueto G, Romanazzo sclerosis, and 200 (45.5%) had a diagnosis of migraine. A total of 104 (23.7%) patients
S, Romaniello C, Guiducci S,
Galimberti S, Cosci F. Allostatic had a DCPR-R diagnosis of AO. Patients with a diagnosis of blood cancer, migraine,
overload in the medically ill patients: or systemic sclerosis did not differ for DCPR-R AO prevalence (P = 0.082). Based on
Results from an observational multiple regression analysis, medically ill patients with DCPR-R AO were more likely to
study. J Clin Basic Psychosom.
2024;2(2):2758. satisfy the diagnosis of DCPR-R illness denial (odds ratio [OR] = 2.99, 95% confidence
https://doi.org/10.36922/jcbp.2758 interval [CI] = 1.04 – 8.58), conversion symptoms (OR = 5.32, 95% CI = 1.16 – 24.38),
Received: January 16, 2024 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
Accepted: March 7, 2024
those without DCPR-R AO. DCPR-R AO is a clinically useful transdiagnostic feature
Published Online: March 26, 2024 potentially associated with other psychosomatic syndromes and mental disorders
Copyright: © 2024 Author(s). that may contribute to the disease burden and the poor global health conditions of
This is an Open-Access article medically ill patients.
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution, Keywords: Stress; Medical disease; Cancer; Migraine; Systemic sclerosis
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with 1. Introduction
regard to jurisdictional claims in
published maps and institutional Physiological response to stress is activated by stressor at the level of the endocrine,
affiliations. nervous, and immune systems and is sustained for a given interval before being turned

Volume 2 Issue 2 (2024) 1 https://doi.org/10.36922/jcbp.2758