Page 19 - JCBP-2-2

Journal of Clinical and
Basic Psychosomatics Allostatic overload in the medically ill

Table 2. Comparison of demographic and clinical variables between subjects without DCPR‑R allostatic overload and subjects
with DCPR‑R allostatic overload
Subjects without Subjects with Statistics
DCPR‑R allostatic DCPR‑R allostatic
overload (n=335) overload (n=104)
n (%) n (%) Chi‑square (df) P Z Phi/ OR (95% CI) a
Cramer’s V
Demographic variables
Sex
Male 67 (20) 11 (10.58) 4.82 0.028 −2.09 −0.105 0.45 (0.22 – 0.89)
(1)
Female 268 (80) 93 (89.42)
Education
Primary school 14 (4.18) 6 (5.77) 2.19 (3) 0.534 0.071 0.534 -
Secondary school 89 (26.57) 21 (20.19)
High school 160 (47.76) 51 (49.04)
University degree and 72 (21.49) 26 (25)
post-university degree
Marital status
Unmarried 107 (31.94) 45 (43.27) 4.50 (1) 0.034 −2.12 −0.101 0.65 (0.41 – 1.04)
Married 228 (68.06) 59 (56.73)
Working activity
Employed 148 (44.18) 51 (49.04) 0.78 0.676 −0.738 0.676 -
(2)
Freelance 48 (14.33) 13 (12.50)
Unemployed 139 (41.49) 40 (38.46)
Clinical variables
Alcohol use 73 (21.79) 21 (20.19) 0.12 0.728 −0.304 −0.017 0.81 (0.46 – 1.42)
(1)
Substance or tobacco use 56 (16.71) 22 (21.15) 1.07 0.301 1.073 0.049 1.25 (0.71 – 2.18)
(1)
Coffee use 270 (80.59) 75 (72.11) 3.39 0.065 −1.861 −0.088 0.62 (0.37 – 1.03)
(1)
Currently under medications 285 (85.07) 84 (80.76) 1.09 0.295 −1.091 −0.050 0.84 (0.46 – 1.55)
(1)
Past psychotherapy 53 (15.82) 37 (35.57) 19.05 (1) <0.001 4.264 0.208 2.81 (1.70 – 4.66)
Currently under psychotherapy 11 (3.28) 11 (10.57) 8.86 0.003 2.872 0.142 3.24 (1.35 – 7.77)
(1)
a
Note: Bonferroni post hoc correction (P≤0.05/17 that is P≤0.0029). Adjusted for age.
Abbreviations: 95% CI: 95% confidence interval; OR: Odds ratio.
DCPR-R AO prevalence, and that medically ill patients Consistent with previous findings, subjects with a
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with DCPR-R AO were more likely to have a diagnosis medical illness and DCPR-R AO, compared to those without
in the cluster of DCPR-R illness behavior, a diagnosis of DCPR-R AO, showed to be more likely to have a diagnosis in
DCPR-R demoralization, and a DSM-5 diagnosis of major the cluster of DCPR-R illness behavior. For instance, illness
depressive episode or major depressive disorder than those denial may help patients to cope with the different stages
without DCPR-R AO. of the disease and with the treatment path by diluting the
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The evidence that the three clinical populations did not distress. On the other hand, it may also be unhelpful delaying
differ for DCPR-R AO prevalence suggests that DCPR-R treatment seeking, decreasing treatment compliance, and
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AO is a transdiagnostic feature. Having a chronic or life- triggering treatment refusal. In addition, patients who are
threatening medical disease, such as cancer, migraine, denial of illness may not seek medical help instantly and
or systemic sclerosis, is a source of stress itself which timely, ending up with more severe illness and exacerbated
requires adaptation and which might exceed the overall stress, which predispose them to much worsened AO.
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individual capacities of coping. Of course, the adaptation Similarly, the diagnosis of conversion symptoms, which
to the stressful experience of disease has interindividual are in the cluster of DCPR-R illness behavior, might have
modulations which should be taken into account. 5,35,36 a role in the occurrence of AO. In DCPR-R, conversion

Volume 2 Issue 2 (2024) 5 https://doi.org/10.36922/jcbp.2758