Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; Laboratory of Psychiatric Neuroscience, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.
Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.
Schizophr Res. 2020 Dec;226:38-43. doi: 10.1016/j.schres.2018.10.002. Epub 2018 Oct 17.
Individuals at ultra-high risk (UHR) for psychosis have an elevated risk of developing psychosis and other psychiatric outcomes. Risk biomarkers can assist in delineating individual risk and allow better prediction of longer-term outcomes. The aim of the present study was to examine if allostatic load (AL), a multisystem index of neuroendocrine, cardiovascular, immune and metabolic dysregulation, is associated with clinical outcomes in youth at UHR for psychosis. AL was measured in 106 participants of the NEURAPRO study (n = 70 female, n = 36 male; mean age 17.21, SD 2.37), a multicentre randomized-controlled trial of long-chain omega-3 polyunsaturated fatty acids versus placebo in people at UHR for psychosis. Psychiatric symptoms and social and occupational functioning were assessed at baseline and 6 and 12 months after study intake. Multivariate linear and logistic regression models were used to test the relationship between AL and clinical outcomes. High AL at baseline was associated with poor social and occupational functioning at 6 months (β = -0.224, p = 0.025) and with more severe manic symptoms at 6 months (β = 0.207, p = 0.026), taking into account relevant covariates including age and smoking status. No significant associations were observed at the 12-month follow-up assessment or with any other clinical outcome measures. Our data provide initial evidence for a link between AL and impaired functioning in individuals at UHR for psychosis. Further studies are needed to evaluate AL as a potential predictor of early treatment response.
超高危个体（UHR）发生精神病的风险增加，存在精神病和其他精神疾病结局的风险。风险生物标志物可辅助个体风险分层，并更好地预测长期结局。本研究旨在探讨神经内分泌、心血管、免疫和代谢失调的多系统指标——全身适应不良负荷（AL）是否与精神病超高危青年的临床结局相关。在精神病超高危的多中心随机对照试验 NEURAPRO 研究中，对 106 名参与者（n=70 名女性，n=36 名男性；平均年龄 17.21，SD 2.37）进行了 AL 测量。在研究开始后 6 和 12 个月评估精神病症状和社会职业功能。采用多元线性和逻辑回归模型检验 AL 与临床结局的关系。基线时 AL 较高与 6 个月时社会职业功能较差（β=-0.224，p=0.025）和 6 个月时躁狂症状更严重（β=0.207，p=0.026）相关，同时考虑了包括年龄和吸烟状况在内的相关协变量。在 12 个月的随访评估或任何其他临床结局测量中未观察到显著相关性。我们的数据提供了初步证据，表明 AL 与精神病超高危个体的功能障碍之间存在关联。需要进一步研究来评估 AL 是否为早期治疗反应的潜在预测指标。
