Misiak Błażej
Department of Genetics, Wroclaw Medical University, Wroclaw, Poland.
Front Psychiatry. 2020 Jan 9;10:937. doi: 10.3389/fpsyt.2019.00937. eCollection 2019.
Stress exposure leads to the activation of several biological mechanisms that have been termed allostasis. These processes enable adaptation to novel situations; however; their prolonged activation exerts systemic and detrimental effects called the allostatic load (AL). The AL concept represents one of useful paradigms to describe biological consequences of chronic stress that might lead to a number of disease outcomes. The AL index, which is a collective measure of cardiovascular, metabolic, neuroendocrine, and immune dysregulations associated with stress exposure, has been found to predict morbidity and mortality in non-clinical populations. Consequently, it has been proposed that the AL concept might be a useful framework to describe biological consequences of chronic stress exposure in patients with psychotic disorders. This perspective article is an overview of studies investigating the AL index and its clinical correlates in patients with psychotic disorders. These studies have consistently reported elevated AL index in patients at the early and chronic course of psychosis. In addition, the AL index has been associated with a higher severity of positive and depressive symptoms, working memory impairments, and lower general functioning. The article provides some critical appraisal of studies in this field and indicates several future directions for investigating the AL concept in psychosis.
应激暴露会导致多种被称为“应变稳态”的生物学机制被激活。这些过程有助于机体适应新情况；然而，它们的长期激活会产生全身性的有害影响，即所谓的“应变稳态负荷”（AL）。AL概念是描述慢性应激可能导致多种疾病结局的生物学后果的有用范例之一。AL指数是与应激暴露相关的心血管、代谢、神经内分泌和免疫失调的综合指标，已被发现可预测非临床人群的发病率和死亡率。因此，有人提出AL概念可能是描述精神障碍患者慢性应激暴露生物学后果的有用框架。这篇观点文章概述了关于精神障碍患者AL指数及其临床相关性的研究。这些研究一致报告称，在精神病早期和慢性病程患者中，AL指数升高。此外，AL指数与阳性和抑郁症状的严重程度更高、工作记忆受损以及总体功能较低有关。本文对该领域的研究进行了一些批判性评价，并指出了未来在精神病学中研究AL概念的几个方向。
