Allostatic load index across the psychosis spectrum: a systematic review and meta-analysis
BackgroundIndividuals diagnosed with schizophrenia spectrum disorders experience significantly higher morbidity and mortality rates than the general population, with evidence of multisystemic alterations. The concept of allostatic load (AL) provides a framework for understanding the cumulative physi...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1590547/full |
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| author | Lander Madaria Lander Madaria Lander Madaria Claudia Aymerich Claudia Aymerich Claudia Aymerich Borja Pedruzo Borja Pedruzo Borja Pedruzo Borja Pedruzo Gonzalo Salazar de Pablo Gonzalo Salazar de Pablo Gonzalo Salazar de Pablo Daniel Alonso-Alconada Paolo Fusar-Poli Paolo Fusar-Poli Paolo Fusar-Poli Miguel Ángel Gonzalez-Torres Miguel Ángel Gonzalez-Torres Miguel Ángel Gonzalez-Torres Miguel Ángel Gonzalez-Torres Ana Catalan Ana Catalan Ana Catalan Ana Catalan Ana Catalan |
| author_facet | Lander Madaria Lander Madaria Lander Madaria Claudia Aymerich Claudia Aymerich Claudia Aymerich Borja Pedruzo Borja Pedruzo Borja Pedruzo Borja Pedruzo Gonzalo Salazar de Pablo Gonzalo Salazar de Pablo Gonzalo Salazar de Pablo Daniel Alonso-Alconada Paolo Fusar-Poli Paolo Fusar-Poli Paolo Fusar-Poli Miguel Ángel Gonzalez-Torres Miguel Ángel Gonzalez-Torres Miguel Ángel Gonzalez-Torres Miguel Ángel Gonzalez-Torres Ana Catalan Ana Catalan Ana Catalan Ana Catalan Ana Catalan |
| author_sort | Lander Madaria |
| collection | DOAJ |
| description | BackgroundIndividuals diagnosed with schizophrenia spectrum disorders experience significantly higher morbidity and mortality rates than the general population, with evidence of multisystemic alterations. The concept of allostatic load (AL) provides a framework for understanding the cumulative physiological burden imposed by chronic stress. This burden is quantified using the AL index, which integrates multiple biomarkers to assess the impact of prolonged stress on various physiological systems. This review aims to measure the difference in the AL index between individuals with psychosis and the general population, as well as to evaluate the methods used to assess AL in this population.MethodsA PRISMA/MOOSE-compliant systematic search was conducted in the Web of Science, PubMed, BIOSIS, KCI-Korean Journal Database, MEDLINE, Russian Science Citation Index, SciELO, and Cochrane Central Register databases from inception to January 28th, 2025. Studies reporting on the AL index of individuals with psychosis or clinical high risk of psychosis (CHR-P) compared to healthy controls (HC) were included. We used random effects meta-analysis to evaluate: (1) differences between patients with a chronic schizophrenia spectrum disorder (C-SSD) or first-episode psychosis (FEP), compared to healthy controls (HC); (2) differences between patients with C-SSD and FEP. We conducted quality assessment, heterogeneity, publication bias, and meta-regression analyses (PROSPERO: CRD 42024579704).ResultsFrom 922 citations, five studies were included (N=669), showing a higher AL in individuals with psychosis (C-SSD, k=3; g= 1.3315; 95% CI: 0.9679–1.6951; FEP, k=4; g = 0.5464; 95% CI, 0.0698 to 1.0230) compared to HC. The AL index was also higher in patients with C-SSD compared to FEP (k=3; g = 0.8196; 95% CI, 0.2977 to 1.3415). No CHR-P data were found for analysis. Different methods for computing the AL index were observed.ConclusionAllostatic load seems higher in individuals with psychosis compared to the general population, with chronic conditions exhibiting higher allostatic load than the early stages of the disorder. However future research is needed to consolidate these emerging trends. |
| format | Article |
| id | doaj-art-a7381ad205ac4c629cb8cf813d994089 |
| institution | Kabale University |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj-art-a7381ad205ac4c629cb8cf813d9940892025-08-20T03:41:11ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-07-011610.3389/fpsyt.2025.15905471590547Allostatic load index across the psychosis spectrum: a systematic review and meta-analysisLander Madaria0Lander Madaria1Lander Madaria2Claudia Aymerich3Claudia Aymerich4Claudia Aymerich5Borja Pedruzo6Borja Pedruzo7Borja Pedruzo8Borja Pedruzo9Gonzalo Salazar de Pablo10Gonzalo Salazar de Pablo11Gonzalo Salazar de Pablo12Daniel Alonso-Alconada13Paolo Fusar-Poli14Paolo Fusar-Poli15Paolo Fusar-Poli16Miguel Ángel Gonzalez-Torres17Miguel Ángel Gonzalez-Torres18Miguel Ángel Gonzalez-Torres19Miguel Ángel Gonzalez-Torres20Ana Catalan21Ana Catalan22Ana Catalan23Ana Catalan24Ana Catalan25Psychiatry Department, Basurto University Hospital., Bilbao, SpainBiobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, SpainNeuroscience Department, University of the Basque Country, UPV/EHU, Leioa, SpainPsychiatry Department, Basurto University Hospital., Bilbao, SpainCentro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, SpainDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, United KingdomPsychiatry Department, Basurto University Hospital., Bilbao, SpainBiobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, SpainNeuroscience Department, University of the Basque Country, UPV/EHU, Leioa, SpainCentro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, SpainDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, United KingdomChild and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, United KingdomDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health. Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, SpainDepartment of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, SpainEarly Psychosis – Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom0Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. Outreach and Support in South-London (OASIS) Service, South London and Maudsley (SLaM) NHS Foundation Trust, London, United Kingdom1Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University (LMU), Munich, GermanyPsychiatry Department, Basurto University Hospital., Bilbao, SpainBiobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, SpainNeuroscience Department, University of the Basque Country, UPV/EHU, Leioa, SpainCentro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, SpainPsychiatry Department, Basurto University Hospital., Bilbao, SpainBiobizkaia Health Research Institute, Organización Sanitaria Integrada (OSI) Bilbao-Basurto, Bilbao, SpainNeuroscience Department, University of the Basque Country, UPV/EHU, Leioa, SpainCentro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, SpainDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, London, United KingdomBackgroundIndividuals diagnosed with schizophrenia spectrum disorders experience significantly higher morbidity and mortality rates than the general population, with evidence of multisystemic alterations. The concept of allostatic load (AL) provides a framework for understanding the cumulative physiological burden imposed by chronic stress. This burden is quantified using the AL index, which integrates multiple biomarkers to assess the impact of prolonged stress on various physiological systems. This review aims to measure the difference in the AL index between individuals with psychosis and the general population, as well as to evaluate the methods used to assess AL in this population.MethodsA PRISMA/MOOSE-compliant systematic search was conducted in the Web of Science, PubMed, BIOSIS, KCI-Korean Journal Database, MEDLINE, Russian Science Citation Index, SciELO, and Cochrane Central Register databases from inception to January 28th, 2025. Studies reporting on the AL index of individuals with psychosis or clinical high risk of psychosis (CHR-P) compared to healthy controls (HC) were included. We used random effects meta-analysis to evaluate: (1) differences between patients with a chronic schizophrenia spectrum disorder (C-SSD) or first-episode psychosis (FEP), compared to healthy controls (HC); (2) differences between patients with C-SSD and FEP. We conducted quality assessment, heterogeneity, publication bias, and meta-regression analyses (PROSPERO: CRD 42024579704).ResultsFrom 922 citations, five studies were included (N=669), showing a higher AL in individuals with psychosis (C-SSD, k=3; g= 1.3315; 95% CI: 0.9679–1.6951; FEP, k=4; g = 0.5464; 95% CI, 0.0698 to 1.0230) compared to HC. The AL index was also higher in patients with C-SSD compared to FEP (k=3; g = 0.8196; 95% CI, 0.2977 to 1.3415). No CHR-P data were found for analysis. Different methods for computing the AL index were observed.ConclusionAllostatic load seems higher in individuals with psychosis compared to the general population, with chronic conditions exhibiting higher allostatic load than the early stages of the disorder. However future research is needed to consolidate these emerging trends.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1590547/fullallostatic loadpsychosisschizophrenia spectrum disordersfirst-episode psychosisallostatic load index |
| spellingShingle | Lander Madaria Lander Madaria Lander Madaria Claudia Aymerich Claudia Aymerich Claudia Aymerich Borja Pedruzo Borja Pedruzo Borja Pedruzo Borja Pedruzo Gonzalo Salazar de Pablo Gonzalo Salazar de Pablo Gonzalo Salazar de Pablo Daniel Alonso-Alconada Paolo Fusar-Poli Paolo Fusar-Poli Paolo Fusar-Poli Miguel Ángel Gonzalez-Torres Miguel Ángel Gonzalez-Torres Miguel Ángel Gonzalez-Torres Miguel Ángel Gonzalez-Torres Ana Catalan Ana Catalan Ana Catalan Ana Catalan Ana Catalan Allostatic load index across the psychosis spectrum: a systematic review and meta-analysis Frontiers in Psychiatry allostatic load psychosis schizophrenia spectrum disorders first-episode psychosis allostatic load index |
| title | Allostatic load index across the psychosis spectrum: a systematic review and meta-analysis |
| title_full | Allostatic load index across the psychosis spectrum: a systematic review and meta-analysis |
| title_fullStr | Allostatic load index across the psychosis spectrum: a systematic review and meta-analysis |
| title_full_unstemmed | Allostatic load index across the psychosis spectrum: a systematic review and meta-analysis |
| title_short | Allostatic load index across the psychosis spectrum: a systematic review and meta-analysis |
| title_sort | allostatic load index across the psychosis spectrum a systematic review and meta analysis |
| topic | allostatic load psychosis schizophrenia spectrum disorders first-episode psychosis allostatic load index |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1590547/full |
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