Allostatic load, emotional hyper-reactivity, and functioning in individuals with bipolar disorder

Area of Science:

• Neuroscience
• Psychiatry
• Biomarkers

Background:

• Bipolar disorder (BD) diagnosis and management lack reliable biomarkers.
• Allostatic load (AL) reflects the cumulative strain of stress on biological systems.
• Emotional hyper-reactivity is a key feature in some BD patients, linked to higher risks.

Purpose of the Study:

• To operationalize an Allostatic Load Index for BD (BALLI).
• To assess BALLI's relevance in characterizing BD patients with and without emotional hyper-reactivity.
• To identify BD patients at risk for immune-cardiometabolic dysregulation and functional impairment.

Main Methods:

• Measured biomarkers of inflammation, cardiovascular, and metabolic functions in 1072 BD outpatients.
• Classified patients into groups with/without emotional hyper-reactivity using the Multidimensional Assessment of Thymic States scale.
• Constructed the BALLI using data-driven biomarker selection.

Main Results:

• BALLI demonstrated 81.1% accuracy in characterizing BD patients with emotional hyper-reactivity.
• BALLI identified patients with elevated inflammation and cardiometabolic disturbances.
• Patients identified by BALLI showed significantly lower global and cognitive functioning.

Conclusions:

• A multidimensional approach using an AL score like BALLI is clinically relevant for BD.
• BALLI can detect physiological dysregulations in BD patients, especially those at higher risk.
• This index aids in identifying BD patients prone to immune-cardiometabolic issues and functional decline.