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

Aroldo Dargél (1) , Stevenn Volant (2) , Elisa Brietzke (3) , Bruno Etain (4, 5) , Emilie Olié (4, 6) , Jean‐michel Azorin (4, 7) , Sebastian Gard (4, 8) , Frank Bellivier (4, 5) , Thierry Bougerol (4, 9) , Jean‐pierre Kahn (4, 10) , Paul Roux (4, 11, 12) , Valérie Aubin (4, 13) , Philippe Courtet (14, 4) , Marion Leboyer (15, 4, 16) , Chantal Henry (4, 1, 16)

1 Perception et Mémoire / Perception and Memory
2 Hub Bioinformatique et Biostatistique - Bioinformatics and Biostatistics HUB
3 Queen's University [Kingston, Canada]
4 Fondation FondaMental [Créteil]
5 Pôle Neurosciences
6 Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier
7 Hôpitaux Sud - Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM]
8 Centre hospitalier Charles Perrens [Bordeaux]
9 GIN - Groupe d'imagerie neurofonctionnelle
10 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
11 UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
12 CHV - Centre Hospitalier de Versailles André Mignot
13 CHPG - Centre Hospitalier Princesse Grace de Monaco
14 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
15 IMRB - Institut Mondor de Recherche Biomédicale
16 UPE - Université Paris-Est

Objectives Diagnosis and management of bipolar disorder (BD) are limited by the absence of available biomarkers. Allostatic load (AL) represents the strain that stress, including the effects of acute phases and inter‐episode chronic mood instability, exerts on interconnected biological systems. This study aimed to operationalize an AL index and explore whether it could be relevant to better characterize BD patients with and without emotional hyper‐reactivity particularly those at higher risk of immune‐cardiometabolic dysregulation and functional impairment. Methods Levels of biomarkers of chronic inflammation (hsCRP and albumin), cardiovascular (systolic/diastolic blood pressure) and metabolic functions (fasting glucose, glycosylated hemoglobin, total cholesterol, LDL, HDL, and triglycerides) were measured in 1072 adult BD outpatients. Patients were classified in two groups (with/without emotional hyper‐reactivity) assessed by the Multidimensional Assessment of Thymic States scale. An Allostatic Load Index for BD (BALLI), comprising six biomarkers, was constructed using data‐driven biomarker selection. Results BALLI showed 81.1% accuracy with good sensitivity (81%) and specificity (81.2%) for characterizing BD patients presenting emotional hyper‐reactivity, elevated risk of inflammation (increased hsCRP, hypoalbuminemia) and cardiometabolic disturbances (hypertension, hyperglycemia, and hypertriglyceridemia). Patients classified by the BALLI as presenting emotional hyper‐reactivity had significantly lower global and cognitive functioning than those without emotional hyper‐reactivity (P < .0001). Conclusions A multidimensional approach based on a simple AL score (eg, BALLI) and dimensions of behavior (eg, emotional hyper‐reactivity) alongside mood is clinically relevant. AL index could be a useful tool to detect multisystemic physiological dysregulations in BD patients with/without emotional hyper‐reactivity particularly those at higher risk of immune‐cardiometabolic disturbances and functional impairment.

Mots clés: Allostatic load; biomarkers; Bipolar disorder; Emotional reactivity; functioning

Domaines: Sciences cognitives; Neurosciences; Psychologie; Statistiques [stat]

Aroldo Dargél, Stevenn Volant, Elisa Brietzke, Bruno Etain, Emilie Olié, et al.. Allostatic load, emotional hyper‐reactivity, and functioning in individuals with bipolar disorder. Bipolar Disorders, 2020, ⟨10.1111/bdi.12927⟩. ⟨pasteur-02612876⟩