Allostatic overload in young adults with type 1 diabetes and healthy controls

Introduction: Type 1 diabetes has widely been associated with an increased prevalence of mental health difficulties, including anxiety and depression. In the setting of chronic diseases, a more comprehensive assessment which integrates psychiatric diagnoses with an evaluation of subthreshold symptomatology of distress, has recently emerged. The aim of this controlled study was to evaluate the incremental utility of clinimetric criteria of allostatic overload in the assessment of distress in patients with type 1 diabetes. Methods: 31 young adult patients with type 1 diabetes (30.63±7.60) and 30 matched healthy controls were interviewed for the presence of psychiatric disorders, psychosomatic syndromes with the following instruments: the Structured Clinical Interview for DSM Disorders (SCID-I), the Diagnostic Criteria for Psychosomatic Research (DCPR). The presence of distress in the form of allostatic overload (AO) was also assessed according to specific criteria (Fava et al., 2010). χ2 was used to analyze socio-demographic and clinical differences between patients and controls. Results: No differences emerged between the two groups in socio-demographic variables. As for psychological variables, patients and controls did not significantly differ in terms of frequency of psychiatric disorders or psychosomatic syndromes, except for the diabetic patients who reported past depressive episodes more frequently than controls (p=0.01). Interestingly, individuals with diabetes presented greater psychological distress in terms of AO than healthy subjects (p=0.037). Discussion/Conclusions: AO entails specific clinical features and emerges as a distinct condition from other form of distress. Thus, clinimetric measures such as AO more than diagnostic criteria, may help to identify important information and clinically relevant distress differences in patients with chronic illness such as type 1 diabetes