The Assessment of Allostatic Overload in Patients with Congestive Heart Failure by Clinimetric Criteria.
The precipitating role of emotional stress in the development of congestive heart failure (CHF) is a long-standing clinical observation. We employed new clinimetric criteria for the assessment of allostatic overload (AO) in a sample of CHF patients, with regard to its associations with psychological distress and health status. Allostatic overload was assessed by a semi-structured interview based on clinimetric criteria in 70 consecutive outpatients with CHF. One observer-rated scale and two self-rating questionnaires for psychological distress were administered. Cardiac variables were also collected at intake. Twenty-three patients (32.9%) were classified as having AO according to clinimetric criteria. Significant differences were found with regard to gender, with women being more likely to report AO than men (23.5% versus 57.9%). Patients with AO presented significantly higher levels of psychological distress (based on scales administered) compared with those who did not. Among cardiac risk factors, hyperglycaemia was found to be significantly associated with the presence of AO. The use of the clinimetric criteria provides a global index for identifying distress that might adversely influence the course and progression of CHF. It may be of use in clinical practice, leading to therapeutic suggestions such as lifestyle modifications and psychotherapy to help patients deal with their difficulties.
Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy.
Jenny
J
Guidi
Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy.
Emanuela
E
Offidani
Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy.
Chiara
C
Rafanelli
Division of Cardiology, Bellaria Hospital, Bologna, Italy.
Renzo
R
Roncuzzi
Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA.|Department of Statistical Sciences, University of Padova, Padua, Italy.
Nicoletta
N
Sonino
Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Bologna, Italy.|Department of Psychiatry, State University of New York at Buffalo, Buffalo, NY, USA.
Giovanni A
GA
Fava
D000368:Aged; D000369:Aged, 80 and over; D052636:Allostasis; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D006943:Hyperglycemia / Q000523:psychology*; D007558:Italy; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires
allostatic overload; clinimetrics; psychological distress; stress