Gustav Bizik

A transdisciplinary perspective of chronic stress in relation to psychopathology throughout life span development.

The allostatic load (AL) model represents an interdisciplinary approach to comprehensively conceptualize and quantify chronic stress in relation to pathologies throughout the life cycle. This article first reviews the AL model, followed by interactions among early adversity, genetics, environmental toxins, as well as distinctions among sex, gender, and sex hormones as integral antecedents of AL. We next explore perspectives on severe mental illness, dementia, and caregiving as unique human models of AL that merit future investigations in the field of developmental psychopathology. A complimenting transdisciplinary perspective is applied throughout, whereby we argue that the AL model goes beyond traditional stress-disease theories toward the advancement of person-centered research and practice that promote not only physical health but also mental health.

Allostatic load as a tool for monitoring physiological dysregulations and comorbidities in patients with severe mental illnesses.

Severe mental illnesses like schizophrenia and bipolar disorder are disabling, chronic conditions that are often accompanied by medical comorbidities. In this theoretical article, we review the allostatic load model representing the “wear and tear” that chronic stress exacts on the brain and body. We propose an innovative way of monitoring physical and psychiatric comorbidities by integrating the allostatic load model into clinical practice. By interpreting peripheral biomarkers differently, medical professionals can calculate a simple, count-based, allostatic load index known to predict diverse stress-related pathologies. In addition to screening for comorbidities, allostatic load indices can be used to monitor the effects of pharmacological and psychosocial interventions. This framework can also be used to generate a dialogue between patient and practitioner to promote preventive and proactive approaches to health care.

Epileptiform Activity in Alcohol Dependent Patients and Possibilities of Its Indirect Measurement

Background Alcohol dependence during withdrawal and also in abstinent period in many cases is related to reduced inhibitory functions and kindling that may appear in the form of psychosensory symptoms similar to temporal lobe epilepsy frequently in conditions of normal EEG and without seizures. Because temporal lobe epileptic activity tend to spread between hemispheres, it is possible to suppose that measures reflecting interhemispheric information transfer such as electrodermal activity (EDA) might be related to the psychosensory symptoms. Methods and Findings We have performed measurement of bilateral EDA, psychosensory symptoms (LSCL-33) and alcohol craving (ACQ) in 34 alcohol dependent patients and 32 healthy controls. The results in alcohol dependent patients show that during rest conditions the psychosensory symptoms (LSCL-33) are related to EDA transinformation (PTI) between left and right EDA records (Spearman r = 0.44, p<0.01). Conclusions The result may present potentially useful clinical finding suggesting a possibility to indirectly assess epileptiform changes in alcohol dependent patients.

Dissociative symptoms reflect levels of tumor necrosis factor alpha in patients with unipolar depression

Recent evidence indicates that the nature of interactions between the nervous system and immune system is important in the pathogenesis of depression. Specifically, alterations in pro-inflammatory cytokines have been related to the development of several psychological and neurobiological manifestations of depressive disorder, as well as to stress exposure. A number of findings point to tumor necrosis factor alpha (TNF-α) as one of the central factors in these processes. Accordingly, in the present study, we test the hypothesis that specific influences of chronic stressors related to traumatic stress and dissociation are related to alterations in TNF-α levels. We performed psychometric measurement of depression (Beck Depression Inventory [BDI]-II), traumatic stress symptoms (Trauma Symptom Checklist [TSC]-40), and psychological and somatoform dissociation (Dissociative Experiences Scale [DES] and Somatoform Dissociation Questionnaire [SDQ]-20, respectively), and immunochemical measure of serum TNF-α in 66 inpatients with unipolar depression (mean age 43.1 ± 7.3 years). The results show that TNF-α is significantly related to DES (Spearman R=−0.42, P<0.01), SDQ-20 (Spearman R=−0.38, P<0.01), and TSC-40 (Spearman R=−0.41, P<0.01), but not to BDI-II. Results of the present study suggest that TNF-α levels are related to dissociative symptoms and stress exposure in depressed patients.

Meta-analysis of Plasma Interleukine-6 Levels in Patients with Depressive Disorder

Growing body of evidence suggests that inflammatory processes play an important role in the pathophysiology and the clinical course of depressive disorder, as well as several others major psychiatric and somatic conditions. Interleukin (IL-6), one of the proinflammatory cytokines, has been extensively examined in a number of studies among depressed patients. To assess quantitatively the relationship between depression and IL-6, a systematic review of relevant literature published to October 2009 was performed and relevant data were meta-analysed using random-effects model. A positive association was found (standardized difference in means=1.055, p>0,001), although a significant heterogeneity among studies (Q(15)=141, p<0,001) points to relevance of further subgroup analyses.

Dissociation and immune dysregulation: a preliminary report

Recent evidence indicates that various types of interactions between nervous and immune system are important in pathogenesis of depression. These findings show that a significant role in developing depression play proinflammatory cytokines that may mediate its psychological and neurobiological manifestations. Great importance among these cytokines plays tumor necrosis factor alpha (TNF-a) and there is growing evidence that inflammatory processes related to depression may be influenced by psychological stress as well as organic inflammatory conditions. These findings suggest that specific influences related to traumatic stress and dissociation could be found in close relationship to increased level of cytokine TNF-a. In the present study we have performed psychometric measurement of depression (BDI-II), traumatic stress symptoms (TSC-40) and dissociation (DES), and immunochemical measure of serum TNF-a in 40 inpatients with unipolar depression (mean age 38.4±8.2). The results show that TNF-a is significantly related to DES (Spearman R= -0.36, p<0.05), but not to BDI-II and TSC-40. Results of the present study suggest that TNF-a alterations related to dissociation could present a specific process of immunomodulation that may be explained by mutual influences between stress and neuroimmune system.