Allostatic load in psychiatry: a systematic review and meta-analysis.
Sabine Finlay, Riana Marie, Donna Rudd et al.
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In 30 seconds
This systematic review and meta-analysis examined associations between allostatic load (AL), a measure of multisystem physiological dysregulation, and psychiatric disorders. Twenty-eight studies were included in the review, with sixteen contributing to meta-analysis. AL was higher in people with psychiatric disorders than in healthy controls overall. The clearest pooled difference was for schizophrenia and first-episode psychosis (SMD: 0.97; 95% CI: 0.76, 1.18; p < .0001), whereas major depressive disorder showed no significant difference from controls (SMD: 0.07; 95% CI: -0.23; 0.37; p = 0.67).
Key findings
- Across included studies, people with psychiatric disorders demonstrated elevated allostatic load compared with healthy controls.
- For schizophrenia and first-episode psychosis, pooled allostatic load was higher than in healthy controls (SMD: 0.97; 95% CI: 0.76, 1.18; p < .0001).
- For major depressive disorder, the meta-analysis found no significant allostatic-load difference from healthy controls (SMD: 0.07; 95% CI: -0.23; 0.37; p = 0.67).
Why it matters
Allostatic load may help characterise how psychiatric disorders relate to dysregulation across multiple physiological systems, rather than focusing on a single biomarker. The differing pooled results across diagnostic groups also caution against assuming that this pattern applies uniformly. Further work could clarify whether AL assessment helps identify systemic comorbidity or informs understanding of illness processes.
What to keep in mind
The review included 28 studies, but only 16 were eligible for meta-analysis; the abstract does not report further limitations.