[Allostatic Load and Transdiagnostic Dimensions in Patients Admitted to the Psychiatric Emergency Department: A Research Protocol Using the Signature Biobank].

Objective People in acute crisis who seek psychiatric emergency services are clearly in great distress and likely already show signs of chronic stress. But how can we best measure chronic stress physiologically? Our study aims to assess allostatic load (AL), the "wear and tear" on biological systems that we can measure using different biological marker called biomarkers. Method We aim to assess biological and psychosocial dimensions related to psychiatric symptom changes among psychiatric emergency patients repeatedly evaluated at four-time points: (T1) 48-hours upon admission, (T2) end of hospitalization (about 2 weeks later), (T3) external follow-up (about 2 months), and (T4) 1 year later. We expect that (1) AL at T1 will distinguish psychiatric conditions, (2) higher AL will predict symptom trajectories over time, and (3) that combinations of modifiable risk and protective factors (e.g. health-related behaviors, psychosocial experiences) will boost or buffer these associations. We acquired funding in order analyze hair, saliva, and blood samples that have already been collected as part of the Signature Biobank that offers measures at T1 (N=1,984; 40% women; mean age 41 with a range from 18-81) as well as at T2 (n=685), T3 (n=606), & T4 (n=370). Results In the proposed project, we acquired funding to analyze biobanked tissues to index AL among all PEP and 149 healthy controls. Among subsamples with T2, T3, and T4 measures, we will assess prospectively changes in AL and psychiatric symptoms trajectories simultaneously. Conclusion From admission to remission, the study of psychiatric emergency patients is a unique opportunity to assess extreme profiles that can help refine precision medicine. The Signature Biobank will provide unique insights on the biological signatures of psychiatric conditions and changes over time while also providing unique knowledge and training opportunities for years to come supported by a transdisciplinary team.