Sex and Age-Related Differences in Neuroticism and Allostatic Load Index in Urban Patients with General Anxiety Disorder Treated with Alprazolam

Abstract

Introduction: Allostatic load (AL) index proposes indicators for the functioning of the main potentially stress-affected systems. Sex differences in stress response and stress-related diseases susceptibility have been described for the general population. In this observational study we describe the effects of sex and age on AL variables, in a cohort of patients with general anxiety disorders and neuroticism treated with alprazolam during 12 weeks, before and after treatment. Methods: Patients with general (DSM IV) anxiety disorders with >6 in Hamilton scale, AL (>1 Crimmins and Seeman AL modified criteria) and neuroticism >18 (NEO-FFI inventory), were included. All patients completed psychiatric assessment, AL index determination before (−1 week) and after 12 weeks of treatment with alprazolam (0.25 - 1 mg/t.i.d). Allostatic load parameters comprised cardiovascular, metabolic and inflammatory variables. Univariate analysis (two-way ANOVA), Student’s t-test (related variables) and Pearson correlations were determined. Results: Fifty-four patients, 35 females (48.6 ± 11.7 years) and 19 males (44.2 ± 12.8 years) with general anxiety disorder were included; 28 patients with <50 years (60.7% females), and 26 with ≥50 years (69.2% females). Younger patients (<50 years) (two-way ANOVA, p = 0.02) were significantly associated with lower AL index after treatment. However, women showed higher anxiety levels in both, before (two-way ANOVA, p = 0.059) and after treatment (two-way ANOVA, p = 0.005), with a significantly better profile than men in many individual AL variables, particularly cardiovascular (systolic blood pressure), obesity (body mass index), and lipids (higher HDL levels). After treatment a higher reduction of fibrinogen levels was found in men (two-way ANOVA, p = 0.02). Conclusions: In this preliminary analysis we described sex and age differences in psychiatry aspects and AL indexes in patients with general anxiety disorders in the short-term treatment with alprazolam. These considerations remark the need of pondering sex and age differences during the use of drugs for protracted periods.