The Adrenaline Dysfunction Spectrum (ADYS): Temporal and Transdiagnostic Pattern of Autonomic Dysregulation Identified Through Prospective Clinical Surveillance.

Background Chronic multisystem conditions of unclear aetiology impose a substantial global healthcare burden yet remain poorly represented within existing diagnostic frameworks.[9] This limitation may stem from a historical mind body dualism that created a conceptual blind spot for the autonomic nervous system (ANS),[10] leading to diagnostic fragmentation of what may be a shared underlying process. This study introduces the Adrenaline Dysfunction Spectrum (ADYS) as a candidate clinical construct characterised by symptoms consistent with chronic sympathetic adrenergic activation.[11] Methods Since September 2019, an ongoing clinical epidemiological surveillance system — the Ramirez Syndrome Differentiation System, Trauma Stress Relief (RSDS TSR) platform — has been implemented at the Chiren Therapy Centre. This analysis includes 1,265 anonymised baseline assessments collected between September 2019 and March 2025 across the six most prevalent ICD 11 diagnostic categories. The platform systematically quantifies a 41 item autonomic symptom inventory (ADYS indicator), Perceived Energy (PE), Hospital Anxiety and Depression Scale (HADS) scores, and trauma recall timing. We mapped ADYS PE distribution across ICD 11 categories, examined the ADYS PE relationship using linear regression, assessed convergent validity through correlations with HADS subscales, and evaluated the independent effect of trauma recall latency using multivariable regression. Results Five core patterns emerged. First, the ADYS indicator demonstrated excellent internal consistency (Cronbach's α = 0.936). Second, ADYS scores showed a moderate inverse correlation with Perceived Energy (r = minus 0.37, p < 0.001), constituting the ADYS PE axis. Third, trauma recall latency >20 years independently predicted higher ADYS scores (b = +13.57, p < 0.001) after adjustment for confounders. Fourth, systematic application of the RSDS TSR framework revealed a transdiagnostic expression of ADYS across all ICD 11 categories examined. Fifth, self harming ideation emerged as a threshold dependent, late phase epidemiological signal: absent below ADYS ≤ 40 and concentrated in the >20 year trauma recall group, which accounted for 68% of all high intensity cases cohort wide (17/25). These observational findings warrant further investigation. Interpretation The ADYS PE axis offers a measurable, transdiagnostic approach to chronic autonomic dysregulation. The stable inverse relationship between symptom burden and functional capacity, together with the identification of a >20 year trauma recall threshold, represents a hypothesis generating epidemiological signal with potential relevance for understanding late stage psychiatric and somatic decompensation.