Depression, Comorbid Anxiety Disorders, and Heart Rate Variability in Physically Healthy, Unmedicated Patients: Implications for Cardiovascular Risk

There is evidence that heart rate variability (HRV) is reduced in major depressive disorder (MDD), although there is debate about whether this effect is caused by medication or the disorder per se. MDD is associated with a two to fourfold increase in the risk of cardiac mortality, and HRV is a robus...

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Vydáno v:	PloS one Ročník 7; číslo 2; s. e30777
Hlavní autoři:	Kemp, Andrew H., Quintana, Daniel S., Felmingham, Kim L., Matthews, Slade, Jelinek, Herbert F.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science 15.02.2012 Public Library of Science (PLoS)
Témata:	Adult Alcoholic beverages Alcoholism Antidepressants Anxiety Anxiety Disorders - complications Anxiety Disorders - psychology Arousal Body mass Brain Brain injuries Brain injury Cardiac patients Cardiovascular diseases Cardiovascular Diseases - diagnosis Cardiovascular Diseases - etiology Cardiovascular Diseases - psychology Case-Control Studies Comorbidity Consciousness Depressive Disorder, Major - complications Depressive Disorder, Major - psychology Disorders Drug abuse Drug addiction Drugs EKG Electrocardiography Female Gender Head injuries Health aspects Health risk assessment Health risks Heart diseases Heart rate Heart Rate - physiology Humans Male Medicine Mental depression Mentally ill persons Mortality Nervous system diseases Patients Post traumatic stress disorder Posttraumatic stress disorder Reduction Risk Risk factors Social and Behavioral Sciences Variability Australia New South Wales Australia
ISSN:	1932-6203, 1932-6203
On-line přístup:	Získat plný text
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Popis
Shrnutí:	There is evidence that heart rate variability (HRV) is reduced in major depressive disorder (MDD), although there is debate about whether this effect is caused by medication or the disorder per se. MDD is associated with a two to fourfold increase in the risk of cardiac mortality, and HRV is a robust predictor of cardiac mortality; determining a direct link between HRV and not only MDD, but common comorbid anxiety disorders, will point to psychiatric indicators for cardiovascular risk reduction. To determine in physically healthy, unmedicated patients whether (1) HRV is reduced in MDD relative to controls, and (2) HRV reductions are driven by MDD alone, comorbid generalized anxiety disorder (GAD, characterized by anxious anticipation), or comorbid panic and posttraumatic stress disorders (PD/PTSD, characterized by anxious arousal). A case-control study in 2006 and 2007 on 73 MDD patients, including 24 without anxiety comorbidity, 24 with GAD, and 14 with PD/PTSD. Seventy-three MDD and 94 healthy age- and sex-matched control participants were recruited from the general community. Participants had no history of drug addiction, alcoholism, brain injury, loss of consciousness, stroke, neurological disorder, or serious medical conditions. There were no significant differences between the four groups in age, gender, BMI, or alcohol use. HRV was calculated from electrocardiography under a standardized short-term resting state condition. HRV was reduced in MDD relative to controls, an effect associated with a medium effect size. MDD participants with comorbid generalized anxiety disorder displayed the greatest reductions in HRV relative to controls, an effect associated with a large effect size. Unmedicated, physically healthy MDD patients with and without comorbid anxiety had reduced HRV. Those with comorbid GAD showed the greatest reductions. Implications for cardiovascular risk reduction strategies in otherwise healthy patients with psychiatric illness are discussed.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Article-2 ObjectType-Feature-1 content type line 23 Conceived and designed the experiments: AK DQ. Performed the experiments: AK DQ. Analyzed the data: AK DQ. Contributed reagents/materials/analysis tools: HJ SM. Wrote the paper: AK DQ KF SM HJ.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0030777