정신과 외래환자의 약물치료 반응과 심박동 변이의 변화 양상
Changes of HRV after Antidepressant Treatment in Psychiatric Outpatients
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초록
약물치료의 반응 여부를 객관적인 생리적 지표로서 예측할 수 있다면, 정신과 임상 영역에 커다란 변화를 일으킬 수 있을 것이다. HRV는 현재 상태의 자율신경 활성도를 측정할 수 있다는 점에서 정신과 영역에서도 많은 관심을 받아왔고 앞으로도 많은 연구가 진행되리라 생각된다. 본 연구는 이러한 관점에서 보다 객관적인 평가 방법으로써 HRV의 이용가능성을 살펴보고자 연구를 진행하였고, HRV 변인들이 4주 약물치료의 반응군에서 유의하게 증가하고 있음을 발견하였다. 이러한 변인들의 평균값은 정상 대조군과 유사하였는데, 이는 증상의 호전에 따라 자율신경계가 정상화되는 양상을 보여주는 것이 아닌가 생각된다.
Abstract
Objectives:The purpose of this study was to investigate the change of heart rate variability after antidepressant treatment in depressed or anxious patients. We tried to find the usefulness of heart rate variability as a predictive marker of response to pharmacological treatments in the psychiatric field. Methods:Forty-seven patients with major depression, anxiety disorder, and somatoform disorder were treated over 4 weeks with antidepressants and were then classified as responders or nonresponders according to Hamilton depression scales or CGI scores. The HRV variables were measured and compared among the responders/nonresponders and the matched normal control. Results:The responders group exhibited low heart rate, low PSI, high SDNN, RMSSD, HRV index, NN50, pNN50, LNTP, LNLF, and LNHF compared with the nonresponders after 4 weeks antidepressant treatment. However, no significant difference in HRV variables was observed between the responders group after treatment and the normal control group and the response group after treatment. Conclusion:These results indicate that HRV variables would are normalized after successful antidepressant treatment and it that HRV has some possible uses as a predicting marker of antidepressant response. (J Korean Neuropsychiatr Assoc 2006; 45(6):527-533)
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