Association between Heart Rate Variability Indices and Depressed Mood in Patients with Panic Disorder
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective: Heart rate variability (HRV) reflects the regulation of the autonomic nervous system. Panic disorder is highly associated with autonomic dysfunction, and is often accompanied by depression. The aim of this study is to determine the association between depression and HRV indices in patients with panic disorder. Methods: A total of 110 outpatients diagnosed with panic disorder participated in this study. The medical records of patients with panic disorder who visited the outpatient clinic of Konkuk University Hospital between December 2018 and March 2020 were retrospectively reviewed. Measurements used in this study include the Panic Disorder Severity Scale-Self Report, Beck Depression Inventory (BDI-II), Insomnia Severity Index, and HRV. Patients were divided into depressive and non-depressive groups based on their BDI-II scores. The association between HRV indices and depressive symptoms was statistically analyzed. Results: The low frequency/high frequency (LF/HF) ratio was reduced in patients with depression (mean = −0.095, p = 0.004 in the above moderate depressive group, mean = −0.120, p = 0.020 in the severe depressive group). Significant correlations were found between depressive symptoms and standard deviation of NN interval (SDNN) (ms) (−0.19, p = 0.044), very low frequency (VLF) (ms2 /Hz) (−0.22, p = 0.021), LF (−0.25, p = 0.008), HF (−0.19, p = 0.043), and LF/HF (−0.25, p = 0.009). Multiple linear regression analysis showed that BDI predicted SDNN (ms), VLF (ms2 /Hz), LF, HF, and LF/HF. Conclusion: We confirmed that the LF/HF ratio decreases when depression is accompanied by panic disorder. HRV indices may be useful markers for detecting depressive symptoms in patients with panic disorder.
Abstract
Objective: Heart rate variability (HRV) reflects the regulation of the autonomic nervous system. Panic disorder is highly associated with autonomic dysfunction, and is often accompanied by depression. The aim of this study is to determine the association between depression and HRV indices in patients with panic disorder. Methods: A total of 110 outpatients diagnosed with panic disorder participated in this study. The medical records of patients with panic disorder who visited the outpatient clinic of Konkuk University Hospital between December 2018 and March 2020 were retrospectively reviewed. Measurements used in this study include the Panic Disorder Severity Scale-Self Report, Beck Depression Inventory (BDI-II), Insomnia Severity Index, and HRV. Patients were divided into depressive and non-depressive groups based on their BDI-II scores. The association between HRV indices and depressive symptoms was statistically analyzed. Results: The low frequency/high frequency (LF/HF) ratio was reduced in patients with depression (mean = −0.095, p = 0.004 in the above moderate depressive group, mean = −0.120, p = 0.020 in the severe depressive group). Significant correlations were found between depressive symptoms and standard deviation of NN interval (SDNN) (ms) (−0.19, p = 0.044), very low frequency (VLF) (ms2 /Hz) (−0.22, p = 0.021), LF (−0.25, p = 0.008), HF (−0.19, p = 0.043), and LF/HF (−0.25, p = 0.009). Multiple linear regression analysis showed that BDI predicted SDNN (ms), VLF (ms2 /Hz), LF, HF, and LF/HF. Conclusion: We confirmed that the LF/HF ratio decreases when depression is accompanied by panic disorder. HRV indices may be useful markers for detecting depressive symptoms in patients with panic disorder.
참고문헌 (59)
- Joonho Lee, "Higher Rightward Laterality of the Hippocampal Tail and Its Association with Early Trauma in Panic Disorder", Clinical Psychopharmacology and Neuroscience, 18(2), pp.311~321 (2020), 대한정신약물학회[DOI]
- Baxter AJ, "The global burden of anxiety disorders in 2010", Psychol Med, 44, pp.2363~2374 (2014)
- Carta MG, "The attributable burden of panic disorder in the impairment of quality of life in a national survey in Italy", Int J Soc Psychiatry, 61, pp.693~699 (2015)
- Rofman ES, "Kaplan and Sadock’s synopsis of psychiatry : behavioral sciences", clinical psychiatry, 10th ed, 2009, pp.70, 940~
- Roy-Byrne PP, "Lifetime panic-depression comorbidity in the National Comorbidity Survey. Association with symptoms, impairment, course and help-seeking", Br J Psychiatry, 176, pp.229~235 (2000)
- Crowe RR, "Panic disorder and agoraphobia", Dis Mon, 32, pp.389~444 (1986)
- Nam YY, "Comorbid panic disorder as an independent risk factor for suicide attempts in depressed outpatients", Compr Psychiatry, 67, pp.13~18 (2016)
- Castriotta N, "Depression and comorbidity with panic disorder", pp.84~99 (2014), Oxford University Press
- Thibodeau MA, "Anxiety disorders are independently associated with suicide ideation and attempts : propensity score matching in two epidemiological samples", Depress Anxiety, 30, pp.947~954 (2013)
- Sheng Min Wang, "Rapid Onset of Intranasal Esketamine in Patients with Treatment Resistant Depression and Major Depression with Suicide Ideation: A Meta-Analysis", Clinical Psychopharmacology and Neuroscience, 19(2), pp.341~354 (2021), 대한정신약물학회[DOI]
- Fawcett J, "Time-related predictors of suicide in major affective disorder", Am J Psychiatry, 147, pp.1189~1194 (1990)
- Woodward SH, "Autonomic activation during sleep in posttraumatic stress disorder and panic : a mattress actigraphic study", Biol Psychiatry, 66, pp.41~46 (2009)
- Friedman BH, "Autonomic balance revisited : panic anxiety and heart rate variability", J Psychosom Res, 44, pp.133~151 (1998)
- Friedman BH, "An autonomic flexibility-neurovisceral integration model of anxiety and cardiac vagal tone", Biol Psychol, 74, pp.185~199 (2007)
- Houck PR, "Reliability of the self-report version of the panic disorder severity scale", Depress Anxiety, 15, pp.183~185 (2002)
- Shear MK, "Multicenter collaborative panic disorder severity scale", Am J Psychiatry, 154, pp.1571~1575 (1997)
- Licht CM, "Association between anxiety disorders and heart rate variability in The Netherlands Study of Depression and Anxiety(NESDA)", Psychosom Med, 71, pp.508~518 (2009)
- Udupa K, "Alteration of cardiac autonomic functions in patients with major depression : a study using heart rate variability measures", J Affect Disord, 100, pp.137~141 (2007)
- Yeragani VK, "Heart rate variability in patients with major depression", Psychiatry Res, 37, pp.35~46 (1991)
- Martinez JM, "Heart rate and blood pressure changes during autonomic nervous system challenge in panic disorder patients", Psychosom Med, 72, pp.442~449 (2010)
- 강은호, "Platelet Serotonin Transporter Function and Heart Rate Variability in Patients with Panic Disorder", Journal of Korean Medical Science, 25(4), pp.613~618 (2010), 대한의학회
- McCraty R, "Analysis of twenty-four hour heart rate variability in patients with panic disorder", Biol Psychol, 56, pp.131~150 (2001)
- Ito T, "Autonomic function in the early stage of panic disorder : power spectral analysis of heart rate variability", Psychiatry Clin Neurosci, 53, pp.667~672 (1999)
- Shear MK, "Reliability and validity of the Panic Disorder Severity Scale : replication and extension", J Psychiatr Res, 35, pp.293~296 (2001)
- Lee EH, "Reliability and validity of the self-report version of the Panic Disorder Severity Scale in Korea", Depress Anxiety, 26, pp.E120~E123 (2009)
- Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
- Beck AT, "Comparison of Beck Depression Inventories-IA and-II in psychiatric outpatients", J Pers Assess, 67, pp.588~597 (1996)
- 임승우, "The Beck Depression Inventory-Second Edition: Psychometric Properties in Korean Adult Populations", Korean Journal of Clinical Psychology, 38(3), pp.300~307 (2019), 한국임상심리학회
- Bastien CH, "Validation of the Insomnia Severity Index as an outcome measure for insomnia research", Sleep Med, 2, pp.297~307 (2001)
- 조용원, "Validation of a Korean Version of the Insomnia Severity Index", Journal of Clinical Neurology, 10(3), pp.210~215 (2014), 대한신경과학회[DOI]
- Draghici AE, "The physiological basis and measurement of heart rate variability in humans", J Physiol Anthropol, 35, pp.22~ (2016)
- Sztajzel J, "Heart rate variability : a noninvasive electrocardiographic method to measure the autonomic nervous system", Swiss Med Wkly, 134, pp.514~522 (2004)
- 문은옥, "Comparative Study of Heart Rate Variability in Patients with Schizophrenia,Bipolar Disorder, Post-traumatic Stress Disorder, or Major Depressive Disorder", Clinical Psychopharmacology and Neuroscience, 11(3), pp.137~143 (2013), 대한정신약물학회
- Choi KW, "Heart rate variability for treatment response between patients with major depressive disorder versus panic disorder : a 12-week follow-up study", J Affect Disord, 246, pp.157~165 (2019)
- Reed MJ, "Heart rate variability measurements and the prediction of ventricular arrhythmias", QJM, 98, pp.87~95 (2005)
- Beauchaine TP, "Heart rate variability as a transdiagnostic biomarker of psychopathology", Int J Psychophysiol, 98(2 Pt 2), pp.338~350 (2015)
- Beauchaine T, "Vagal tone, development, and Gray’s motivational theory : toward an integrated model of autonomic nervous system functioning in psychopathology", Dev Psychopathol, 13, pp.183~214 (2001)
- Kemp AH, "Impact of depression and antidepressant treatment on heart rate variability : a review and meta-analysis", Biol Psychiatry, 67, pp.1067~1074 (2010)
- 박소연, "주요우울장애 환자에서 심박변이도 분석", Mood and Emotion, 10(3), pp.152~158 (2012), 대한우울조울병학회
- Chalmers JA, "Anxiety disorders are associated with reduced heart rate variability : a meta-analysis", Front Psychiatry, 5, pp.80~ (2014)
- Hsin-An Chang, "Generalized Anxiety Disorder, Comorbid Major Depression and Heart Rate Variability: A Case-Control Study in Taiwan", PSYCHIATRY INVESTIGATION, 10(4), pp.326~335 (2013), 대한신경정신의학회
- Thayer JF, "Autonomic characteristics of generalized anxiety disorder and worry", Biol Psychiatry, 39, pp.255~266 (1996)
- Pittig A, "Heart rate and heart rate variability in panic, social anxiety, obsessive-compulsive, and generalized anxiety disorders at baseline and in response to relaxation and hyperventilation", Int J Psychophysiol, 87, pp.19~27 (2013)
- Cohen H, "Power spectral analysis of heart rate variability in posttraumatic stress disorder patients", Biol Psychiatry, 41, pp.627~629 (1997)
- Cohen H, "Autonomic dysregulation in panic disorder and in posttraumatic stress disorder : application of power spectrum analysis of heart rate variability at rest and in response to recollection of trauma or panic attacks", Psychiatry Res, 96, pp.1~13 (2000)
- Cohen H, "Normalization of heart rate variability in post-traumatic stress disorder patients following fluoxetine treatment : preliminary results", Isr Med Assoc J, 2, pp.296~301 (2000)
- Hauschildt M, "Heart rate variability in response to affective scenes in posttraumatic stress disorder", Biol Psychol, 88, pp.215~222 (2011)
- Alvarenga ME, "Psychophysiological mechanisms in panic disorder : a correlative analysis of noradrenaline spillover, neuronal noradrenaline reuptake, power spectral analysis of heart rate variability, and psychological variables", Psychosom Med, 68, pp.8~16 (2006)
- Kikuchi M, "Heart rate variability in drug-naïve patients with panic disorder and major depressive disorder", Prog Neuropsychopharmacol Biol Psychiatry, 33, pp.1474~1478 (2009)
- Slaap BR, "Five-minute recordings of heart rate variability in obsessivecompulsive disorder, panic disorder and healthy volunteers", J Affect Disord, 78, pp.141~148 (2004)
- Malik M, "Heart rate variability : Standards of measurement, physiological interpretation, and clinical use", Eur Heart J, 17, pp.354~381 (1996)
- Koch C, "A meta-analysis of heart rate variability in major depression", Psychol Med, 49, pp.1948~1957 (2019)
- Liang CS, "Reactive heart rate variability in male patients with first-episode major depressive disorder", Prog Neuropsychopharmacol Biol Psychiatry, 56, pp.52~57 (2015)
- O’Regan C, "Antidepressants strongly influence the relationship between depression and heart rate variability : findings from The Irish Longitudinal Study on Ageing(TILDA)", Psychol Med, 45, pp.623~636 (2015)
- Brown L, "Heart rate variability alterations in late life depression : a meta-analysis", J Affect Disord, 235, pp.456~466 (2018)
- 조한규, "Heart Rate Variability as an Early Objective Indicator of Subjective Feeling of Depression in Daily Life", Healthcare Informatics Research, 27(3), pp.249~254 (2021), 대한의료정보학회
- Ziegler MG, "Primer on the autonomic nervous system", pp.291~293 (2012), Elsevier Inc
- Fritz S, "Clinical massage in the healthcare setting" (2008), Elsevier Health Sciences
- Licht CM, "Association between major depressive disorder and heart rate variability in the Netherlands Study of Depression and Anxiety(NESDA)", Arch Gen Psychiatry, 65, pp.1358~1367 (2008)
