Post-Traumatic Stress Disorder, Depression, and Heart-Rate Variability among North Korean Defectors
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Objective This study evaluated the symptoms of post-traumatic stress disorder (PTSD) among North Korean defectors and their level of suicidal ideation and the correlation between these and heart-rate variability (HRV) to explore the possibility of using HRV as an objective neurobiological index of signs of autonomic nervous system disorder. Methods A total of 32 North Korean defectors (nine men, 23 women) were selected as subjects, and their HRV was measured after they completed the Minnesota Multiphasic Personality Inventory-PTSD (MMPI-PTSD) scale and the Beck Depression Inventory (BDI). Results 1) Low-frequency (LF)/high-frequency (HF) ratios in the HRV index and MMPI-PTSD scores were correlated (r=0.419, p<0.05), as were BDI item 9 (suicidal ideation) and MMPI-PTSD scores (r=0.600, p<0.01). 2) A regression analysis of LF/HF ratios and MMPI-PTSD scores revealed an R-value of 13.8% (Adj. R2=0.138, F=4.695, p=0.041), and a regression analysis of BDI item 9 and MMPI-PTSD scores showed an R-value of 32.8% (Adj. R2=0.328, F=11.234, p=0.003). In other words, the LF/HF ratio (β=0.419) and BDI item 9 (β=0.600) appear to be risk factors in predicting MMPI-PTSD scores. Conclusion The LF/HF ratio, a standard index of autonomic nervous system activity, can be used as an objective neurobiological index to analyze PTSD among North Korean defectors presenting with various mental and physical symptoms, and the approximate level of suicide -ideation can act as a predicting factor for PTSD.
Abstract
Objective This study evaluated the symptoms of post-traumatic stress disorder (PTSD) among North Korean defectors and their level of suicidal ideation and the correlation between these and heart-rate variability (HRV) to explore the possibility of using HRV as an objective neurobiological index of signs of autonomic nervous system disorder. Methods A total of 32 North Korean defectors (nine men, 23 women) were selected as subjects, and their HRV was measured after they completed the Minnesota Multiphasic Personality Inventory-PTSD (MMPI-PTSD) scale and the Beck Depression Inventory (BDI). Results 1) Low-frequency (LF)/high-frequency (HF) ratios in the HRV index and MMPI-PTSD scores were correlated (r=0.419, p<0.05), as were BDI item 9 (suicidal ideation) and MMPI-PTSD scores (r=0.600, p<0.01). 2) A regression analysis of LF/HF ratios and MMPI-PTSD scores revealed an R-value of 13.8% (Adj. R2=0.138, F=4.695, p=0.041), and a regression analysis of BDI item 9 and MMPI-PTSD scores showed an R-value of 32.8% (Adj. R2=0.328, F=11.234, p=0.003). In other words, the LF/HF ratio (β=0.419) and BDI item 9 (β=0.600) appear to be risk factors in predicting MMPI-PTSD scores. Conclusion The LF/HF ratio, a standard index of autonomic nervous system activity, can be used as an objective neurobiological index to analyze PTSD among North Korean defectors presenting with various mental and physical symptoms, and the approximate level of suicide -ideation can act as a predicting factor for PTSD.
참고문헌 (36)
- "North Korean Refugees Immigration Status"[URL]
- Blair RG, "Risk factors associated with PTSD and major depression among Cambodian refugees in Utah", Health Soc Work, 25, pp.23~30 (2000)
- Jeon W, "Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea", JOURNAL OF TRAUMATIC STRESS, 18(2), pp.147~154 (2005)
- Lee Y, "Traumatic experience of North Korean refugees in China", Am J Pre Med, 20, pp.225~229 (2001)
- Min SG, "Can We Live along Together after the Unification" (2004), Yonsei University Press
- Simon G, "Somatic symptoms of distress: an international primary care study", Psychosom Med, 58, pp.481~488 (1996)
- Hein S, "Lifetime depressive and somatic symptoms as preclinical markers of late onset depression", Eur Arch Psychiatry Clin Neurosci, 253, pp.16~21 (2003)
- 채정호, "외상후 스트레스 장애의 진단과 병태 생리", 대한정신약물학회지, 15(1), pp.14~21 (2004), 대한정신약물학회
- Lange JT, "Primary care treatment of post-traumatic stress disorder", Am Fam Physician, 62, pp.1035~1040 (2000)
- Nakell L, "Adult post-traumatic stress disorder: screening and treating in primary care", Prim Care, 34, pp.593~610 (2007)
- Goodwin J, "The Etiology of Combat Related Posttraumatic Stress Disorders, in Posttraumatic Stress Disorders of the Vietnam Veteran", pp.1~23 (1980), Disabled American Veterans
- Friedman BH, "Anxiety and autonomic flexibility: a cardiovascular approach", Biol Psychol, 47, pp.243~263 (1998)
- Appel ML, "Beat to beat variability in cardiovascular variables: noise or music", J Am Coll Cardiol, 14, pp.1139~1148 (1989)
- Carney RM, "Change in heart rate and heart rate variability during treatment for depression in patients with coronary heart disease", Psychosom Med, 62, pp.639~647 (2000)
- Bigger JT Jr, "Frequency domain measures of heart period variability to assess risk late after myocardial infarction", J Am Coll Cardiol, 21, pp.729~736 (1993)
- Lee YH, "A Study of the reliability and the validity of the BDI, SDS, and MMPI-D scales", Korean J Clin Psychol, 10, pp.98~113 (1991)
- Kang YS, (1997), Chonbuk Univ. Press
- Evrengul H, "Time and frequency domain analyses of heart rate variability in patients with epilepsy", Epilepsy Res, 63, pp.131~139 (2005)
- Sztajzel J, "Heart rate variability: a noninvasive electrocardiographic method to measure the autonomic nervous system", Swiss Med Wkly, 134, pp.514~522 (2004)
- Kay SM, "Spectrum analysis- A modern perspective", Proc IEEE, 69, pp.1380~1419 (1981)
- Akselrod S, "Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control", Science, 213, pp.220~222 (1981)
- Institute of HeartMath, "Autonomic Assessment Report: A Comprehensive Heart Rate Variability Analysis", pp.8~11 (1996), HeartMath Research Center
- Pagani M, "Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog", Circ Res, 59, pp.178~193 (1986)
- Mellman TA, "Heart rate variability during sleep and the early development of posttraumatic stress disorder", Biol Psychiatry, 55, pp.953~956 (2004)
- Cohen H, "Power spectral analysis of heart rate variability in post-traumatic stress disorder patients", Biol Psychiatry, 41, pp.627~629 (1997)
- Kinjie JD, "Severe Posttraumatic Stress Disorder among Cambodian Refugees : Symtoms, Clinical Course, and Treatment Approaches, in Diaster Stress Studies: New Methods and Findings", pp.123~1140 (1986), American Psychiatric Press
- Tulen JH, "Anxiety and autonomic regulation in major depressive disorder: an exploratory study", J Affect Disord, 40, pp.61~71 (1996)
- Nahshoni E, "Heart rate variability in patients with major depression", Psychosomatics, 45, pp.129~134 (2004)
- Yeragani VK, "Heart rate variability in patients with major depression", Psychiatry Res, 37, pp.35~46 (1991)
- Breslau N, "Risk factors for PTSD-related traumatic event: a prospective analysis", Am J Psychiatry, 152, pp.529~535 (1995)
- Breslau N, "Traumatic events and posttraumatic stress disorder in a urban population of young adults", Arch Gen Psychiatry, 48, pp.216~222 (1991)
- Kessler RC, "Posttraumatic stress disorder in the National Comorbidity Survey", Arch Gen Psychiatry, 52, pp.1048~1060 (1995)
- Fullerton CS, "Gender differences in posttraumatic stress disorder after motor vehicle accidents", Am J Psychiatry, 158, pp.1486~1491 (2001)
- 민성길, "북한이탈주민의 남한에서의 삶의 질:3년 추적 조사", 신경정신의학, 49(1), pp.104~113 (2010), 대한신경정신의���회
- Kang SR, "Development of Trauma Scale for North Korean Refugee" (2001), Younsei University Press
- Yehuda R, "Impact of cumulative lifetime trauma and recent stress on current posttraumatic stress disorder symptoms in holocaust survivors", Am J Psychiatry, 152, pp.1815~1818 (1995)
