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Sun B, Wu J, Li C, Li C, Hu Z, Wang R. Effects of different extreme cold exposure on heart rate variability. ERGONOMICS 2024; 67:1147-1163. [PMID: 37988319 DOI: 10.1080/00140139.2023.2286906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 11/18/2023] [Indexed: 11/23/2023]
Abstract
Frequent extreme cold events in recent years have brought serious threats to outdoor workers and rescuers. Changes in ambient temperature are associated with altered cardiac autonomic function. The study aims to investigate heart rate variability (HRV) and its relationship to other physiological parameters under extreme cold exposures. Twelve males underwent a 30-min preconditioning phase in a neutral environment followed by a 30-min cold exposure (-5, -10, -15, and -20 °C). Time-domain indexes(meanRR, SDNN, RMSSD, and pNN50), frequency domain indexes [Log(HF), Log(LF), and low frequency/high frequency (LF/HF)], parasympathetic nervous system (PNS), and sympathetic nervous system (SNS) were analysed. Results showed all HRV indexes of four cold exposures were significant. The decrease in temperature was accompanied by progressive PNS activation with SNS retraction. SDNN was the most sensitive HRV index and had good linear relationships with blood pressure, pulse, and hand temperature. The results are significant for formulating safety protection strategies for workers in extremely cold environments.Practitioner Summary: This study investigated heart rate variability (HRV) in 12 males during a 30-min cold exposure (-5, -10, -15, and -20 °C). Results showed all HRV indexes of four cold exposures were significant. The decrease in temperature was accompanied by progressive PNS activation with SNS retraction. SDNN was the most sensitive HRV index and had good linear relationships with blood pressure, pulse, and hand temperature.
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Affiliation(s)
- Boyang Sun
- School of Emergency Management & Safety Engineering, China University of Mining and Technology, Beijing, China
| | - Jiansong Wu
- School of Emergency Management & Safety Engineering, China University of Mining and Technology, Beijing, China
| | - Chuan Li
- School of Emergency Management & Safety Engineering, China University of Mining and Technology, Beijing, China
| | - Chenming Li
- System Engineering Institute, Beijing, China
| | - Zhuqiang Hu
- School of Emergency Management & Safety Engineering, China University of Mining and Technology, Beijing, China
| | - Ruotong Wang
- School of Emergency Management & Safety Engineering, China University of Mining and Technology, Beijing, China
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2
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Jakubowska P, Balcerczyk-Lis M, Fortuna M, Janiak A, Kopaczyńska A, Skwira S, Młynarska E, Rysz J, Franczyk B. Influence of Metabolic Dysregulation in the Management of Depressive Disorder-Narrative Review. Nutrients 2024; 16:1665. [PMID: 38892598 PMCID: PMC11174513 DOI: 10.3390/nu16111665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/16/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Depressive disorders are heterogeneous in nature, and their global reach makes them the cause of suffering for a million individuals worldwide. Standard treatment does not work for one in three people, and side effects can significantly reduce the quality of life. A multidisciplinary approach allows for a broader insight into the nature of the disease, given its complex etiology. One of its elements is the hypothesis of inflammation, which also accompanies obesity-related disease. Obesity and depression interact, causing many researchers to develop new non-pharmacological treatment methods for both diseases. One suggestion is physical exercises that have great potential to be used in clinical practice. They can exert changes on the central nervous system and thus modulate mood. Another is diet, which concentrates on active molecules that also affect the central nervous system (CNS). There is an urgent need to create appropriate criteria and recommendations that systematize existing knowledge and allow it to be used in practice. There is an urgent need to create appropriate criteria and recommendations that systematize existing knowledge and allow it to be used in practice.
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Affiliation(s)
- Paulina Jakubowska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Marta Balcerczyk-Lis
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Milena Fortuna
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Aleksandra Janiak
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Adrianna Kopaczyńska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Sylwia Skwira
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Ewelina Młynarska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Beata Franczyk
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
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Qin Q, Jiang Y, Mei X, Zhu Y, Li H, Li S, Chen K, Zhang C, Wang X, Bai H, Zhang J, Wang W. The effect of childhood trauma on depression in college students: A moderated mediation model. J Affect Disord 2024; 352:490-497. [PMID: 38403134 DOI: 10.1016/j.jad.2024.02.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/05/2024] [Accepted: 02/17/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE Childhood trauma is considered as a critical risk factor for depression. Although many studies have investigated the pathway of Childhood trauma to depression, especially the mediating or moderating effects of cognitive emotion regulation strategies or neuroticism or stress perception, the results were inconsistent and the underlying psychological mechanisms of depression remain unclear. This study aims to explore the influence and mechanism of childhood trauma on depression in college students, and establish a full model among these interactive factors. METHODS 1272 college students were surveyed using the childhood trauma questionnaire (CTQ), short version of center for epidemiologic studies depression scale (CES-D), Chinese perceived stress scale (CPSS), neuroticism extraversion openness five-factor inventory (NEO-FFI), and the Cognitive Emotion Regulation Questionnaire (CERQ). RESULTS (1) Childhood trauma, neuroticism, stress perception, and maladaptive cognitive emotion regulation strategies were all significantly and positively correlated with depression among college students; (2) Stress perception and neuroticism act as a chain mediator between childhood trauma and depression in college students. (3) Maladaptive cognitive emotion regulation strategies play a moderating role in "childhood trauma-neuroticism-depression". CONCLUSION Childhood trauma increases the risk of depression in college students by affecting neuroticism and stress perception, and high levels of maladaptive cognitive emotion regulation strategies link neuroticism and enhance the effect of childhood trauma on depression in college students.
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Affiliation(s)
- Qiyue Qin
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Yulian Jiang
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Xian Mei
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China; School of Qian Xuesen College, Xi'an Jiaotong University, Xi'an, Shanxi 710049, China
| | - Yuqiong Zhu
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Hui Li
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Shuxuan Li
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Kexin Chen
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Chen Zhang
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Xiucheng Wang
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Huaiyu Bai
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China
| | - Jing Zhang
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China.
| | - Wenjuan Wang
- School of Mental Health, Bengbu Medical University, Bengbu, Anhui 233030, China.
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4
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Ritz T. Putting back respiration into respiratory sinus arrhythmia or high-frequency heart rate variability: Implications for interpretation, respiratory rhythmicity, and health. Biol Psychol 2024; 185:108728. [PMID: 38092221 DOI: 10.1016/j.biopsycho.2023.108728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
Research on respiratory sinus arrhythmia, or high-frequency heart rate variability (its frequency-domain equivalent), has been popular in psychology and the behavioral sciences for some time. It is typically interpreted as an indicator of cardiac vagal activity. However, as research has shown for decades, the respiratory pattern can influence the amplitude of these noninvasive measures substantially, without necessarily reflecting changes in tonic cardiac vagal activity. Although changes in respiration are systematically associated with experiential and behavioral states, this potential confound in the interpretation of RSA, or HF-HRV, is rarely considered. Interpretations of within-individual changes in these parameters are therefore only conclusive if undertaken relative to the breathing pattern. The interpretation of absolute levels of these parameters between individuals is additionally burdened with the problem of residual inspiratory cardiac vagal activity in humans. Furthermore, multiple demographic, anthropometric, life-style, health, and medication variables can act as relevant third variables that might explain associations of RSA or HF-HRV with experiential and behavioral variables. Because vagal activity measured by these parameters only represents the portion of cardiac vagal outflow that is modulated by the respiratory rhythm, alternative interpretations beyond cardiac vagal activity should be considered. Accumulating research shows that activity of multiple populations of neurons in the brain and the periphery, and with that organ activity and function, are modulated rhythmically by respiratory activity. Thus, observable health benefits ascribed to the cardiac vagal system through RSA or HF-HRV may actually reflect beneficial effects of respiratory modulation. Respiratory rhythmicity may ultimately provide the mechanism that integrates central, autonomic, and visceral activities.
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Affiliation(s)
- Thomas Ritz
- Department of Psychology, Southern Methodist University, Dallas, TX, USA.
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5
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Li X, Song Y, Wang H, Su X, Wang M, Li J, Ren Z, Zhong D, Huang Z. Evaluation of measurement accuracy of wearable devices for heart rate variability. iScience 2023; 26:108128. [PMID: 37867933 PMCID: PMC10587522 DOI: 10.1016/j.isci.2023.108128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/29/2023] [Accepted: 10/01/2023] [Indexed: 10/24/2023] Open
Abstract
This paper proposed a method based on heart rate variability (HRV) for evaluating the accuracy of wearable devices in measuring heart rate. HRV refers to the variation in time intervals between successive heartbeats, widely used in many fields such as clinical and sports fields. Wearable devices such as Electrocardiogram (ECG) electrode patches have gained popularity due to their portability and ease of use. However, they can be prone to measurement interference caused by environmental noise, human respiration, etc. The proposed method consists of four main components: selection of "gold standard measurement devices", identification of HRV measurement metrics, construction of an HRV evaluation framework, and quantification of measurement errors. The method is validated through simulated experiments using ECG patches. The evaluation framework and quantification model established in this method have significant implications in establishment of industry standards and diagnosis of diseases in clinical practice.
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Affiliation(s)
- Xiangchen Li
- China Institute of Sport Science, Beijing 100061, China
| | - Yuting Song
- School of Nursing, Qingdao University, Qingdao 266021, China
| | - Huang Wang
- China Institute of Sport Science, Beijing 100061, China
| | - Xinyu Su
- School of Sport Science, Beijing Sport University, Beijing 100084, China
| | - Mengyao Wang
- School of Microelectronics and Communication Engineering, Chongqing University, Chongqing 400044, China
| | - Jing Li
- Bioengineering College, Chongqing University, Chongqing 400044, China
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518063, China
| | - Zhiqiang Ren
- National Sports Technology Innovation Center Beijing Co., Ltd. Beijing 100061, China
| | - Daidi Zhong
- Bioengineering College, Chongqing University, Chongqing 400044, China
| | - Zhiyong Huang
- School of Microelectronics and Communication Engineering, Chongqing University, Chongqing 400044, China
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6
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Lekkas D, Gyorda JA, Price GD, Jacobson NC. Depression deconstructed: Wearables and passive digital phenotyping for analyzing individual symptoms. Behav Res Ther 2023; 168:104382. [PMID: 37544229 PMCID: PMC10529827 DOI: 10.1016/j.brat.2023.104382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/20/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
Wearable technology enables unobtrusive collection of longitudinally dense data, allowing for continuous monitoring of physiology and behavior. These digital phenotypes, or device-based indicators, are frequently leveraged to study depression. However, they are usually considered alongside questionnaire sum-scores which collapse the symptomatic gamut into a general representation of severity. To explore the contributions of passive sensing streams more precisely, associations of nine passive sensing-derived features with self-report responses to Center for Epidemiologic Studies Depression (CES-D) items were modeled. Using data from the NetHealth study on N=469 college students, this work generated mixed ordinal logistic regression models to summarize contributions of pulse, movement, and sleep data to depression symptom detection. Emphasizing the importance of the college context, wearable features displayed unique and complementary properties in their heterogeneously significant associations with CES-D items. This work provides conceptual and exploratory blueprints for a reductionist approach to modeling depression within passive sensing research.
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Affiliation(s)
- Damien Lekkas
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, 03766, United States; Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, NH, 03755, United States.
| | - Joseph A Gyorda
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, 03766, United States; Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, NH, 03755, United States
| | - George D Price
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, 03766, United States; Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, NH, 03755, United States
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, 03766, United States; Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, NH, 03755, United States; Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, 03766, Lebanon, NH, United States; Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, 03755, United States
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7
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Verhoeven JE, Han LKM, Lever-van Milligen BA, Hu MX, Révész D, Hoogendoorn AW, Batelaan NM, van Schaik DJF, van Balkom AJLM, van Oppen P, Penninx BWJH. Antidepressants or running therapy: Comparing effects on mental and physical health in patients with depression and anxiety disorders. J Affect Disord 2023; 329:19-29. [PMID: 36828150 DOI: 10.1016/j.jad.2023.02.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 02/11/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Antidepressant medication and running therapy are both effective treatments for patients with depressive and anxiety disorders. However, they may work through different pathophysiological mechanisms and could differ in their impact on physical health. This study examined effects of antidepressants versus running therapy on both mental and physical health. METHODS According to a partially randomized patient preference design, 141 patients with depression and/or anxiety disorder were randomized or offered preferred 16-week treatment: antidepressant medication (escitalopram or sertraline) or group-based running therapy ≥2 per week. Baseline (T0) and post-treatment assessment at week 16 (T16) included mental (diagnosis status and symptom severity) and physical health indicators (metabolic and immune indicators, heart rate (variability), weight, lung function, hand grip strength, fitness). RESULTS Of the 141 participants (mean age 38.2 years; 58.2 % female), 45 participants received antidepressant medication and 96 underwent running therapy. Intention-to-treat analyses showed that remission rates at T16 were comparable (antidepressants: 44.8 %; running: 43.3 %; p = .881). However, the groups differed significantly on various changes in physical health: weight (d = 0.57; p = .001), waist circumference (d = 0.44; p = .011), systolic (d = 0.45; p = .011) and diastolic (d = 0.53; p = .002) blood pressure, heart rate (d = 0.36; p = .033) and heart rate variability (d = 0.48; p = .006). LIMITATIONS A minority of the participants was willing to be randomized; the running therapy was larger due to greater preference for this intervention. CONCLUSIONS While the interventions had comparable effects on mental health, running therapy outperformed antidepressants on physical health, due to both larger improvements in the running therapy group as well as larger deterioration in the antidepressant group. TRIAL REGISTRATION Trialregister.nl Number of identification: NTR3460.
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Affiliation(s)
- Josine E Verhoeven
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands.
| | - Laura K M Han
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Bianca A Lever-van Milligen
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Mandy X Hu
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Dóra Révész
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Adriaan W Hoogendoorn
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Neeltje M Batelaan
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Digna J F van Schaik
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Anton J L M van Balkom
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, Amsterdam, the Netherlands
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8
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Garabiles MR, Shen ZZ, Yang L, Chu Q, Hannam K, Hall BJ. Investigating the Physical and Mental Health Nexus: a Network Analysis of Depression, Cardiometabolic Health, Bone Mass, and Perceived Health Status Among Filipino Domestic Workers. Int J Behav Med 2023; 30:234-249. [PMID: 35578098 DOI: 10.1007/s12529-022-10087-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Migrant domestic workers are vulnerable to physical and mental health problems given the many challenges they experience while working abroad. Using network analysis, this study examined the structure of depression, cardiometabolic health indicators (BMI, waist-hip ratio (WHR), blood pressure, and heart rate), bone mass, and perceived health status in this population. The network model allowed for an examination of central symptoms or symptoms with the most direct connections with other symptoms; bridge symptoms, or symptoms that link two or more communities; and edges, or relationships among symptoms. METHOD Cross-sectional data were gathered from 1375 Filipino domestic workers in Macao (SAR), China. Data from a subsample of 510 participants who met a cutoff indicating depression were analyzed. Anthropometric measurements and surveys were used to collect data, which was analyzed using R statistical software. RESULTS Results showed four community clusters: three communities consisted of at least two depression symptoms each and the fourth community included physical health indicators. Strong edges were formed between BMI-bone mass, psychomotor-concentration, BMI-WHR, and sad mood-anhedonia. The node with the highest expected influence was BMI. There were three bridges: worthlessness, psychomotor difficulties, and concentration difficulties. CONCLUSION The link between depression, cardiometabolic indicators, bone mass, and poor perceived health reinforces the need to address multimorbidity within migrant populations. Health promotion interventions that address mental and physical health may improve the health of this population.
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Affiliation(s)
- Melissa R Garabiles
- Department of Psychology, Ateneo de Manila University, Quezon City, NCR, Philippines
- UGAT Foundation Inc, Ateneo de Manila University, Quezon City, NCR, Philippines
- Psychology Department, De La Salle University, Manila, NCR, Philippines
- Scalabrini Migration Center, Quezon City, NCR, Philippines
| | - Zhuo Zhuo Shen
- School of Psychology, South China Normal University, Guangzhou City, Guangdong, People's Republic of China
| | - Lawrence Yang
- New York University School of Global Public Health, New York, NY, USA
| | - Qian Chu
- Shanghai Jiaotong University, Shanghai, People's Republic of China
| | - Kevin Hannam
- University of St. Joseph, Macao SAR, People's Republic of China
| | - Brian J Hall
- New York University School of Global Public Health, New York, NY, USA.
- Center for Global Health Equity, New York University Shanghai, Pudong, Shanghai, People's Republic of China.
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9
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Lin Y, Cai H, Liu HH, Su XJ, Zhou CY, Li J, Tang YL, Jackson T, Xiang YT. Prevalence of depression and its association with quality of life in patients after pacemaker implantation during the COVID-19 pandemic: A network analysis. Front Psychiatry 2023; 14:1084792. [PMID: 37009113 PMCID: PMC10060541 DOI: 10.3389/fpsyt.2023.1084792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundThis study was designed to investigate the prevalence and predictors of depression in patients after pacemaker implantation during the COVID-19 pandemic in addition to identifying specific depressive symptoms associated with quality of life (QOL) using network analysis (NA).MethodsThis cross-sectional, observational study was conducted in China between July 1, 2021, and May 17, 2022. Descriptive analysis was used to calculate depression prevalence. Univariate analyses were used to compare differences in demographic and clinical characteristics between depressed and non-depressed patients following pacemaker implantation. Binary logistic regression analysis was used to assess factors independently associated with depression. Network analysis “expected influence,” and flow function indexes were used to identify symptoms central to the depression network of the sample and depressive symptoms that were directly associated with QOL, respectively. Network stability was examined using a case-dropping bootstrap procedure.ResultsIn total, 206 patients implanted with a pacemaker met the study entry criteria and completed the assessment. The overall prevalence of depression (PHQ-9 total score ≥ 5) was 39.92% [95% confidence interval (CI) = 29.37−42.47%]. A binary logistic regression analysis revealed that patients with depression were more likely to report a poor health status (p = 0.031), severe anxiety symptoms (p < 0.001), and fatigue (p < 0.001). In the network model for depression, “Sad mood,” “Poor Energy,” and “Guilt” were the most influential symptoms. “Fatigue” had the strongest negative association with QOL, followed by “Sad mood” and “Appetite”.ConclusionDepression is common among patients having undergone pacemaker implantation during the COVID-19 pandemic. Anxiety, central symptoms of depression (i.e., “Sad mood”, “Poor Energy”, and “Guilt”) and depressive symptoms linked to QOL (i.e., “Sad mood”, “Appetite”, and “Fatigue”) identified in this study are promising targets for interventions and preventive measures for depression in patients who have undergone pacemaker implants.
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Affiliation(s)
- Yun Lin
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Yun Lin,
| | - Hong Cai
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
| | - Hong-Hong Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xue-Jian Su
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Chen-Yu Zhou
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jing Li
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital and the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
- Atlanta VA Medical Center, Atlanta, GA, United States
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao, Macao SAR, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, Macao SAR, China
- *Correspondence: Yu-Tao Xiang,
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10
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Does Being Ignored on WhatsApp Hurt? A Pilot Study on the Effect of a Newly Developed Ostracism Task for Adolescents. J Clin Med 2023; 12:jcm12052056. [PMID: 36902843 PMCID: PMC10004513 DOI: 10.3390/jcm12052056] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
(1) Background: Many studies have used a well-known social exclusion task, namely Cyberball, to assess the psychophysiological reactions to ostracism in laboratory settings. However, this task has been recently criticized for its lack of realism. Instant messaging communication platforms are currently central communication channels where adolescents conduct their social life. These should be considered when recreating the emotional experiences that fuel the development of negative emotions. To overcome this limitation, a new ostracism task, namely SOLO (Simulated On-Line Ostracism), recreating hostile interactions (i.e., exclusion and rejection) over WhatsApp was developed. The aim of this manuscript is to compare adolescents' self-reported negative and positive affect, as well as physiological reactivity (i.e., heat rate, HR; heart rate variability, HRV) exhibited during SOLO to Cyberball. (2) Method: A total of 35 participants (Mage = 15.16; SD = 1.48; 24 females) took part in the study. The first group (n = 23; transdiagnostic group), recruited at an inpatient and outpatient unit of a clinic for children and adolescent psychiatry, psychotherapy, and psychosomatic therapy in Baden-Württemberg (Germany), reported clinical diagnoses linked with emotional dysregulation (e.g., self-injury and depression). The second group (n = 12; control group), recruited in the district of Bavaria and Baden-Württemberg, had no pre-existing clinical diagnoses. (3) Results: The transdiagnostic group showed higher HR (b = 4.62, p < 0.05) and lower HRV (b = 10.20, p < 0.01) in SOLO than in Cyberball. They also reported increased negative affect (interaction b = -0.5, p < 0.01) after SOLO but not after Cyberball. In the control group, no differences in either HR (p = 0.34) or HRV (p = 0.08) between tasks were found. In addition, no difference in negative affect after either task (p = 0.83) was found. (4) Conclusion: SOLO could be an ecologically valid alternative to Cyberball when assessing reactions to ostracism in adolescents with emotional dysregulation.
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Kim D, Lee Y, Jeong J, Kim S. Stimulation method and individual health index study for real-time cardiovascular and autonomic nervous system reactivity analysis using PPG signal. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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La Marca R, Pallich G, Holtforth MG, Hochstrasser B. Higher Resting Cardiovagal Activity Predicts Larger Decrease of Depressive Symptoms in Inpatients Treated for Stress-Related Depression. J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Depression is one of the most prevalent mental disorders, with treatment outcomes generally being unsatisfactory. The identification of outcome predictors could contribute to improving diagnosis, treatment, and outcome. Heart rate variability (HRV), an index of cardiovagal activity, has been proposed as a potential correlate of depression as well as a predictor of treatment effectiveness. The aim of the present study was to examine if HRV at baseline could predict the outcome of inpatient treatment for stress-related depressive disorder (SRDD). Depressive symptoms of n = 57 inpatients with an SRDD, who were treated in a specialized burnout ward, were assessed using the Beck Depression Inventory (BDI) at the beginning, the end of treatment, and at 3-month follow-up. HRV (i.e., RMSSD, the root mean square of successive RR interval differences) was determined from a five-minute measurement in the supine position. RMSSD was not significantly associated with the BDI score at the beginning, end, and follow-up. Higher RMSSD was revealed to be a significant predictor of a stronger decrease in depressive severity from the beginning to the end of the treatment. Thereby, the regression model explained 7.6% of the total variance in the BDI decrease. The results revealed initial HRV to predict a larger decrease in depressive severity. Therefore, resting HRV represents a physiological resource and index of successful neurovisceral interaction, which supports inpatients in benefitting from specialized treatment.
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Affiliation(s)
- Roberto La Marca
- Centre for Stress-Related Disorders, Clinica Holistica Engiadina SA, Susch, Switzerland
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland
| | - Gianandrea Pallich
- Clinical Psychology and Psychotherapy, University of Zurich, Switzerland
- Clinical Psychology and Psychotherapy, University of Bern, Switzerland
- Private Hospital Meiringen, Switzerland
| | - Martin grosse Holtforth
- Clinical Psychology and Psychotherapy, University of Bern, Switzerland
- Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
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Antoniou F, Alkhadim GS. The Stressful Experience of Goal Orientations Under Frustration: Evidence Using Physiological Means. Front Psychol 2022; 13:823655. [PMID: 35496138 PMCID: PMC9043329 DOI: 10.3389/fpsyg.2022.823655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
The purpose of the present study was to test the hypothesis that goal orientation is associated with divergent forms of emotional reactivity under frustration. Goal orientations were assessed using bifurcations of performance goals described earlier. Physiological stress levels were measured via a blood volume pulse analysis after individuals were subjected to a computerized Stroop task using a malfunctioning mouse to induce enhanced frustration. The results indicated that performance-avoidance goals were associated with the highest levels of emotional reactivity, with normative outcome goals being significantly more detrimental than ability goals. We concluded that the motivation to avoid failure or to outperform others is the most detrimental determinant of stress and needs to be avoided by all means. Instead, it is suggested that educators emphasize performance using personal best outcomes or by valuing engagement, deep processing and task completion.
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Affiliation(s)
- Faye Antoniou
- Department of Educational Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Ghadah S. Alkhadim
- Department of Psychology, College of Arts, Taif University, Taif, Saudi Arabia
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Keogh TM, Howard S, Gallagher S. Early Life Adversity and Blunted Cardiovascular Reactivity to Acute Psychological Stress: The Role of Current Depressive Symptoms. Psychosom Med 2022; 84:170-178. [PMID: 34654025 DOI: 10.1097/psy.0000000000001024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The pathways underlying the early life adversity and cardiovascular reactivity association remain unclear. The current study examined the role of current depressive symptoms on this relationship. METHODS Mediation analyses were conducted using data from 639 participants drawn from the Midlife Development in the United States 2 Biomarker Project. Responses were derived from the Childhood Trauma Questionnaire and Center for Epidemiologic Studies Depression Scale. Participants had their systolic and diastolic blood pressure (SBP, DBP) and heart rate monitored throughout a standardized stress testing protocol. RESULTS The association between early life adversity and reactivity was mediated by current depressive symptoms; all adversity factors were linked to higher levels of current depressive symptoms, which, in turn, were associated with lower cardiovascular reactivity. For emotional abuse, this was noted for SBP (β = -0.06 [95% confidence interval {CI}, -0.13 to -0.01]) and DBP (β = -0.04 [-0.07 to -0.01]), physical abuse (SBP: β = -0.05 [-0.11 to -0.01]; DBP: β = -0.03 [-0.06 to -0.01]), sexual abuse (SBP: β = -0.04 [-0.09 to -0.01]; DBP: β = -0.02 [-0.05 to -0.01]), emotional neglect (SBP: β = -0.04 [-0.09 to -0.01]; DBP: β = -0.02 [-0.05 to -0.01]), physical neglect (SBP: β = -0.09 [-0.17 to -0.02]; DBP: β = -0.05 [-0.09 to -0.02]), and total Childhood Trauma Questionnaire score (SBP: β = -0.02 [-0.03 to -0.00]; DBP: β = -0.01 [-0.02 to -0.00]). CONCLUSIONS The present findings extend research and demonstrate that depression is an underlying mechanism linking early life adversity and blunted cardiovascular reactivity.
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Affiliation(s)
- Tracey M Keogh
- From the Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory (Keogh, Howard, Gallagher), and Health Research Institute (Keogh, Howard, Gallagher), University of Limerick, Castletroy, Limerick, Ireland
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Ghane M, Sullivan-Toole H, DelGiacco AC, Richey JA. Subjective arousal and perceived control clarify heterogeneity in inflammatory and affective outcomes. Brain Behav Immun Health 2021; 18:100341. [PMID: 34988494 PMCID: PMC8710414 DOI: 10.1016/j.bbih.2021.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 01/10/2023] Open
Abstract
Only a portion of individuals experiencing chronic stress and associated increases in inflammation go on to develop pathological elevations in mood and anxiety symptoms. Some prevailing models suggest that the outcomes of chronic stress may largely depend on individual differences in perceived control. In the current study, we used this theoretical framework to disambiguate the influence of autonomic arousal and perceived control on inflammatory and psychological outcomes in a large sample of adults from the Midlife in the United States dataset (wave 2; MIDUS-2) (Final N = 1030), and further replicated our approach in a second (MIDUS-Refresher) cohort (Final N = 728). Using k-means clustering we created subgroups systematically differing in subjective arousal (high/low) and perceived control (low/high) and compared these subgroups on inflammatory markers and psychological outcomes. Overall results showed that individuals in the high subjective arousal subgroups had higher levels of IL-6, CRP, and FIB, independent of level of CNTL. However, distinctive, and pathological psychological symptom patterns became more apparent when individuals were characterized by both subjective arousal and perceived control. These findings suggest that subtyping individuals based on subjective arousal and perceived control can help us disentangle pathological versus adaptive mental health outcomes in those with co-occurring inflammation and may help identify those vulnerable to psychopathology in the context of physical or psychological stressor exposure.
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Affiliation(s)
- Merage Ghane
- Virginia Tech, Department of Psychology, Clinical Science Program, Blacksburg, VA, USA
- National Institute of Mental Health, Intramural Research Training Program, Bethesda, MD, USA
| | - Holly Sullivan-Toole
- Virginia Tech, Department of Psychology, Clinical Science Program, Blacksburg, VA, USA
- Department of Psychology, Temple University, 1701 North 13th Street, Weiss Hall, Philadelphia, PA, 19122, USA
| | - Amanda C. DelGiacco
- National Institute of Mental Health, Intramural Research Training Program, Bethesda, MD, USA
| | - John A. Richey
- Virginia Tech, Department of Psychology, Clinical Science Program, Blacksburg, VA, USA
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Effects of a dance program on psychophysiological variables in hospitalized patients with depression: A mixed model approach. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Tóth-Vajna G, Tóth-Vajna Z, Konkoly Thege B, Balog P. Depression among predictors of intermittent claudication: A cross-sectional study. Physiol Int 2021; 108:440-449. [PMID: 34662292 DOI: 10.1556/2060.2021.00186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 09/12/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of the present cross-sectional study was to investigate the relationship between depression and intermittent claudication (IC), independently of traditional risk factors. MAIN METHODS The sample consisted of 300 individuals (M age = 65.3 ± 8.7 years, 61.0% female) recruited from the offices of 33 general practitioners. Participants' medical history and the presence of major cardiovascular risk factors were recorded. Participants completed the Edinburgh Claudication Questionnaire. The role of depression (assessed by a shortened version of the Beck Depression Inventory) in predicting IC was examined using a binary logistic regression analysis - controlled for sex, age, hypertonia, diabetes, smoking, hypercholesterinemia, hazardous drinking, and body mass index (BMI). RESULTS The descriptive data indicated that the prevalence of depression was 57.9% in the IC subgroup and 16.1% in those free of IC. The bivariate analyses indicated that hypercholesterinemia, smoking, hazardous drinking, BMI, and depression were significantly associated with IC. Male sex and age showed a trend toward being a significant correlate of IC. Results of the multivariate analyses indicated that depressive symptomatology was significant in predicting IC (OR: 1.08 (1.05-1.11)), even after controlling for lifestyle and traditional risk factors such as smoking, hazardous drinking, and BMI. Among traditional risk factors, smoking (OR: 2.44 (1.26-4.74)), hazardous drinking (OR: 1.19 (1.02-1.40)), and hypercholesterinemia (OR: 2.17 (1.26-3.75)) showed a significant, positive relationship with IC. CONCLUSIONS These results underscore the importance of a multidisciplinary approach that focuses on supporting health-related behavioral changes and managing mental health symptoms when providing care for patients with IC.
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Affiliation(s)
- Gergely Tóth-Vajna
- 1 Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
| | - Zsombor Tóth-Vajna
- 2 Heart and Vascular Center, Department of Vascular Surgery, Semmelweis University, Budapest, Hungary
| | - Barna Konkoly Thege
- 3 Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario,Canada
- 4 Department of Psychiatry, University of Toronto, Toronto, Ontario,Canada
| | - Piroska Balog
- 1 Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
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Personal Resilience Can Be Well Estimated from Heart Rate Variability and Paralinguistic Features during Human-Robot Conversations. SENSORS 2021; 21:s21175844. [PMID: 34502736 PMCID: PMC8433993 DOI: 10.3390/s21175844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 12/04/2022]
Abstract
Mental health is as crucial as physical health, but it is underappreciated by mainstream biomedical research and the public. Compared to the use of AI or robots in physical healthcare, the use of AI or robots in mental healthcare is much more limited in number and scope. To date, psychological resilience—the ability to cope with a crisis and quickly return to the pre-crisis state—has been identified as an important predictor of psychological well-being but has not been commonly considered by AI systems (e.g., smart wearable devices) or social robots to personalize services such as emotion coaching. To address the dearth of investigations, the present study explores the possibility of estimating personal resilience using physiological and speech signals measured during human–robot conversations. Specifically, the physiological and speech signals of 32 research participants were recorded while the participants answered a humanoid social robot’s questions about their positive and negative memories about three periods of their lives. The results from machine learning models showed that heart rate variability and paralinguistic features were the overall best predictors of personal resilience. Such predictability of personal resilience can be leveraged by AI and social robots to improve user understanding and has great potential for various mental healthcare applications in the future.
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Pham T, Lau ZJ, Chen SHA, Makowski D. Heart Rate Variability in Psychology: A Review of HRV Indices and an Analysis Tutorial. SENSORS (BASEL, SWITZERLAND) 2021; 21:3998. [PMID: 34207927 PMCID: PMC8230044 DOI: 10.3390/s21123998] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/04/2021] [Accepted: 06/04/2021] [Indexed: 12/16/2022]
Abstract
The use of heart rate variability (HRV) in research has been greatly popularized over the past decades due to the ease and affordability of HRV collection, coupled with its clinical relevance and significant relationships with psychophysiological constructs and psychopathological disorders. Despite the wide use of electrocardiograms (ECG) in research and advancements in sensor technology, the analytical approach and steps applied to obtain HRV measures can be seen as complex. Thus, this poses a challenge to users who may not have the adequate background knowledge to obtain the HRV indices reliably. To maximize the impact of HRV-related research and its reproducibility, parallel advances in users' understanding of the indices and the standardization of analysis pipelines in its utility will be crucial. This paper addresses this gap and aims to provide an overview of the most up-to-date and commonly used HRV indices, as well as common research areas in which these indices have proven to be very useful, particularly in psychology. In addition, we also provide a step-by-step guide on how to perform HRV analysis using an integrative neurophysiological toolkit, NeuroKit2.
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Affiliation(s)
- Tam Pham
- School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore; (T.P.); (Z.J.L.); (D.M.)
| | - Zen Juen Lau
- School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore; (T.P.); (Z.J.L.); (D.M.)
| | - S. H. Annabel Chen
- School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore; (T.P.); (Z.J.L.); (D.M.)
- Centre for Research and Development in Learning, Nanyang Technological University, Singapore 637460, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore
- National Institute of Education, Nanyang Technological University, Singapore 637616, Singapore
| | - Dominique Makowski
- School of Social Sciences, Nanyang Technological University, Singapore 639818, Singapore; (T.P.); (Z.J.L.); (D.M.)
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Tang M, He Y, Zhang X, Li H, Huang C, Wang C, Gao Y, Li Y, Kan H, Hu J, Chen R. The acute effects of temperature variability on heart rate variability: A repeated-measure study. ENVIRONMENTAL RESEARCH 2021; 194:110655. [PMID: 33358871 DOI: 10.1016/j.envres.2020.110655] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 12/05/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The impacts of temperature variability on cardiac autonomic function remain unclear. OBJECTIVE To explore the short-term associations between daily temperature variability and parameters of heart rate variability (HRV). METHODS This is a repeated-measure study among 78 eligible participants in Shanghai, China. We defined temperature variability as diurnal temperature range (DTR), the standard-deviation of temperature (SDT) and temperature variability (TV). We evaluated 3 frequency-domain HRV parameters (VLF, LF and HF) and 4 time-domain parameters (SDNN, SDANN, rMSSD and pNN50). We used linear mixed-effect models to analyze the data after controlling for environmental and individual confounders. RESULTS Temperature variability was significantly associated with decreased HRV, especially on the concurrent day. The exposure-response relationships were almost inversely linear for most parameters. Every one interquartile range (IQR) increase of DTR was associated with a decrease of 3.92% for VLF, 6.99% for LF, 5.88% for HF, 3.94% for rMSSD and 1.30% for pNN50. Each IQR increase of SDT was associated with a decline of 6.48% for LF, 5.91% for HF, 4.26% for rMSSD and 1.87% for pNN50. Every IQR increase of SDT was associated with a decrease of 4.39% for VLF, 7.67% for LF, 6.52% for HF, 3.22% for SDNN, 2.98% for SDANN, 4.05% for rMSSD, and 1.41% for pNN50. The decrements in HRV associated with temperature variability were more prominent in females. CONCLUSION Temperature variability on the concurrent day could significantly decrease cardiac autonomic function, especially in females.
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Affiliation(s)
- Minna Tang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yu He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Xiaochun Zhang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H.Chan School of Public Health, Boston, MA, USA
| | - Chang Huang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Cuiping Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yinliang Li
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Jialu Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China.
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Bretherton B, Atkinson L, Murray A, Clancy J, Deuchars S, Deuchars J. Effects of transcutaneous vagus nerve stimulation in individuals aged 55 years or above: potential benefits of daily stimulation. Aging (Albany NY) 2020; 11:4836-4857. [PMID: 31358702 PMCID: PMC6682519 DOI: 10.18632/aging.102074] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 06/28/2019] [Indexed: 12/23/2022]
Abstract
Ageing is associated with attenuated autonomic function. Transcutaneous vagal nerve stimulation (tVNS) improved autonomic function in healthy young participants. We therefore investigated the effects of a single session of tVNS (studies 1 and 2) and tVNS administered daily for two weeks (study 3) in volunteers aged ≥ 55 years. tVNS was performed using modified surface electrodes on the tragus and connected to a transcutaneous electrical nerve stimulation (TENS) machine. Study 1: participants (n=14) received a single session of tVNS and sham. Study 2: all participants (n=51) underwent a single session of tVNS. Study 3: participants (n=29) received daily tVNS for two weeks. Heart rate variability and baroreflex sensitivity were derived. Quality of life (QoL), mood and sleep were assessed in study 3. tVNS promoted increases in measures of vagal tone and was associated with greater increases in baroreflex sensitivity than sham. Two weeks of daily tVNS improved measures of autonomic function, and some aspects of QoL, mood and sleep. Importantly, findings showed that improvements in measures of autonomic balance were more pronounced in participants with greater baseline sympathetic prevalence. This suggests it may be possible to identify individuals who are likely to encounter significant benefits from tVNS.
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Affiliation(s)
- Beatrice Bretherton
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Lucy Atkinson
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Aaron Murray
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Jennifer Clancy
- School of Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Susan Deuchars
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Jim Deuchars
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK
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Brugnera A, Zarbo C, Tarvainen MP, Carlucci S, Tasca GA, Adorni R, Auteri A, Compare A. Higher levels of Depressive Symptoms are Associated with Increased Resting-State Heart Rate Variability and Blunted Reactivity to a Laboratory Stress Task among Healthy Adults. Appl Psychophysiol Biofeedback 2020; 44:221-234. [PMID: 31041646 DOI: 10.1007/s10484-019-09437-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Laboratory stress tasks induce strong changes in linear and non-linear indices of heart rate variability (HRV) among healthy adults, due to a task-induced parasympathetic withdrawal. Previous findings suggested that negative affectivity and its correlates (i.e., depressive symptoms, anxiety, hostility, type D personality, and situational stress) could profoundly affect autonomic activity. However, to date no studies considered these psychological dimensions simultaneously while trying to disentangle their acute effects on HRV during a laboratory stress task. A total of 65 healthy participants completed a battery of questionnaires and later underwent a psychosocial stress protocol, which involves a stressful and a non-stressful mental arithmetic task, with the latter serving as a control condition for the former. During the entire procedure, autonomic activity was recorded through a portable ECG device. We analysed longitudinal changes in HRV indices using Mixed Models, taking into account respiration rates and the associations between psychophysiological variables through bivariate Pearson's r (partial) correlation indices. We found significant changes in linear (e.g., HF power, RMSSD) and non-linear (e.g., Poincaré Plot and Correlation Dimension D2) HRV indices during the procedure, with the lowest point reached during the stressful mental arithmetic task. Interestingly, only depressive symptomatology was significantly and positively related to a higher resting-state HRV and to a blunted reactivity to the stress task, even after controlling for baseline values. Results suggest that healthy individuals with higher levels of depressive symptoms could experience atypical cardiovascular responses to stressful events: several speculative interpretations, considering autonomic, behavioral, and motivational dysregulations, are discussed.
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Affiliation(s)
- Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, 24129, Bergamo, Italy.
| | - Cristina Zarbo
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, 24129, Bergamo, Italy
| | - Mika P Tarvainen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | | | | | - Roberta Adorni
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, 24129, Bergamo, Italy
| | - Adalberto Auteri
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, 24129, Bergamo, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, P.le S. Agostino, 2, 24129, Bergamo, Italy
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Hirokawa K, Ohira T, Kajiura M, Imano H, Kitamura A, Kiyama M, Okada T, Iso H. Cardiovascular reactivity to acute stress associated with sickness absence among Japanese men and women: A prospective study. Brain Behav 2020; 10:e01541. [PMID: 32077640 PMCID: PMC7177567 DOI: 10.1002/brb3.1541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 12/25/2019] [Accepted: 01/04/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE We aimed to investigate associations between cardiovascular reactivity to acute stress and sickness absence among Japanese male and female workers, in a prospective study. METHODS Among healthy employed Japanese workers who underwent mental health checks between 2006 and 2009, data of 111 participants were analyzed. Changes in blood pressure, pulse rate, peripheral blood flow (PBF), and heart rate variability (HRV) (high frequency [HF] and low frequency [LF]) were calculated using differences between the two tasks, mirror drawing stress [MDS] and a maze task, and the postperiod value. Sickness absence through March 2010 was followed up by mail survey (average follow-up 2.3 years). Logistic regression analysis was used, adjusting for lifestyle factors. RESULTS Among 12 participants who took sickness absences, eight were owing to mental problems. Changes in the LF during the MDS and maze tasks and LF-to-HF ratio during the MDS task were positively associated with all sickness absences (odds ratio [OR], 95% confidence interval [CI]: 2.09, 1.03-4.22; 2.04, 1.09-3.82; and 3.10, 1.46-6.58, respectively). Changes in PBF during the MDS task were also associated with increased risk of sickness absence (OR, 95% CI: 2.53, 1.10-5.81). CONCLUSION Cardiovascular reactivity to acute stress should be considered at workers' health checks.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University (Hirokawa), Ibaraki, Osaka, Japan.,Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tetsuya Ohira
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan.,Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Mitsugu Kajiura
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Akihiko Kitamura
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan.,Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Lo HHM, Wong SWL, Wong JYH, Yeung JWK, Snel E, Wong SYS. The Effects of Family-Based Mindfulness Intervention on ADHD Symptomology in Young Children and Their Parents: A Randomized Control Trial. J Atten Disord 2020; 24:667-680. [PMID: 29185375 DOI: 10.1177/1087054717743330] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: The aim of the study is to investigate the feasibility of a family-based mindfulness intervention in improving children with inattention and hyperactivity symptoms. Method: A total of 100 children aged 5 to 7 years with ADHD symptoms and their parents were randomly assigned to a family-based mindfulness intervention (n = 50) or a wait-list control group (n = 50). Results: Families from intervention group had greater improvements in children's ADHD symptoms, with medium effect sizes of -0.60 for inattention and -0.59 for hyperactivity; overall behaviors; and parenting stress and well-being than those in wait-list control group. Conclusion: The positive results on the child primary outcome measures have provided initial evidence of the family-based mindfulness intervention as a treatment option to ADHD. The reduction of parental stress and increase in psychological well-being has demonstrated the value of mindfulness in enhancing parent's self-management.
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Affiliation(s)
| | | | | | | | - Eline Snel
- The Academy of Mindful Teaching, Leusden, The Netherlands
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25
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Jester DJ, Rozek EK, McKelley RA. Heart rate variability biofeedback: implications for cognitive and psychiatric effects in older adults. Aging Ment Health 2019; 23:574-580. [PMID: 29381375 DOI: 10.1080/13607863.2018.1432031] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Two decades of heart rate variability (HRV) biofeedback research have focused on adolescent and adult populations with a variety of symptoms and conditions at the exclusion of older adults. This study explores HRV biofeedback as a novel treatment to decrease psychiatric symptoms and improve cognitive functioning in older adults. METHODS Participants enrolled in a three-week intervention that included six 30-min biofeedback sessions. Neuropsychological and psychiatric measures were administered before and after the intervention. RESULTS Decreases in depression (Cohen's d = 1.02, p < .001), state anxiety (Cohen's d = 0.82, p = .003), and trait anxiety (Cohen's d = 0.84, p = .002) were observed. An increase in attentional skills as measured by the Trail Making Test - Part A was seen (Cohen's d = 1.00, p = .001). Differences in executive skills as measured by the Trial Making Test - Part B and the Stroop Task did not reach statistical significance. CONCLUSION This study suggests that older adults may benefit from HRV biofeedback interventions much like the younger populations that have been studied for decades. Depression, anxiety, and attentional skills were positively affected. Several participants reported improved sleep quality and stress management. Future studies should corroborate these findings.
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Affiliation(s)
- Dylan J Jester
- a Department of Psychology , University of Wisconsin - La Crosse , La Crosse , WI , USA
| | - Ellen K Rozek
- a Department of Psychology , University of Wisconsin - La Crosse , La Crosse , WI , USA
| | - Ryan A McKelley
- a Department of Psychology , University of Wisconsin - La Crosse , La Crosse , WI , USA
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26
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Hohl R, Deslandes AC, Mármora CHC. The Effect of Single-Dose Massage Session on Autonomic Activity, Mood, and Affective Responses in Major Depressive Disorder. J Holist Nurs 2019; 37:312-321. [PMID: 30810079 DOI: 10.1177/0898010119832493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Massage therapy (MT) is a holistic procedure that includes hand pressure (HP), therapeutic communication (TC), and attentive care (AC); together, these procedures could decrease symptoms of depression. Purpose: To study the influence of TC and AC during MT. Methods: Within-subject experimental design with counterbalancing order of treatment. Comparison analysis of the effect of a typical Swedish massage session (SM) with a "sham" massage (ShM; without HP) on the heart rate variability (HRV) mood and affective responses of patients with major depressive disorder (N = 11). During the ShM, clay stones were randomly placed on the body, and the patients were informed about the (sham) therapeutic effect of stones. Findings: A main effect of time showed that after intervention, both SM and ShM increased the HRV (high-frequency power; F[1, 10] = 7.58, p = .02) and reduced scores for anxiety (F[1, 10] = 37.57, p < .001), other feelings (F[1, 10] = 22.64, p = .001), and physical sedation (F[1, 10] = 10.72, p = .008). The SM was associated with more positive affective responses than ShM (qualitative analysis). Conclusions: AC and TC included in MT session improved mood and HRV in the absence of HP. Additional effect on affective responses was observed owing to the HP.
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Kwon HB, Yoon H, Choi SH, Choi JW, Lee YJ, Park KS. Heart rate variability changes in major depressive disorder during sleep: Fractal index correlates with BDI score during REM sleep. Psychiatry Res 2019; 271:291-298. [PMID: 30513461 DOI: 10.1016/j.psychres.2018.11.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 11/10/2018] [Accepted: 11/10/2018] [Indexed: 02/06/2023]
Abstract
We investigated the relationship between autonomic nervous system activity during each sleep stage and the severity of depressive symptoms in patients with major depressive disorder (MDD) and healthy control subjects. Thirty patients with MDD and thirty healthy control subjects matched for sex, age, and body mass index completed standard overnight polysomnography. Depression severity was assessed using the Beck Depression Inventory (BDI). Time- and frequency-domain, and fractal HRV parameters were derived from 5-min electrocardiogram segments during light sleep, deep sleep, rapid eye movement (REM) sleep, and the pre- and post-sleep wake periods. Detrended fluctuation analysis (DFA) alpha-1 values during REM sleep were significantly higher in patients with MDD than in control subjects, and a significant correlation existed between DFA alpha-1 and BDI score in all subjects. DFA alpha-1 was the strongest predictor for the BDI score, along with REM density as a covariate. This study found that compared with controls, patients with MDD show reduced complexity in heart rate during REM sleep, which may represent lower cardiovascular adaptability in these patients, and could lead to cardiac disease. Moreover, DFA alpha-1 values measured during REM sleep may be useful as an indicator for the diagnosis and monitoring of depression.
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Affiliation(s)
- Hyun Bin Kwon
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea
| | - Heenam Yoon
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea
| | - Sang Ho Choi
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 03080, Republic of Korea
| | - Jae-Won Choi
- Department of Neuropsychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul 01830, Republic of Korea
| | - Yu Jin Lee
- Department of Neuropsychiatry and the Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Kwang Suk Park
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea.
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Wilkowska A, Rynkiewicz A, Wdowczyk J, Landowski J, Cubała WJ. Heart rate variability and incidence of depression during the first six months following first myocardial infarction. Neuropsychiatr Dis Treat 2019; 15:1951-1956. [PMID: 31371968 PMCID: PMC6628206 DOI: 10.2147/ndt.s212528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/22/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Post-myocardial depression is a highly prevalent condition worsening the course and prognosis of coronary artery disease. One of the possible pathogenetic factors is dysregulation of the autonomous nervous system, resulting in heart rate variability reduction. METHODS Twenty two patients hospitalised due to a first myocardial infarction were included. The Beck Depression Inventory (BDI) was used to rate the severity of their depressive symptoms. RESULTS Depressive symptomatology, defined as BDI ≥10, was present in 36.3% of the patients. Increase in heart rate variability (HRV) was observed in both groups during the first 6 months after the myocardial infarction. The HRV was significantly lower in the depressed group compared to patients without depression. CONCLUSION Presence of depression after the myocardial infarction (MI) is associated with a significant decrease of the time domain HRV measure SDNN (standard deviation of all normal RR intervals) and with its slower increase during at least a three months period.
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Affiliation(s)
- Alina Wilkowska
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Andrzej Rynkiewicz
- Department of Cardiology and Cardiosurgery, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Joanna Wdowczyk
- First Department of Cardiology, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Jerzy Landowski
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Wiesław Jerzy Cubała
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdansk, Gdańsk, Poland
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29
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Ultra-short term heart rate variability as a tool to assess changes in valence. Psychiatry Res 2018; 270:517-522. [PMID: 30336421 DOI: 10.1016/j.psychres.2018.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 07/29/2018] [Accepted: 10/02/2018] [Indexed: 11/23/2022]
Abstract
Heart rate variability (HRV) is an index that has been extensively used in fields such as clinical cardiology, psychiatry, and psychology to assess affective experiences. Although traditionally The European Society of Cardiology and The North American Society of Pacing and Electrophysiology recommended to use either a recording length of 24-h (long-term) or five minutes (short-term), recent advances in the field have suggested the use of ultra-short term (<5 min) HRV measurements. In this study, we investigated whether ultra-short term HRV measurements can be used to investigate the temporal dynamics of experimentally induced emotions using pictures from the International Affective Picture System. We took electrocardiogram recordings from thirty-nine participants, and analyzed the root mean square of the successive differences of the R-R interval using a thirty-second moving window. No significant differences in HRV during positive and negative emotion induction were found. These results call into question the use of ultra-short term HRV as a tool for psychologists to measure changes in valence in affective studies.
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30
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Manolis TA, Manolis AA, Manolis AS. Cardiovascular Safety of Psychiatric Agents: A Cautionary Tale. Angiology 2018; 70:103-129. [PMID: 29874922 DOI: 10.1177/0003319718780145] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Psychiatric agents are among the most commonly prescribed medications. Despite the advent of newer generation agents, patients receiving them still experience cardiovascular (CV) side effects. However, these agents may have heterogeneous properties, calling for an individualized approach based on efficacy and also on the particular side effect profile of each specific agent. Proarrhythmic effects arising from drug-induced long-QT syndrome and consequent potentially life-threatening polymorphic ventricular arrhythmias in the form of torsade de pointes, the metabolic syndrome contributing to atherosclerosis and acute coronary syndromes, and drug-induced orthostatic hypotension raise major concerns. Of course, it is also crucial that fear of potential CV adverse effects does not deprive psychiatric patients of appropriate drug therapy. Modification of CV risk factors in psychiatric patients together with optimal management of their CV diseases and appropriate selection of psychotropic agents with greater efficacy and least CV toxicity are of paramount importance in mitigating CV risks and enhancing safety. Identifying patients at high risk of CV complications and close monitoring of all patients receiving these agents are crucial steps to prevent and manage such complications. All these issues are herein reviewed, relevant guidelines are discussed, and schemas are depicted that illustrate the interrelated connections among the psychotropic agents and their CV effects.
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Affiliation(s)
| | | | - Antonis S Manolis
- 3 Third Department of Cardiology, Athens University School of Medicine, Athens, Greece
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31
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Utzinger ML. Enhancing Heart Rate Variability. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00096-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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32
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Kelly UA, Evans DD, Baker H, Noggle Taylor J. Determining Psychoneuroimmunologic Markers of Yoga as an Intervention for Persons Diagnosed With PTSD: A Systematic Review. Biol Res Nurs 2017; 20:343-351. [PMID: 29130314 DOI: 10.1177/1099800417739152] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is a growing body of research on yoga as a therapeutic intervention for psychological symptoms of post-traumatic stress disorder (PTSD) accompanied by speculations on underlying physiologic mechanisms. The purpose of this systematic review is to identify, qualitatively evaluate, and synthesize studies of yoga as an intervention for PTSD that measured physiologic outcomes in order to gain insights into potential mechanisms. The focus is on studies evaluating yoga as a therapeutic intervention for PTSD rather than for trauma exposure, PTSD prevention, or subclinical PTSD. Multiple databases were searched for publications from the past two decades using terms derived from the question, "In people with PTSD, what is the effect of yoga on objective outcomes?" Eligibility criteria included yoga-only modalities tested as an intervention for formally diagnosed PTSD with at least one physiologic outcome. Results of this review confirmed that, though much of the published literature proposes physiological mechanisms underlying yoga's effects on PTSD, very few studies ( n = 3) have actually evaluated physiological evidence. Additionally, several studies had methodological limitations. In light of the limited data supporting yoga's beneficial effects on autonomic nervous system dysregulation, we present a theoretical model of the psychoneuroimmunologic processes associated with PTSD and the effects yoga may have on these processes to guide future research. Gaps in the literature remain for mechanisms related to activation of the hypothalamic-pituitary-adrenal axis and inflammation. Additional rigorous mechanistic studies are needed to guide development of effective yoga interventions for PTSD to augment existing evidence-based PTSD treatments.
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Affiliation(s)
- Ursula Ann Kelly
- 1 Atlanta VA Medical Center, Decatur, GA, USA.,2 Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA
| | - Dian Dowling Evans
- 2 Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA
| | - Helen Baker
- 2 Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA
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33
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Ancient roots – Modern applications: Mindfulness as a novel intervention for cardiovascular disease. Med Hypotheses 2017; 108:57-62. [DOI: 10.1016/j.mehy.2017.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 07/05/2017] [Accepted: 08/02/2017] [Indexed: 01/10/2023]
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34
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Tolgou T, Rohrmann S, Stockhausen C, Krampen D, Warnecke I, Reiss N. Physiological and psychological effects of imagery techniques on health anxiety. Psychophysiology 2017; 55. [PMID: 28833227 DOI: 10.1111/psyp.12984] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 07/19/2017] [Accepted: 07/28/2017] [Indexed: 12/24/2022]
Abstract
Previous research has shown that intrusions are part of the psychopathology of mental disorders. Imagery techniques seem to be an effective treatment of negative intrusions. Since negative mental imagery is part of health anxiety, the present study investigated the impact of imagery techniques on health anxiety. A total of 159 students with elevated scores in a health anxiety questionnaire watched an aversive film concerning a cancer patient and were randomly allocated to one of three interventions (positive imagery, imagery reexperiencing, imagery rescripting) or the control group. The intervention lasted 9 min. Physiological data (heart rate and cortisol) as well as psychological measures, such as mood ratings, health anxiety scores, and intrusions, were assessed during the appointment, while psychological measures were assessed over a period of 1 week after the intervention. Cortisol levels changed over time depending on the intervention. Heart rate changed during the 9-min interventions as well, with the fastest decrease during imagery rescripting. Moreover, negative mood and distress decreased after the intervention, while intrusions were reduced 1 week after the intervention in all groups equally. The results suggest that imagery rescripting is a promising technique that seems to activate a process of deep elaboration. Therefore, it might be an adequate way to target health anxiety symptoms such as anxiety, intrusions, and avoidance or safety-seeking behavior. Further studies should focus on imagery rescripting in clinical samples with health anxiety and target individual intrusive images to increase effectiveness. Nevertheless, the development of a long-term explanatory model of rescripting is needed.
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Affiliation(s)
- T Tolgou
- Department of Differential Psychology and Psychological Assessment, Goethe University, Frankfurt, Germany
| | - S Rohrmann
- Department of Differential Psychology and Psychological Assessment, Goethe University, Frankfurt, Germany
| | - C Stockhausen
- Institute of Computer Science, Goethe University, Frankfurt, Germany
| | - D Krampen
- Department of Educational Psychology, Goethe University, Frankfurt, Germany
| | | | - N Reiss
- Department of Differential Psychology and Psychological Assessment, Goethe University, Frankfurt, Germany
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Carvalho AF, Sharma MS, Brunoni AR, Vieta E, Fava GA. The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature. PSYCHOTHERAPY AND PSYCHOSOMATICS 2017; 85:270-88. [PMID: 27508501 DOI: 10.1159/000447034] [Citation(s) in RCA: 348] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 05/24/2016] [Indexed: 11/19/2022]
Abstract
Newer generation antidepressant drugs (ADs) are widely used as the first line of treatment for major depressive disorders and are considered to be safer than tricyclic agents. In this critical review, we evaluated the literature on adverse events, tolerability and safety of selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors, bupropion, mirtazapine, trazodone, agomelatine, vilazodone, levomilnacipran and vortioxetine. Several side effects are transient and may disappear after a few weeks following treatment initiation, but potentially serious adverse events may persist or ensue later. They encompass gastrointestinal symptoms (nausea, diarrhea, gastric bleeding, dyspepsia), hepatotoxicity, weight gain and metabolic abnormalities, cardiovascular disturbances (heart rate, QT interval prolongation, hypertension, orthostatic hypotension), genitourinary symptoms (urinary retention, incontinence), sexual dysfunction, hyponatremia, osteoporosis and risk of fractures, bleeding, central nervous system disturbances (lowering of seizure threshold, extrapyramidal side effects, cognitive disturbances), sweating, sleep disturbances, affective disturbances (apathy, switches, paradoxical effects), ophthalmic manifestations (glaucoma, cataract) and hyperprolactinemia. At times, such adverse events may persist after drug discontinuation, yielding iatrogenic comorbidity. Other areas of concern involve suicidality, safety in overdose, discontinuation syndromes, risks during pregnancy and breast feeding, as well as risk of malignancies. Thus, the rational selection of ADs should consider the potential benefits and risks, likelihood of responsiveness to the treatment option and vulnerability to adverse events. The findings of this review should alert the physician to carefully review the appropriateness of AD prescription on an individual basis and to consider alternative treatments if available.
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Affiliation(s)
- André F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
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36
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[Activity trails in the therapy of clinical depression: A randomized controlled equivalence trial]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2017; 63:163-175. [PMID: 28585508 DOI: 10.13109/zptm.2017.63.2.163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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37
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Stange JP, Hamilton JL, Olino TM, Fresco DM, Alloy LB. Autonomic reactivity and vulnerability to depression: A multi-wave study. Emotion 2017; 17:602-615. [PMID: 27991819 PMCID: PMC5444964 DOI: 10.1037/emo0000254] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The ability of the autonomic nervous system to flexibly adapt to environmental changes is thought to indicate efficient use of self-regulatory resources. Deficits in autonomic reactivity appear to characterize current depression; however, whether autonomic reactivity confers vulnerability to future depression when individuals encounter environmental stressors is unknown. Fluctuations in respiratory sinus arrhythmia (RSA) and heart rate (HR) were evaluated in response to emotion-eliciting films among 134 undergraduates. Negative events and depressive symptoms were assessed 5 times across 12 weeks. Multilevel modeling demonstrated that smaller decreases in RSA in response to sadness, greater increases in HR following sadness, and smaller increases in HR to amusement were prospectively associated with greater depressive symptoms when individuals encountered high levels of idiographically assessed negative events. These results demonstrate that the lack of contextually appropriate autonomic reactivity may confer vulnerability to depression under conditions of environmental stress, perhaps due to attenuated capacity for effective self-regulation. (PsycINFO Database Record
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Gantt MA, Dadds S, Burns DS, Glaser D, Moore AD. The Effect of Binaural Beat Technology on the Cardiovascular Stress Response in Military Service Members With Postdeployment Stress. J Nurs Scholarsh 2017; 49:411-420. [DOI: 10.1111/jnu.12304] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2017] [Indexed: 11/27/2022]
Affiliation(s)
- MeLisa A. Gantt
- Chief Executive Officer; Gantt Clinical Research Institute; LLC.; Orlando FL USA
| | | | - Debra S. Burns
- Chair, Department of Music and Arts Technology; Purdue School of Engineering and Technology at Indiana University Purdue University Indianapolis; Indianapolis IN USA
| | - Dale Glaser
- Chief Executive Officer; Glaser Consulting; San Diego CA USA
| | - Angelo D. Moore
- President and Chief Executive Officer; Moore & Moore Healthcare Consulting; LLC.; Cumberland NC USA
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Sudarshan Kriya Yoga improves cardiac autonomic control in patients with anxiety-depression disorders. J Affect Disord 2017; 214:74-80. [PMID: 28285240 DOI: 10.1016/j.jad.2017.03.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 01/30/2017] [Accepted: 03/06/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Several studies have demonstrated that adjuvant therapies as exercise and breathing training are effective in improving cardiac autonomic control (CAC) in patients with affective spectrum disorders. However, the effects of Sudarshan Kriya Yoga (SKY) on autonomic function in this population is unknown. Our objective was to test the hypothesis that SKY training improves CAC and cardiorespiratory coupling in patients with anxiety and/or depression disorders. METHODS Forty-six patients with a diagnosis of anxiety and/or depression disorders (DSM-IV) were consecutively enrolled and divided in two groups: 1) conventional therapy (Control) and 2) conventional therapy associated with SKY (Treatment) for 15 days. Anxiety and depression levels were determined using quantitative questionnaires. For the assessment of CAC and cardiorespiratory coupling, cardiorespiratory traces were analyzed using monovariate and bivariate autoregressive spectral analysis, respectively. RESULTS After 15-days, we observed a reduction of anxiety and depression levels only in Treatment group. Moreover, sympathetic modulation and CAC were significantly lower while parasympathetic modulation and cardiorespiratory coupling were significantly higher in the Treatment compared to Control group. CONCLUSIONS Intensive breathing training using SKY approach improves anxiety and/or depressive disorders as well as CAC and cardiorespiratory coupling. These finding suggest that the SKY training may be a useful non-pharmacological intervention to improve symptoms and reduce cardiovascular risk in patients with anxiety/depression disorders.
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A biological perspective on differences and similarities between burnout and depression. Neurosci Biobehav Rev 2016; 73:112-122. [PMID: 27993607 DOI: 10.1016/j.neubiorev.2016.12.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 10/10/2016] [Accepted: 12/09/2016] [Indexed: 12/26/2022]
Abstract
To compare and contrast burnout and depression is not only a conceptual issue, but may deliver important directions for treatment approaches and stabilize the awareness of disease which is essential for affected individuals. Because of the symptomatic overlap, it is a subject of multidimensional research and discussion to find specific signatures to differentiate between the two phenomena or to present evidence that they are different aspects of the same disorder. Both pathologies are regarded as stress-related disorders. Therefore, in this review burnout and depression are discussed on the basis of biological parameters, mainly heart rate variability (HRV) and brain-derived neurotrophic factor (BDNF), which are crucial to the stress response system. It emerges that instead of finding one specific discriminating marker, future research should rather concentrate on elaborating indices for burnout and depression which integrate combinations of parameters found in genetics, neurobiology, physiology and environment.
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Wormald D, Lawrence AJ, Carter G, Fisher AD. Reduced heart rate variability in pet dogs affected by anxiety-related behaviour problems. Physiol Behav 2016; 168:122-127. [PMID: 27838312 DOI: 10.1016/j.physbeh.2016.11.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 11/01/2016] [Accepted: 11/08/2016] [Indexed: 12/12/2022]
Abstract
We present here the first evidence of correlation between canine anxiety-related behavioural problems and heart rate variability (HRV). HRV is known to be related to a range of mental disorders in humans; however this has not been explored in dogs. Behavioural problems in dogs can result in suffering, property destruction and human injury. Dog behaviour problems were assessed by owner questionnaire and the extreme high and low scoring dogs were recruited into either affected (n=10) or unaffected (n=20) groups. HRV was assessed in dogs at their homes, while being held in lateral recumbency for 5min using manual restraint. Salivary cortisol samples were taken before and after HRV testing. Dogs were assessed as either being reactive to the procedure (barking, growling, struggling or shaking) or unreactive. There was no effect of reactivity or behaviour problems on salivary cortisol levels at baseline or in response to the treatment. There was a significant effect of reactivity on HR (F1,26=5.54; P=0.026), and no effect of behaviour problems (F1,26=1.07; P=0.311). There was no effect of reactivity on any of the HRV measures. The presence of behaviour problems had a significant effect on a range of measures of HRV, with unaffected dogs having higher standard deviation of RR intervals (F1,26=6.39; P=0.018), higher high frequency spectrum (F1,26=5.23; P=0.031) and higher low frequency spectrum (F1,26=9.25; P=0.005) power. There was no effect of behaviour problems on very low frequency spectrum power (F1,26=1.40; P=0.248). Together these results provide evidence for a fundamental physiological difference between dogs affected or unaffected with behaviour problems. This study provides evidence for further investigation into the role of HRV in the pathophysiology of canine anxiety-related behaviour problems.
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Affiliation(s)
- Dennis Wormald
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, 250 Princes Hwy, Werribee, VIC 3030, Australia; Animal Welfare Science Centre, The University of Melbourne, Parkville, VIC 3010, Australia.
| | - Andrew J Lawrence
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3010, Australia
| | | | - Andrew D Fisher
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, 250 Princes Hwy, Werribee, VIC 3030, Australia; Animal Welfare Science Centre, The University of Melbourne, Parkville, VIC 3010, Australia
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Boal AH, Smith DJ, McCallum L, Muir S, Touyz RM, Dominiczak AF, Padmanabhan S. Monotherapy With Major Antihypertensive Drug Classes and Risk of Hospital Admissions for Mood Disorders. Hypertension 2016; 68:1132-1138. [PMID: 27733585 PMCID: PMC5058642 DOI: 10.1161/hypertensionaha.116.08188] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 08/31/2016] [Indexed: 12/29/2022]
Abstract
Major depressive and bipolar disorders predispose to atherosclerosis, and there is accruing data from animal model, epidemiological, and genomic studies that commonly used antihypertensive drugs may have a role in the pathogenesis or course of mood disorders. In this study, we propose to determine whether antihypertensive drugs have an impact on mood disorders through the analysis of patients on monotherapy with different classes of antihypertensive drugs from a large hospital database of 525 046 patients with follow-up for 5 years. There were 144 066 eligible patients fulfilling the inclusion criteria: age 40 to 80 years old at time of antihypertensive prescription and medication exposure >90 days. The burden of comorbidity assessed by Charlson and Elixhauser scores showed an independent linear association with mood disorder diagnosis. The median time to hospital admission with mood disorder was 847 days for the 299 admissions (641 685 person-years of follow-up). Patients on angiotensin-converting enzyme inhibitors or angiotensin receptor blockers had the lowest risk for mood disorder admissions, and compared with this group, those on β-blockers (hazard ratio=2.11; [95% confidence interval, 1.12-3.98]; P=0.02) and calcium antagonists (2.28 [95% confidence interval, 1.13-4.58]; P=0.02) showed higher risk, whereas those on no antihypertensives (1.63 [95% confidence interval, 0.94-2.82]; P=0.08) and thiazide diuretics (1.56 [95% confidence interval, 0.65-3.73]; P=0.32) showed no significant difference. Overall, our exploratory findings suggest possible differential effects of antihypertensive medications on mood that merits further study: calcium antagonists and β-blockers may be associated with increased risk, whereas angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may be associated with a decreased risk of mood disorders.
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Affiliation(s)
- Angela H Boal
- From the Institute of Cardiovascular and Medical Sciences (A.H.B., L.M., S.M., R.M.T., A.F.D., S.P.) and Institute of Health and Wellbeing (D.J.S.), University of Glasgow, United Kingdom
| | - Daniel J Smith
- From the Institute of Cardiovascular and Medical Sciences (A.H.B., L.M., S.M., R.M.T., A.F.D., S.P.) and Institute of Health and Wellbeing (D.J.S.), University of Glasgow, United Kingdom
| | - Linsay McCallum
- From the Institute of Cardiovascular and Medical Sciences (A.H.B., L.M., S.M., R.M.T., A.F.D., S.P.) and Institute of Health and Wellbeing (D.J.S.), University of Glasgow, United Kingdom
| | - Scott Muir
- From the Institute of Cardiovascular and Medical Sciences (A.H.B., L.M., S.M., R.M.T., A.F.D., S.P.) and Institute of Health and Wellbeing (D.J.S.), University of Glasgow, United Kingdom
| | - Rhian M Touyz
- From the Institute of Cardiovascular and Medical Sciences (A.H.B., L.M., S.M., R.M.T., A.F.D., S.P.) and Institute of Health and Wellbeing (D.J.S.), University of Glasgow, United Kingdom
| | - Anna F Dominiczak
- From the Institute of Cardiovascular and Medical Sciences (A.H.B., L.M., S.M., R.M.T., A.F.D., S.P.) and Institute of Health and Wellbeing (D.J.S.), University of Glasgow, United Kingdom
| | - Sandosh Padmanabhan
- From the Institute of Cardiovascular and Medical Sciences (A.H.B., L.M., S.M., R.M.T., A.F.D., S.P.) and Institute of Health and Wellbeing (D.J.S.), University of Glasgow, United Kingdom.
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Hirokawa K, Ohira T, Nagayoshi M, Kajiura M, Imano H, Kitamura A, Kiyama M, Okada T, Iso H. Dehydroepiandrosterone-sulfate is associated with cardiovascular reactivity to stress in women. Psychoneuroendocrinology 2016; 69:116-22. [PMID: 27104812 DOI: 10.1016/j.psyneuen.2016.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 03/29/2016] [Accepted: 04/05/2016] [Indexed: 10/22/2022]
Abstract
Cardiovascular stress reactivity is a predictor of atherosclerosis and cardiac events. Dehydroepiandrosterone (DHEA) protects against cardiovascular diseases, but results among previous studies have been inconsistent. We investigated the association between dehydroepiandrosterone-sulfate (DHEA-s) and cardiovascular stress reactivity in Japanese women and men. Among 979 healthy Japanese subjects (641 women and 338 men), serum levels of DHEA-s, systolic blood pressure (SBP) and diastolic blood pressure (DBP), heart rate, heart rate variability, and peripheral blood flow were measured under rest and two types of task. Mean differences in measured variables during tasks and a post-task period were calculated as changes in stress reactivity. Variables of stress reactivity were adjusted for multiple potential confounding factors. In women, DHEA-s levels showed positive associations with changes in SBP and DBP (standardized beta=0.12, p=0.020; 0.17, 0.002, respectively). Stratification by menopausal status and other lifestyle factors (e.g., smoking status, alcohol consumption) were conducted. Significant positive associations remained in pre-menopausal (standardized beta=0.13, p=0.037; 0.18, 0.005), non-smoking (0.12, 0.010; 0.18, <0.001), and non-drinking women (0.14, 0.021; 0.21, 0.001), and women without a medical history (0.15, 0.020; 0.20, 0.001). In men, there was no significant association between DHEA-s levels and changes in stress reactivity. DHEA-s levels were positively associated with high blood-pressure reactivity to stress in women, and being menopausal, smoking, and alcohol consumption modified this association.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University, 2-19-5 Shukunosho, Ibaraki, Osaka 567-8578, Japan; Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.
| | - Tetsuya Ohira
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.
| | - Mako Nagayoshi
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.
| | - Mitsugu Kajiura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan.
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.
| | - Akihiko Kitamura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan.
| | - Masahiko Kiyama
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan.
| | - Takeo Okada
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan.
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan.
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Kao LC, Liu YW, Tzeng NS, Kuo TBJ, Huang SY, Chang CC, Chang HA. Linking an Anxiety-Related Personality Trait to Cardiac Autonomic Regulation in Well-Defined Healthy Adults: Harm Avoidance and Resting Heart Rate Variability. Psychiatry Investig 2016; 13:397-405. [PMID: 27482240 PMCID: PMC4965649 DOI: 10.4306/pi.2016.13.4.397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 09/19/2015] [Accepted: 10/24/2015] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE Anxiety trait, anxiety and depression states have all been reported to increase risks for cardiovascular disease (CVD), possibly through altering cardiac autonomic regulation. Our aim was to investigate whether the relationship between harm avoidance (HA, an anxiety-related personality trait) and cardiac autonomic regulation is independent of anxiety and depression states in healthy adults. METHODS We recruited 535 physically and mentally healthy volunteers. Participants completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Tri-dimensional Personality Questionnaire. Participants were divided into high or low HA groups as discriminated by the quartile value. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV). We obtained the time and frequency-domain indices of HRV including variance (total HRV), the low-frequency power (LF; 0.05-0.15 Hz), which may reflect baroreflex function, the high-frequency power (HF; 0.15-0.40 Hz), which reflects cardiac parasympathetic activity, as well as the LF/HF ratio. RESULTS The BDI and HA scores showed associations with HRV parameters. After adjustment for the BDI scores and other control variables, HA is still associated with reduced variance, LF and HF power. Compared with the participants with low HA, those with high HA displayed significant reductions in variance, LF and HF power and a significant increase in their LF/HF ratio. CONCLUSION This study highlights the independent role of HA in contributing to decreased autonomic cardiac regulation in healthy adults and provides a potential underlying mechanism for anxiety trait to confer increased risk for CVD.
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Affiliation(s)
- Lien-Cheng Kao
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Wen Liu
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Terry B. J. Kuo
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - San-Yuan Huang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Hu MX, Lamers F, de Geus EJC, Penninx BWJH. Differential Autonomic Nervous System Reactivity in Depression and Anxiety During Stress Depending on Type of Stressor. Psychosom Med 2016; 78:562-72. [PMID: 26910796 DOI: 10.1097/psy.0000000000000313] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES It remains unclear whether depressive and anxiety disorders are associated with hyporeactivity or hyperreactivity of the autonomic nervous system (ANS) and whether deviant reactivity occurs in all types of stressors. This study compared ANS reactivity in people with current or remitted depression/anxiety with reactivity in healthy controls during two stress conditions. METHODS From the Netherlands Study of Depression and Anxiety, data of 804 individuals with current depression/anxiety, 913 individuals with remitted depression/anxiety, and 466 healthy controls (mean age = 44.1 years; 66.4% female) were available. Two conditions were used to evoke stress: a) an n-back task, a cognitively challenging stressor, and 2) a psychiatric interview, evoking personal-emotional stress related to the occurrence of symptoms of depression/anxiety. Indicators of ANS activity were heart rate (HR), root mean square of differences between successive interbeat intervals (RMSSD), respiratory sinus arrhythmia (RSA), and preejection period. RESULTS As compared with controls, participants with psychopathology had significant hyporeactivity of HR (controls = 4.1 ± 4.2 beats/min; remitted = 3.5 ± 3.5 beats/min; current psychopathology = 3.1 ± 3.4 beats/min), RMSSD (controls = -6.2 ± 14.5 milliseconds; remitted = -5.4 ± 17.8 milliseconds; current psychopathology = -3.5 ± 15.4 milliseconds), and RSA (controls = -9.3 ± 17.0 milliseconds; remitted = -7.4 ± 16.5 milliseconds; current psychopathology = -6.9 ± 15.0 milliseconds) during the n-back task. In contrast, during the psychiatric interview, they showed significant hyperreactivity of HR (controls = 2.7 ± 3.4 beats/min; remitted = 3.5 ± 3.4 beats/min; current psychopathology = 4.0 ± 3.3 beats/min), RMSSD (controls = -3.4 ± 12.2 milliseconds; remitted = -4.1 ± 12.1 milliseconds; current psychopathology = -5.6 ± 11.8 milliseconds), and RSA (controls = -3.8 ± 8.1 milliseconds; remitted = -4.3 ± 7.9 milliseconds; current psychopathology = -5.0 ± 7.9 milliseconds). The lack of group differences in preejection period reactivity suggests that the found effects were driven by altered cardiac vagal reactivity in depression/anxiety. CONCLUSIONS The direction of altered ANS reactivity in depressed/anxious patients is dependent on the type of stressor, and only the more ecologically valid stressors may evoke hyperreactivity in these patients.
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Affiliation(s)
- Mandy X Hu
- From the Department of Psychiatry and EMGO Institute for Health and Care Research (Hu, Lamers, Penninx), VU University Medical Centre, Amsterdam, the Netherlands; and Department of Biological Psychology and EMGO Institute for Health and Care Research (de Geus), VU University, Amsterdam, the Netherlands
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Hirokawa K, Ohira T, Nagayoshi M, Kajiura M, Imano H, Kitamura A, Kiyama M, Okada T, Iso H. Occupational status and job stress in relation to cardiovascular stress reactivity in Japanese workers. Prev Med Rep 2016; 4:61-7. [PMID: 27413662 PMCID: PMC4929058 DOI: 10.1016/j.pmedr.2016.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 04/11/2016] [Accepted: 05/16/2016] [Indexed: 12/02/2022] Open
Abstract
This study aimed to investigate the effects of occupational status and job stress factors on cardiovascular stress reactivity in Japanese workers. In this baseline assessment between 2001 and 2009 in Osaka, Japan, we examined 928 healthy Japanese employees (330 men, 598 women) from two occupational statuses: managers/professionals and general workers. A brief job stress questionnaire was used to evaluate job stress levels. Systolic and diastolic blood pressure (SBP, DBP), heart rate, heart rate variability (high-frequency [HF], low-frequency [LF], LF/HF], and peripheral blood flow were measured at rest and during two stressful tasks. Changes in stress reactivity were calculated as the difference between the measured variables during the tasks and the rest period. Men showed inverse associations between quantitative job overload and DBP, heart rate, and LF/HF, between physical demands and blood pressure (SBP, DBP), and between a poor physical environment and HF. Men also had positive associations between qualitative job overload and heart rate, and between physical demands and peripheral blood flow (all p < 0.05). Women showed inverse associations between qualitative job overload and SBP, and showed positive associations between qualitative job overload and peripheral blood flow, and between a poor physical environment and SBP (all p < 0.05). When stratified by occupational status, significant associations between job stress and changes in stress reactivity were observed in male managers/professionals and female general workers (p < 0.05). Job stress levels are associated with changes in cardiovascular stress reactivity in men and women. Occupational status may modify these associations. Job stressors are associated with changes in stress reactivity in men and women. Job stressors associated with stress reactivity in male managers/professionals. Job stressors associated with stress reactivity in female general workers. Occupational status and gender differences should be considered.
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Affiliation(s)
- Kumi Hirokawa
- Department of Nursing, Baika Women's University, 2-19-5 Shukunosho, Ibaraki, Osaka 567-8578, Japan; Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Tetsuya Ohira
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Department of Epidemiology, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Mako Nagayoshi
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science 1-12-4 Sakamoto, Nagasaki 852-8523 JAPAN
| | - Mitsugu Kajiura
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
| | - Akihiko Kitamura
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan; Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Masahiko Kiyama
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Takeo Okada
- Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, 1-3-2 Nakamich, Higashinari-ku, Osaka 537-0025, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita-shi, Osaka 565-0871, Japan
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Akar SA, Kara S, Bilgiç V. Investigation of heart rate variability in major depression patients using wavelet packet transform. Psychiatry Res 2016; 238:326-332. [PMID: 27086252 DOI: 10.1016/j.psychres.2016.02.058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 01/11/2016] [Accepted: 02/25/2016] [Indexed: 12/01/2022]
Abstract
Studies conducted in major depression (MD) patients have reported a high risk of cardiac morbidity as a result of the relationship between changed cardiovascular activity (CA) and autonomic dysfunctions. The investigation of heart rate variability (HRV) gives valuable idea about variances in autonomic CA of MD patients. To get this knowledge, frequency-domain HRV analysis is frequently performed using Fourier transformation (FT) or discrete-wavelet transformation (DWT) to decompose the data into high-frequency (HF) and low-frequency (LF) bands. Nevertheless, it has been reported that the FT is not useful for nonstationary HRV signals and the DWT does not ensure required frequency boundaries of each band. This study aims to compare the frequency-domain HRV features using wavelet-packet-transform (WPT) with absolutely excellent approximation to required band ranges between the controls and patients. In addition to LF and HF band energies, sympathovagal balance that indicates the variation of sympathetic and parasympathetic activities were compared between two groups. Patients had a significantly lower HF energy, higher values of LF energy and higher LF/HF ratio. Our results recommend that impairments in coordination between parasympathetic and sympathetic behavior in MD patients can be assessed by HRV analysis using WPT with high resolution decomposition for needed bands.
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Affiliation(s)
- Saime Akdemir Akar
- Institute of Biomedical Engineering, Fatih University, Istanbul 34500, Turkey.
| | - Sadık Kara
- Institute of Biomedical Engineering, Fatih University, Istanbul 34500, Turkey
| | - Vedat Bilgiç
- Department of Psychiatry, School of Medicine, Fatih University, Istanbul 34500, Turkey
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Lo HHM, Wong SYS, Wong JYH, Wong SWL, Yeung JWK. The effect of a family-based mindfulness intervention on children with attention deficit and hyperactivity symptoms and their parents: design and rationale for a randomized, controlled clinical trial (Study protocol). BMC Psychiatry 2016; 16:65. [PMID: 26980323 PMCID: PMC4791862 DOI: 10.1186/s12888-016-0773-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 03/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND About 4 % of children in Hong Kong have attention deficit hyperactivity disorder (ADHD). The parents of children with ADHD report higher levels of stress and show more negative parenting behavior. Medication and behavior training are evidence-based treatments, but both show significant limitations. In short, medical treatment is not suitable for preschool children and would suppress growth, whereas parents under stress may not be capable of consistently applying behavior management skills. Mindfulness training can improve attention and facilitate cognitive development and overall functioning. It has been widely adopted as a treatment option in health care, but its application in a family context is limited. In this context, a family-based mindfulness intervention (FBMI) has been developed to promote the attention and mental health of children with attention symptoms and to reduce the stress experienced by their parents. This article describes the design and conduct of the trial. METHODS/DESIGN A multicenter, 8-week, waitlist, randomized controlled trial of FBMI is currently being conducted in Hong Kong (from mid-2015 to mid-2016). Its effectiveness will be examined by comparing the participants who receive treatment to those in a waitlist control group. The study population consists of one hundred twenty children with ADHD, or with symptoms of inattention and hyperactivity, between 5 and 7 years of age and their parents. To be included in the study, the children are required to meet or exceed the borderline cutoff score of the Chinese version of the Strengths and Weaknesses of ADHD Symptoms and Normal Behaviors Rating Scale (SWAN-C). The primary outcome measures are the children's ADHD symptoms and behavior and the parents' stress. The secondary outcome measures include the children's overall behavioral problems and performance on the Attention Network Test, the parents' ADHD symptoms, the parents' mindful parenting scores, and heart rate variability of parents. DISCUSSION This study is probably the first randomized controlled trial of FBMI for young children and their caregivers. A rigorous design and multiple outcome measures are used to examine the effectiveness of FBMI. If the hypotheses are confirmed, FBMI may serve as an additional treatment option for children with ADHD. TRIAL REGISTRATION This study is registered with the Chinese Clinical Trial Registry (reference number: ChiCTR-IOR-15007292 ). Registered 28 October 2015.
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Affiliation(s)
- Herman H. M. Lo
- Department of Applied Social Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, SAR China
| | - Samuel Y. S. Wong
- Division of Family Medicine and Primary Health Care, School of Public Health and Health Care, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Janet Y. H. Wong
- School of Nursing, The University of Hong Kong, Hong Kong, SAR China
| | - Simpson W. L. Wong
- Department of Psychological Studies, The Hong Kong Institute of Education, Hong Kong, SAR China
| | - Jerf W. K. Yeung
- Department of Applied Social Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, SAR China
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Sammito S, Böckelmann I. [Options and limitations of heart rate measurement and analysis of heart rate variability by mobile devices: A systematic review]. Herzschrittmacherther Elektrophysiol 2016; 27:38-45. [PMID: 26860408 DOI: 10.1007/s00399-016-0419-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 01/20/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Heart rate (HR) and heart rate variability (HRV) have been established in the last few years as a non-invasive method for recording the demands on the cardiovascular system. The development enables us today to measure the interbeat intervals with different technologies for calculating HR and HRV. MATERIALS AND METHODS This review is based on a systematic literature search in PubMed for validity of different measurement techniques and their pros and cons for the measurement of HR and the analysis of HRV. RESULTS Measurement equipment for recording of interbeat intervals should have a high storage capacity and a sampling rate of 1000 Hz ideally. The quality criteria of freedom of feedback (small, little disruptive), robustness and a non-invasive measurement (e. g. freeze-electrodes or sensors) have to be fulfilled. In addition to the Holter ECG, several portable heart rate watch and chest belt systems provide adequate validity and good applicability. DISCUSSION The Holter ECG is still the gold standard for the measurement of NN intervals and for the analysis of HRV. Modern heart rate watches show a good correlation with the conformance of freedom from discomfort, robustness and non-invasive measurement and are a good alternative due to the lower disturbance of test persons.
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Affiliation(s)
- Stefan Sammito
- Kommando Sanitätsdienst der Bundeswehr, Sachgebiet Gesundheitsförderung, Sportmedizin, Ernährungsmedizin, VI 1.3, Von-Kuhl-Straße 50, 56070, Koblenz, Deutschland.
- Bereich Arbeitsmedizin der Medizinischen Fakultät der Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland.
| | - Irina Böckelmann
- Bereich Arbeitsmedizin der Medizinischen Fakultät der Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland
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50
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Cabiddu R, Trimer R, Monteiro CI, Borghi-Silva A, Trimer V, Carvalho P, Rocha T, Paredes S, Bianchi AM, Henriques J. Correlation between autonomous function and left ventricular performance after acute myocardial infarction. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:3343-6. [PMID: 26737008 DOI: 10.1109/embc.2015.7319108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Reduced ejection fraction (EF), possibly induced/mediated by autonomic abnormal activation, is one of the most powerful predictors of adverse outcome after acute myocardial infarction (MI). A deep understanding of the correlation between the autonomous functionality and the left ventricular performance in these patients is therefore of paramount importance. The autonomous function is reflected in the cardiac activity and, specifically, in the heart rate variability (HRV) signal. Given the cardiac activity nonlinearity, growing interest is being manifested towards nonlinear methods of analysis, which might provide more significant information than the traditional linear approaches. The aim of the present study was to investigate if non-linear HRV metrics change between MI patients with preserved EF (pEF) and MI patients with reduced EF (rEF). Data were acquired in the context of the cardioRisk project. Ten MI patients with rEF and six MI patients with pEF, admitted to Intensive Cardiac Care after a first acute MI episode, were studied. The ECG was acquired during a Holter recording and the tachogram was extracted. Sample entropy (SE) and Lempel-Ziv Complexity (LZC 1 and LZC 2) metrics were computed on five hour long tachogram portions. A significant correlation was found between LZC indices and EF in the whole population; SE, LZC 1 and LZC 2 were significantly higher in patients with pEF. Our results indicate that lower complexity characterizes the HRV of MI patients with rEF. Complexity reduction might be due to a simplification of regulatory mechanisms, which might explain why MI patients with rEF are at higher risk for subsequent non-fatal and fatal events.
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