Mausbach Brent T, Dimsdale Joel E, Ziegler Michael G, Mills Paul J, Ancoli-Israel Sonia, Patterson Thomas L, Grant Igor
Department of Psychiatry, University of California at San Diego,La Jolla, CA 92093-0680, USA.
Psychosom Med. 2005 Jul-Aug;67(4):638-42. doi: 10.1097/01.psy.0000173312.90148.97.
Increased depressive symptoms have been associated with increased basal plasma norepinephrine (NE), and may be associated with exaggerated NE response to stress. This exaggerated response may play a role in health consequences associated with caring for a loved-one with Alzheimer's disease. The current study examined the relations between the level of depressive symptoms in spousal caregivers and the physiological response to a psychological stress task.
Fifty-five spousal caregivers (mean age 73 +/- 8 years) completed the depression subscale of the Brief Symptom Inventory (BSI). Plasma NE levels were assessed before and immediately after a speech stressor conducted at the caregiver's home. Hierarchical linear regression was used to determine whether caregiver depressive symptoms significantly improved prediction of change in NE levels beyond other factors theoretically and empirically related to NE.
Level of depressive symptoms significantly predicted post-stressor change in NE levels (p < .01), even when controlling for age, caregiver distress, presence of caregiver hypertension, and care recipient level of cognitive function. Higher levels of depressive symptoms were associated with a greater plasma NE response to the psychological stress task.
Depressive symptoms may act to exaggerate NE response to the stress of caregiving, potentially leading to an allostatic load that might predispose caregivers to negative health consequences, including cardiovascular morbidity.
抑郁症状的增加与基础血浆去甲肾上腺素（NE）水平升高有关，并且可能与对压力的NE反应过度有关。这种过度反应可能在与照顾患有阿尔茨海默病的亲人相关的健康后果中起作用。本研究考察了配偶照顾者抑郁症状水平与对心理应激任务的生理反应之间的关系。
55名配偶照顾者（平均年龄73±8岁）完成了简明症状量表（BSI）的抑郁分量表。在照顾者家中进行言语应激源刺激之前和之后立即评估血浆NE水平。采用分层线性回归来确定照顾者的抑郁症状是否能显著改善对NE水平变化的预测，超过理论上和经验上与NE相关的其他因素。
即使在控制了年龄、照顾者困扰、照顾者高血压的存在以及受照顾者的认知功能水平后，抑郁症状水平仍能显著预测应激源刺激后NE水平的变化（p<.01）。更高水平的抑郁症状与对心理应激任务的更大血浆NE反应相关。
抑郁症状可能会加剧NE对照顾压力的反应，潜在地导致一种负荷过重状态，这可能使照顾者易患负面健康后果，包括心血管疾病。
