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青春期前儿童的躯体及认知-情感抑郁症状与心脏自主神经功能和皮质醇的关系存在差异:TRAILS研究

Preadolescents' somatic and cognitive-affective depressive symptoms are differentially related to cardiac autonomic function and cortisol: the TRAILS study.

作者信息

Bosch Nienke M, Riese Harriëtte, Dietrich Andrea, Ormel Johan, Verhulst Frank C, Oldehinkel Albertine J

机构信息

Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center Groningen, CC72, P.O. Box 30001, 9700 RB Groningen, Netherlands.

出版信息

Psychosom Med. 2009 Nov;71(9):944-50. doi: 10.1097/PSY.0b013e3181bc756b. Epub 2009 Oct 15.

Abstract

OBJECTIVE

To examine in a nonclinical sample of preadolescents the possibility that somatic and cognitive-affective depressive symptoms are differentially related with the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis. Depression is a well-known risk factor for cardiovascular disease and mortality. Dysregulation of the ANS and the HPA axis have been proposed as underlying mechanisms. Several studies suggest that only a subset of the depression symptoms account for associations with cardiovascular prognosis.

METHODS

Self-reported somatic and cognitive-affective depressive symptoms were examined in relationship to heart rate variability (HRV), spontaneous baroreflex sensitivity (BRS), and the cortisol awakening response (CAR) in 2049 preadolescents (mean age = 11.1 years; 50.7% = girls) from the Tracking Adolescents' Individual Lives Survey (TRAILS).

RESULTS

Physiological measurements were not associated with the overall measure of depressive symptoms. Somatic depressive symptoms were negatively related to HRV and BRS, and positively to the CAR; cognitive-affective depressive symptoms were positively related to HRV and BRS, and negatively to the CAR. Associations with the CAR pertained to boys only.

CONCLUSIONS

Somatic and cognitive-affective depressive symptoms differ in their association with both cardiac autonomic and HPA axis function in preadolescents. Particularly, somatic depression symptoms may mark cardiac risk.

摘要

目的

在青春期前儿童的非临床样本中研究躯体和认知-情感抑郁症状与自主神经系统(ANS)及下丘脑-垂体-肾上腺(HPA)轴存在不同关联的可能性。抑郁症是心血管疾病和死亡的一个众所周知的危险因素。ANS和HPA轴功能失调被认为是潜在机制。几项研究表明,只有一部分抑郁症状与心血管预后相关。

方法

在追踪青少年个体生活调查(TRAILS)中的2049名青春期前儿童(平均年龄=11.1岁;50.7%为女孩)中,研究自我报告的躯体和认知-情感抑郁症状与心率变异性(HRV)、自发性压力反射敏感性(BRS)及皮质醇觉醒反应(CAR)之间的关系。

结果

生理测量结果与抑郁症状的总体测量值无关。躯体抑郁症状与HRV和BRS呈负相关,与CAR呈正相关;认知-情感抑郁症状与HRV和BRS呈正相关,与CAR呈负相关。与CAR的关联仅见于男孩。

结论

在青春期前儿童中,躯体和认知-情感抑郁症状在与心脏自主神经及HPA轴功能的关联方面存在差异。特别是,躯体抑郁症状可能标志着心脏风险。

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