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抑郁心境状态下的心血管反应迟钝是否与抑郁症有关?对缓解期抑郁症、抑郁症和健康对照组的比较。

Is blunted cardiovascular reactivity in depression mood-state dependent? A comparison of major depressive disorder remitted depression and healthy controls.

机构信息

University of South Florida, United States.

出版信息

Int J Psychophysiol. 2013 Oct;90(1):50-7. doi: 10.1016/j.ijpsycho.2013.05.018. Epub 2013 Jun 10.

Abstract

Prior work has repeatedly demonstrated that people who have current major depression exhibit blunted cardiovascular reactivity to acute stressors (e.g., Salomon et al., 2009). A key question regards the psychobiological basis for these deficits, including whether such deficits are depressed mood-state dependent or whether these effects are trait-like and are observed outside of depression episodes in vulnerable individuals. To examine this issue, we assessed cardiovascular reactivity to a speech stressor task and a forehead cold pressor in 50 individuals with current major depressive disorder (MDD), 25 with remitted major depression (RMD), and 45 healthy controls. Heart rate (HR), blood pressure and impedance cardiography were assessed and analyses controlled for BMI and sex. Significant group effects were found for SBP, HR, and PEP for the speech preparation period and HR, CO, and PEP during the speech. For each of these parameters, only the MDD group exhibited attenuated reactivity as well as impaired SBP recovery. Reactivity and recovery in the RMD group more closely resembled the healthy controls. Speeches given by the MDD group were rated as less persuasive than the RMD or healthy controls' speeches. No significant differences were found for the cold pressor. Blunted cardiovascular reactivity and impaired recovery in current major depression may be mood-state dependent phenomena and may be more reflective of motivational deficits than deficits in the physiological integrity of the cardiovascular system.

摘要

先前的研究已经反复证明,当前患有重度抑郁症的人在急性应激源下表现出心血管反应迟钝(例如,Salomon 等人,2009 年)。一个关键问题是这些缺陷的心理生物学基础,包括这些缺陷是否取决于抑郁情绪状态,或者这些影响是否具有特质性,并且在易患个体的抑郁发作之外被观察到。为了研究这个问题,我们评估了 50 名当前患有重度抑郁症(MDD)、25 名缓解期重度抑郁症(RMD)和 45 名健康对照者对言语应激源任务和前额冷加压的心血管反应。评估了心率(HR)、血压和阻抗心动图,并控制了 BMI 和性别进行分析。在言语准备期和言语期间的 SBP、HR 和 PEP 以及 HR、CO 和 PEP 方面,均发现了显著的组间效应。对于这些参数中的每一个,只有 MDD 组表现出反应迟钝和 SBP 恢复受损。RMD 组的反应和恢复更类似于健康对照组。MDD 组的演讲被评为不如 RMD 或健康对照组的演讲有说服力。冷加压没有发现显著差异。当前重度抑郁症患者的心血管反应迟钝和恢复受损可能是情绪状态依赖的现象,并且可能更能反映出动机缺陷,而不是心血管系统的生理完整性缺陷。

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