SCAN Research & Teaching Unit, School of Psychology, University of Sydney, Australia; Discipline of Psychiatry, University of Sydney, Australia; Hospital Universitário, University of São Paulo, São Paulo, Brazil.
Int J Psychophysiol. 2013 Sep;89(3):288-96. doi: 10.1016/j.ijpsycho.2013.06.018. Epub 2013 Jun 22.
Here we review our recent body of work on the impact of mood and comorbid anxiety disorders, alcohol dependence, and their treatments on heart rate variability (HRV), a psychophysiological marker of mental and physical wellbeing. We have shown that otherwise healthy, unmedicated patients with these disorders display reduced resting-state HRV, and that pharmacological treatments do not ameliorate these reductions. Other studies highlight that tricyclic medications and the serotonin and noradrenaline reuptake inhibitors in particular may have adverse cardiovascular consequences. Reduced HRV has important functional significance for motivation to engage social situations, social approach behaviours, self-regulation and psychological flexibility in the face of stressors. Over the longer-term, reduced HRV leads to immune dysfunction and inflammation, cardiovascular disease and mortality, attributable to the downstream effects of a poorly functioning cholinergic anti-inflammatory reflex. We place our research in the context of the broader literature base and propose a working model for the effects of mood disorders, comorbid conditions, and their treatments to help guide future research activities. Further research is urgently needed on the long-term effects of autonomic dysregulation in otherwise healthy psychiatric patients, and appropriate interventions to halt the progression of a host of conditions associated with morbidity and mortality.
在这里，我们回顾了我们最近关于情绪和共病焦虑障碍、酒精依赖及其治疗对心率变异性（HRV）的影响的研究成果。HRV 是心理健康和身体健康的心理生理标志物。我们已经表明，患有这些疾病的健康、未经药物治疗的患者静息状态下的 HRV 降低，而药物治疗并不能改善这种降低。其他研究强调，三环类药物和 5-羟色胺和去甲肾上腺素再摄取抑制剂尤其可能产生不良的心血管后果。HRV 降低对社交情境、社交接近行为、压力下的自我调节和心理灵活性的动机具有重要的功能意义。从长远来看，HRV 降低会导致免疫功能障碍和炎症、心血管疾病和死亡率，这归因于胆碱能抗炎反射功能不良的下游影响。我们将我们的研究置于更广泛的文献基础中，并提出了一个关于情绪障碍、共病及其治疗效果的工作模型，以帮助指导未来的研究活动。迫切需要对健康精神病患者自主神经失调的长期影响进行进一步研究，并采取适当的干预措施来阻止与发病率和死亡率相关的一系列疾病的发展。
