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当前和缓解期重度抑郁症的呼吸窦性心律失常反应性。

Respiratory sinus arrhythmia reactivity in current and remitted major depressive disorder.

机构信息

Department of Psychology, University of South Florida, PCD 4118G, Tampa, FL 33620.

出版信息

Psychosom Med. 2014 Jan;76(1):66-73. doi: 10.1097/PSY.0000000000000019. Epub 2013 Dec 23.

Abstract

OBJECTIVE

Low resting respiratory sinus arrhythmia (RSA) levels and blunted RSA reactivity are thought to index impaired emotion regulation capacity. Major depressive disorder (MDD) has been associated with aberrant RSA reactivity and recovery to a speech stressor task relative to healthy controls. Whether impaired RSA functioning reflects aspects of the depressed mood state or a stable vulnerability marker for depression is unknown.

METHODS

We compared resting RSA and RSA reactivity between adults with MDD (n = 49), remitted depression (RMD, n = 24), and healthy controls (n = 45). Electrocardiogram data were collected during a resting baseline, a paced-breathing baseline, and two reactivity tasks (speech stressor, cold exposure).

RESULTS

A group by time quadratic effect emerged (F(2,109) = 4.36, p = .015) for RSA across phases of the speech stressor (baseline, instruction, preparation, speech, recovery). Follow-up analyses revealed that those with MDD uniquely exhibited blunted RSA reactivity, whereas RMD and controls both exhibited the anticipated task-related vagal withdrawal and posttask recovery. The group by time interaction remained after covariation for age, sex, waist circumference, physical activity, and respiration, but not sleep quality.

CONCLUSIONS

These results provide new evidence that aberrant RSA reactivity marks features that track the depressed state, such as poor sleep, rather than a stable trait evident among asymptomatic persons.

摘要

目的

低静息呼吸窦性心律失常(RSA)水平和 RSA 反应迟钝被认为是情绪调节能力受损的指标。与健康对照组相比,重度抑郁症(MDD)与 RSA 反应异常和对言语应激任务的恢复有关。受损的 RSA 功能是否反映了抑郁情绪状态的某些方面,或者是抑郁的稳定脆弱性标志物,目前尚不清楚。

方法

我们比较了 MDD 患者(n=49)、缓解抑郁(RMD,n=24)和健康对照组(n=45)的静息 RSA 和 RSA 反应性。在静息基线、 paced-breathing 基线和两个反应性任务(言语应激、冷暴露)期间采集心电图数据。

结果

言语应激过程中出现了组间时间二次效应(F(2,109)=4.36,p=.015)(基线、指令、准备、言语、恢复)。进一步的分析表明,MDD 患者表现出独特的 RSA 反应迟钝,而 RMD 和对照组都表现出预期的与任务相关的迷走神经撤退和任务后恢复。在考虑年龄、性别、腰围、身体活动和呼吸,但不考虑睡眠质量后,组间时间交互仍然存在。

结论

这些结果提供了新的证据,表明异常的 RSA 反应性标志着与抑郁状态相关的特征,例如睡眠质量差,而不是无症状人群中明显的稳定特征。

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