Department of Counseling and School Psychology, University of Massachusetts Boston, Wheatley Building, Second Floor, Room 143-9, 100 Morriseey Boulevard, Boston, MA 02125, USA.
Psychiatry Res. 2014 Dec 30;220(3):890-5. doi: 10.1016/j.psychres.2014.07.059. Epub 2014 Aug 6.
Numerous studies have documented a significant association between symptom severity and cognitive functioning in bipolar disorder (BD). These findings advanced speculations about a potential link between the physiological stress associated with illness severity and cognitive dysfunction. To explore this hypothesis, the current study employed heart rate variability (HRV) as a physiological measure that is sensitive to the effects of chronic stress, and a scale of trait anxiety for assessing a psychological condition that is correlated with hyper sympathetic arousal. Analyses indicated that BD patients with High Illness Severity reported more symptoms of trait-anxiety (i.e., State Trait Anxiety Inventory), performed more poorly on a computerized neuropsychological battery (i.e., CNS Vital Signs), and exhibited a more constricted HRV profile (i.e., lower SDNN with elevated LF/HF ratio) than patients with Low Illness Severity. Illness severity was determined by a history of psychosis, illness duration, and number of mood episodes. A third group of healthy controls (n=22) performed better on the neuropsychological battery and exhibited a healthier HRV profile than the BD groups. This study provides preliminary evidence that illness severity and cognitive impairment in BD may be associated with state anxiety and neuro-cardiac alterations that are sensitive to physiological stress.
许多研究都记录了双相情感障碍（BD）患者症状严重程度与认知功能之间存在显著关联。这些发现进一步推测，疾病严重程度相关的生理压力与认知功能障碍之间可能存在潜在联系。为了探究这一假说，本研究采用心率变异性（HRV）作为一种对慢性应激敏感的生理测量指标，以及特质焦虑量表来评估与交感神经兴奋相关的心理状态。分析结果表明，高疾病严重程度的 BD 患者表现出更多的特质焦虑症状（即状态特质焦虑量表），在计算机化神经心理学测试中表现更差（即 CNS 生命体征），并且 HRV 谱更狭窄（即 SDNN 降低，LF/HF 比值升高），而低疾病严重程度的患者则没有。疾病严重程度由精神病病史、病程和情绪发作次数决定。第三组健康对照组（n=22）在神经心理学测试中表现更好，并且 HRV 谱更健康。本研究初步证明，BD 患者的疾病严重程度和认知障碍可能与状态焦虑以及对生理应激敏感的神经心脏改变有关。
