Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Naval Pohang Hospital, Pohang, Republic of Korea.
Department of Psychiatry, Armed Forces Capital Hospital, Seongnam, Republic of Korea.
Psychiatry Res. 2018 Mar;261:428-435. doi: 10.1016/j.psychres.2017.12.065. Epub 2018 Jan 4.
Only few studies addressing the biological background of adjustment disorder (AD) exist. We examined the psychophysiological correlates indicative of autonomic regulation in AD. Heart rate variability (HRV), skin conductance, skin temperature, electromyography, and respiration were measured during serial stress tasks in 33 soldiers with AD and 60 healthy controls (HC). Patients with AD displayed lower relative power of high frequency (rHF) HRV and higher relative power of very low frequency (rVLF) HRV compared with HC at baseline. Inversely, the rHF of patients with AD remained higher and their rVLF remained lower compared with HC parameters after the single stress task, which suggests a reversed sympathovagal balance in AD. Mean heart rate and skin conductance increased during stress tasks in patients, although to a lesser extent than in HC. Skin temperature remained unchanged in all tasks in patients with AD. The tension of the frontalis muscle was higher in patients compared with HC from the second stress task onward. Thoracic breathing was more prevalent in patients with AD. Our study suggests altered autonomic reactivity in AD, which leads to a lack of sympathetic response to stress. We conclude that the distinctive biological mechanisms underlying AD are different from normal stress reactions.
仅有少数研究探讨了适应障碍(AD)的生物学背景。我们研究了 AD 患者自主调节的生理心理学相关性。33 名 AD 患者和 60 名健康对照(HC)在连续的应激任务中测量了心率变异性(HRV)、皮肤电导、皮肤温度、肌电图和呼吸。与 HC 相比,AD 患者在基线时 HRV 的高频相对功率(rHF)较低,极低频相对功率(rVLF)较高。相反,与 HC 参数相比,AD 患者在单次应激任务后,其 rHF 仍较高,rVLF 仍较低,这表明 AD 中存在交感神经迷走神经平衡的逆转。尽管患者的平均心率和皮肤电导在应激任务中增加,但增加幅度小于 HC。AD 患者在所有任务中皮肤温度均保持不变。与 HC 相比,患者的额肌张力从第二个应激任务开始就更高。AD 患者的胸式呼吸更为常见。我们的研究表明 AD 患者自主反应改变,导致对压力缺乏交感神经反应。我们得出结论,AD 患者的独特生物学机制与正常应激反应不同。