Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
J Psychosom Res. 2019 Aug;123:109729. doi: 10.1016/j.jpsychores.2019.05.007. Epub 2019 May 22.
The relationship between resting-state heart rate variability (HRV) and somatic symptom disorder (SSD) has been explored in several studies. We planned to examine HRV during the performance of psychological tasks, and assumed that it could be applied for the diagnosis of SSD.
Fifty-three patients with SSD and 52 healthy controls were recruited. Demographic and psychological data were collected. Subjects' HRV was measured over five 5-minute blocks during which they viewed different scripts (resting state; health anxiety; somatic distress; depression; neutral topic). After each block they completed a self-assessment manikin. Generalized estimated equation analysis was used to analyze the impact of mental scripts, SSD and sex on physiological and psychological indicators.
In men there was a scriptSSD interaction concerning high-frequency power (HF) involving the neutral script; SSD men showed significantly higher HF than healthy men when viewing neutral script. In women there were scriptSSD interactions with respect to low-frequency power (LF) and HF involving the somatic distress script and a scriptSSD interaction with respect to LF and emotional valence involving the neutral script; SSD women revealed significantly lower LF and HF than healthy women when viewing somatic distress script, they also showed significantly lower LF and higher valence than healthy ones during neutral script. The somatic distress scriptSSD interaction still influenced LF and HF in women after adjusting for potential confounders.
In women cue-specific HRV is a better method of differentiating people with SSD from healthy individuals than resting-state HRV.
The Research Ethics Committee of National Taiwan University Hospital approved this study (approval number: 201410050RINB).
已有多项研究探讨了静息心率变异性（HRV）与躯体症状障碍（SSD）之间的关系。我们计划检查心理任务过程中的 HRV，并假设它可用于 SSD 的诊断。
招募了 53 名 SSD 患者和 52 名健康对照者。收集人口统计学和心理学数据。在 5 个 5 分钟的块中测量受试者的 HRV，在此期间他们观看不同的脚本（静息状态；健康焦虑；躯体不适；抑郁；中性话题）。每个块后，他们完成自我评估情绪图。广义估计方程分析用于分析心理脚本、SSD 和性别对生理和心理指标的影响。
在男性中，高频功率（HF）存在与中性脚本相关的脚本SSD 交互作用；当观看中性脚本时，SSD 男性的 HF 明显高于健康男性。在女性中，低频功率（LF）和 HF 存在与躯体不适脚本相关的脚本SSD 交互作用，LF 和情绪效价存在与中性脚本相关的脚本SSD 交互作用；当观看躯体不适脚本时，SSD 女性的 LF 和 HF 明显低于健康女性，与健康女性相比，她们在观看中性脚本时的 LF 也明显较低，而效价较高。在调整了潜在混杂因素后，躯体不适脚本SSD 交互作用仍影响女性的 LF 和 HF。
在女性中，与静息状态 HRV 相比，提示特异性 HRV 是区分 SSD 患者和健康个体的更好方法。
台湾大学医院伦理委员会批准了这项研究（批准号：201410050RINB）。
