Department of Psychiatry, Korea University Guro Hospital, College of medicine, Guro-gu, Seoul, 08308, Republic of Korea.
Department of Psychiatry, National Medical Center, 245 Eulji-ro, Jung-gu, Seoul, 04564, Republic of Korea.
Appl Psychophysiol Biofeedback. 2021 Mar;46(1):11-18. doi: 10.1007/s10484-020-09491-y. Epub 2020 Oct 19.
North Korean Defectors (NKDs) are known to experience multiple psychological symptoms such depression and anxiety. Heart rate variability (HRV) has been implicated in various psychiatric disorders, including posttraumatic stress disorder (PTSD) and depression. No studies have prospectively evaluated HRV parameters in NKDs. We recruited 34 NKDs (2 men, 32 women; age range 25-58 years) who were diagnosed with major depressive disorder. We evaluated psychiatric symptoms using the Korean version of the Hamilton Depression Rating Scale (HDRS), Montgomery-Asberg Depression Rating Scale, and PTSD checklist civilian version. We also performed HRV measurements before and after 12 weeks of antidepressant treatment. In the baseline, HDRS item 14 and 15 showed statistically significant positive correlation with LF/HF ratio. At the endpoint, HDRS item 5 and 8 were found to have positive correlations with some HRV parameters. We found that the sum of fatigue-related HDRS symptoms scores (number 7 and 13) showed significant positive correlation with LF. HDRS total scores also showed significant positive correlations with LF and HF. When the severity of depression was decreased and only the PTSD symptoms persisted at the endpoint, the relationships between HRV and clinical measures were more clearly revealed. This study shows the possibility of using HRV as an objective neurobiological index of autonomic nervous system disorder and reaction to stress in NKDs.
朝鲜脱北者（NKDs）已知会经历多种心理症状，如抑郁和焦虑。心率变异性（HRV）已被牵连到各种精神疾病中，包括创伤后应激障碍（PTSD）和抑郁症。目前还没有前瞻性研究评估 NKDs 中的 HRV 参数。我们招募了 34 名 NKDs（2 名男性，32 名女性；年龄范围 25-58 岁），他们被诊断患有重度抑郁症。我们使用汉密尔顿抑郁评定量表（HDRS）、蒙哥马利-阿斯伯格抑郁评定量表和 PTSD 检查表平民版评估了精神病症状。我们还在抗抑郁治疗前和治疗后 12 周进行了 HRV 测量。在基线时，HDRS 项目 14 和 15 与 LF/HF 比值呈显著正相关。在终点时，HDRS 项目 5 和 8 与某些 HRV 参数呈正相关。我们发现，与疲劳相关的 HDRS 症状评分总和（第 7 和 13 项）与 LF 呈显著正相关。HDRS 总分也与 LF 和 HF 呈显著正相关。当抑郁严重程度降低，而仅在终点时 PTSD 症状持续存在时，HRV 与临床测量之间的关系更加明显。这项研究表明 HRV 作为 NKDs 自主神经系统障碍和应激反应的客观神经生物学指标的可能性。
