Eos-Klinik, Münster, Germany.
Department for Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Mainz, Germany.
PLoS One. 2021 Mar 23;16(3):e0248686. doi: 10.1371/journal.pone.0248686. eCollection 2021.
Vagally mediated heart rate variability (HRV) is a psychophysiological indicator of mental and physical health. Limited research suggests there is reduced vagal activity and resulting lower HRV in patients with Major Depressive Disorder (MDD); however little is actually known about the association between HRV and symptoms of depression and whether the association mirrors symptom improvement following psychotherapy. The aim of this study was to investigate the association between antidepressant therapy, symptom change and HRV in 50 inpatients (68% females; 17-68 years) with a diagnosis of MDD. Severity of depressive symptoms was assessed by self-report (Beck Depression Inventory II) and the Hamilton Rating Scale of Depression. Measures of vagally mediated HRV (root mean square of successive differences and high-frequency) were assessed at multiple measurement points before and after inpatient psychotherapeutic and psychiatric treatment. Results showed an expected negative correlation between HRV and depressive symptoms at intake. Depressive symptoms improved (d = 0.84) without corresponding change in HRV, demonstrating a de-coupling between this psychophysiological indicator and symptom severity. To our knowledge, this study is the first to examine an association between HRV and depressive symptoms before and after psychotherapy. The observed de-coupling of depression and HRV, and its methodological implications for future research are discussed.
迷走神经介导的心率变异性（HRV）是心理和身体健康的生理心理指标。有限的研究表明，患有重度抑郁症（MDD）的患者迷走神经活动减少，导致 HRV 降低；然而，实际上对于 HRV 与抑郁症状之间的关联以及这种关联是否反映了心理治疗后症状的改善知之甚少。本研究的目的是调查 50 名住院患者（68%为女性；年龄 17-68 岁）抗抑郁治疗、症状变化与 HRV 之间的关系，这些患者被诊断为 MDD。抑郁症状的严重程度通过自我报告（贝克抑郁量表二）和汉密尔顿抑郁评定量表进行评估。在住院心理治疗和精神病治疗之前和之后的多个测量点评估迷走神经介导的 HRV（连续差异的均方根和高频）的测量值。结果显示，HRV 与摄入时的抑郁症状呈负相关。抑郁症状改善（d = 0.84），而 HRV 没有相应变化，表明这种生理心理指标与症状严重程度脱钩。据我们所知，这项研究首次检查了心理治疗前后 HRV 与抑郁症状之间的关联。讨论了观察到的抑郁和 HRV 脱钩及其对未来研究的方法学意义。
