Anxiety Disorders Program (PROTAN), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, School of Medicine, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil.
Laboratório de Pânico de Respiração (LABPR), Instituto de Psiquiatria (IPUB), Universidade Federal Do Rio de Janeiro (UFRJ), Brazil.
J Psychiatr Res. 2021 Aug;140:22-29. doi: 10.1016/j.jpsychires.2021.05.059. Epub 2021 May 27.
Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders but the least successfully treated. The search for accessible clinical, psychological and biological markers is crucial for developing more effective and personalized interventions.
To evaluate if changes in heart rate variability (HRV) between rest and stress conditions before interventions could predict improvement in emotional interference (EI) in a cognitive task after three different treatment modalities in patients with GAD.
This is a post-hoc analysis study reporting data from a larger randomized controlled trial (NCT03072264) assessing a mindfulness-based intervention (BMT), fluoxetine (FLX), and an active comparison group (QoL) in adult patients diagnosed with GAD. We assessed pulse plethysmography (PPG) data using a Shimmer3 GSR to measure HRV. Regression analyses were performed using the variation between baseline and endpoint EI scores as dependent variables and contrasts considering changing in HRV*group interaction in the baseline.
106 individuals were included. The correlations between HRV changing from rest to task predicted improvement in IE only in the FLX versus control group contrast (estimated = -80.24; SE = 27.31; p = 0.005) and not in the BMT and control group contrast.
More flexible HRV at baseline predicted EI improvement only in the FLX group. This finding is clinically relevant since it may help us develop more personalized interventions for GAD.
广泛性焦虑障碍(GAD)是最常见的焦虑障碍之一,但治疗效果最差。寻找易于获取的临床、心理和生物学标志物对于开发更有效和个性化的干预措施至关重要。
评估在 GAD 患者接受三种不同治疗方式之前,干预前后静息和应激状态下的心率变异性(HRV)变化是否可以预测认知任务中情绪干扰(EI)的改善。
这是一项事后分析研究,报告了一项更大的随机对照试验(NCT03072264)的数据,该试验评估了正念减压疗法(BMT)、氟西汀(FLX)和积极对照组(QoL)在成年 GAD 患者中的疗效。我们使用 Shimmer3 GSR 进行脉搏体积描记(PPG)数据评估,以测量 HRV。使用基线和终点 EI 评分之间的变化作为因变量,使用基线时 HRV*组间变化的对比进行回归分析。
共纳入 106 名个体。仅在 FLX 与对照组的对比中,从静息到任务时 HRV 的变化与 IE 的改善呈正相关(估计值=-80.24;SE=27.31;p=0.005),而在 BMT 与对照组的对比中则无相关性。
基线时更灵活的 HRV 仅在 FLX 组中预测 EI 的改善。这一发现具有临床意义,因为它可能有助于我们为 GAD 开发更个性化的干预措施。