行为激活对亚临床抑郁老年人心率变异性时域和频域的影响：泰国的一项集群随机对照试验。
Effect of behavioral activation on time and frequency domain heart rate variability in older adults with subthreshold depression: a cluster randomized controlled trial in Thailand.
机构信息
Department of Community Public Health, School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand.
Research Center of Workers Health, Walailak University, Nakhon Si Thammarat, Thailand.
出版信息
BMC Psychiatry. 2022 May 5;22(1):319. doi: 10.1186/s12888-022-03962-8.
BACKGROUND
Increased prevalence of depression highlights the need for effective interventions. Behavioral activation (BA), which can easily be adapted for non-clinical populations, has been the recommended treatment for depression. It is based on a model of psychopathology explaining that losses or chronically low levels of positive reinforcement yield behavioral and emotional changes in depression and that encouraging individuals to increase their engagement in reinforcing activities can improve their mood and enhance their valuable life experiences. Heart rate variability (HRV) provides indices of autonomic function related to depression, but only a few studies have investigated the effect of BA on HRV, particularly among older adults with subthreshold depression. Accordingly, we aimed to investigate the effect of BA on HRV in older adults with subthreshold depression.
METHODS
We conducted a 9-month cluster randomized controlled trial in two Health Promoting Hospitals (HPHs). Eighty-two participants were randomized into either intervention (BA with usual care) or control (usual care only) groups, with 41 participants per group. Daily step count was collected weekly during the 12-week BA intervention period, while HRV parameters, including the Standard Deviation of the Normal-to-Normal interval (SDNN), High Frequency (lnHF), Low Frequency (LF), and Low Frequency/High Frequency ratio (LF/HF), were examined at 0, 3, 6 and 9 months. Generalized Estimating Equations (GEEs) were used in the data analysis.
RESULTS
Over nine months, the intervention and control groups differed significantly in the unadjusted mean change of HRV, SDNN [7.59 ms (95% CI: 1.67, 13.50)], lnHF [0.44 ms (95% CI: 0.04, 0.85)], and LF [0.53 ms (95% CI: 0.09, 0.98)], whereas the groups did not differ significantly in LF/HF ratio [0.01 ms (95% CI: -0.04, 0.06)].
CONCLUSION
Our results suggest that BA may have a therapeutic effect on depression symptoms of older adults with subthreshold depression via improved HRV.
TRIAL REGISTRATION
TCTR20211019003 , thaiclinicaltrials.org, retrospectively registered on 19 October 2021.
背景
抑郁患病率的增加凸显了对有效干预措施的需求。行为激活（BA），可以很容易地适用于非临床人群，已被推荐为抑郁症的治疗方法。它基于一种解释精神病理学的模型，该模型表明，损失或慢性低水平的正强化会导致抑郁中的行为和情绪变化，鼓励个人增加参与强化活动可以改善他们的情绪并增强他们有价值的生活体验。心率变异性（HRV）提供了与抑郁相关的自主功能的指标，但只有少数研究调查了 BA 对 HRV 的影响，特别是在有阈下抑郁的老年人中。因此，我们旨在研究 BA 对有阈下抑郁的老年人 HRV 的影响。
方法
我们在两家健康促进医院（HPH）进行了为期 9 个月的集群随机对照试验。82 名参与者被随机分为干预组（BA 加常规护理）或对照组（仅常规护理），每组 41 名参与者。在 12 周的 BA 干预期间，每周收集一次日常步数，而在 0、3、6 和 9 个月时检查 HRV 参数，包括正常到正常间期的标准差（SDNN）、高频（lnHF）、低频（LF）和低频/高频比（LF/HF）。使用广义估计方程（GEE）进行数据分析。
结果
在 9 个月的时间里，干预组和对照组在未经调整的 HRV 平均变化方面存在显著差异，SDNN[7.59ms（95%CI：1.67，13.50）]、lnHF[0.44ms（95%CI：0.04，0.85）]和 LF[0.53ms（95%CI：0.09，0.98）]，而两组在 LF/HF 比[0.01ms（95%CI：-0.04，0.06）]方面没有显著差异。
结论
我们的结果表明，BA 可能通过改善 HRV 对有阈下抑郁的老年人的抑郁症状产生治疗作用。
试验注册
TCTR20211019003，thaiclinicaltrials.org，于 2021 年 10 月 19 日回顾性注册。
Zotero 插件