Balogh S, Fitzpatrick D F, Hendricks S E, Paige S R
Creighton-Nebraska Department of Psychiatry, Omaha.
Psychopharmacol Bull. 1993;29(2):201-6.
We obtained Hamilton Rating Scale for Depression (HAM-D) scores and recorded 5 minutes of rhythm strip both before and after a therapeutic trial of antidepressant medications in 17 patients diagnosed with major depressive disorder (MDD). We calculated the standard deviation (SD) of interbeat intervals and the mean squared successive difference (MSSD) as measures of heart-rate variability (HRV). We then calculated Spearman rank-ordered correlation coefficients between the HRV measures and the HAM-D scores. Changes in SD and MSSD correlated with post-treatment HAM-D scores and with changes in HAM-D scores. These relationships were strongest in patients who responded positively to nontricyclic antidepressant medications. HRV before treatment was not predictive of treatment response, nor did HRV reliably reflect the severity of depressive symptoms. These findings indicate that pharmacologic treatment leading to improvement in MDD is associated with increased HRV. Hence, brief measures of HRV could be developed as a useful adjunctive, physiologic measure of treatment response to pharmacotherapy in clinical trials and other settings. Further, increased HRV associated with successful treatment of MDD may reflect improved autonomic function, decreasing the risk of cardiovascular mortality found in patients with MDD.
我们获取了17名被诊断为重度抑郁症（MDD）的患者在进行抗抑郁药物治疗试验前后的汉密尔顿抑郁量表（HAM-D）评分，并记录了5分钟的心律图。我们计算了心跳间期的标准差（SD）和均方连续差（MSSD）作为心率变异性（HRV）的指标。然后，我们计算了HRV指标与HAM-D评分之间的斯皮尔曼等级相关系数。SD和MSSD的变化与治疗后的HAM-D评分以及HAM-D评分的变化相关。这些关系在对非三环类抗抑郁药物反应阳性的患者中最为明显。治疗前的HRV不能预测治疗反应，HRV也不能可靠地反映抑郁症状的严重程度。这些发现表明，导致MDD改善的药物治疗与HRV增加有关。因此，在临床试验和其他环境中，可将简短的HRV测量开发为一种有用的辅助生理指标，用于评估药物治疗的反应。此外，与MDD成功治疗相关的HRV增加可能反映了自主神经功能的改善，降低了MDD患者心血管死亡的风险。
