Anxiety and autonomic regulation in major depressive disorder: an exploratory study

Abstract

Spectral analysis of fluctuations in heart rate and blood pressure was employed to explore sympathetic and parasympathetic cardiovascular control mechanisms in relation to trait anxiety in major depressive disorder. Sixteen drug-free female depressed patients were divided into two groups: those who were high on trait anxiety (HTA, n = 9) and those who were normal or low on trait anxiety (LTA, n = 7). In patients and age-matched female controls (n = lo), heart rate (HR), blood pressure (BP; Finapres device) and respiration were recorded during a period of supine rest (10 min), orthostatic challenge (60" head-up tilting, 8 min), and post-orthostatic supine rest (8 min). Power spectra were calculated over the last 4 min of these three situations for HR, systolic BP, as well as for respiration. Spectral density was assessed for three frequency bands: low (0.02-0.06 Hz), mid (0.07-0.14 Hz) and high (0.15-0.50 Hz). Patients did not differ from controls during supine rest. During orthostatic challenge, HTA patients showed significantly more HR increase and suppression of high-frequency fluctuations of HR (suggesting stronger vagal inhibition) in comparison with the controls; this effect was accompanied by a significant increase in respiratory frequency. Both patients groups did not show the normal increase in mid-frequency band fluctuations of BP during orthostatic challenge, indicating reduced sympathetic activation. Low-frequency fluctuations of HR, as well as respiratory frequency during post-orthostatic supine rest of the HTA patients were significantly increased versus controls. This exploratory study indicates that trait anxiety may be a relevant factor when evaluating parasympathetic and sympathetic dysbalances in the state of a major depressive disorder.

Reactivity of heart rate variability after exposure to colored lights in healthy adults with symptoms of anxiety and depression

“…Previous studies comparing the resting HRV in healthy depressed participants with participants that were not depressed have reported inconsistent results. Some studies have reported no differences (Dishman et al, 2000;Hughes and Stoney, 2000;Shinba et al, 2008;Tulen et al, 1996). However, the most consistent finding is that anxiety and depressed mood are related to low levels of HF during exposure to stress (Hughes and Stoney, 2000;Ledowski et al, 2005;Light et al, 1998;Shinba et al, 2008).…”

Anxiety and Hostility Are Associated With Reduced Baroreflex Sensitivity and Increased Beat-to-Beat Blood Pressure Variability

“…Although reduced HRV based on 24-hour recording of the heart rate is associated with depression in patients with coronary artery disease (17,18), short-term HRV measured at supine rest does not differentiate depressive patients from their healthy controls (9,19,20). No data exist of the relationship between HRV and depression in the general population.…”

“…However, the effects of psychological symptoms, such as hostility, on HRV may only be revealed in recordings that are sufficiently long to produce transactions between individuals and their environments (15). Posture may also modify results during short-term recordings, as persons with panic disorder or anxiety have been found to have altered HRV only in the standing position and not at supine rest (8,9,11,19).…”

“…Previous studies of associations between psychological factors and HRV have been carried out predominantly with selected groups of subjects suffering from psychiatric disorders (7)(8)(9)(10)(11) or with apparently healthy volunteers (12)(13)(14)(15)(16). Although reduced HRV based on 24-hour recording of the heart rate is associated with depression in patients with coronary artery disease (17,18), short-term HRV measured at supine rest does not differentiate depressive patients from their healthy controls (9,19,20).…”

A biological perspective on differences and similarities between burnout and depression

“…stronger vagal withdrawal, compared to patients low on trait anxiety (Tulen et al, 1996). In a study involving different subgroups of unmedicated MDD patients -MDD without comorbidity, MDD with comorbid panic disorder and/or posttraumatic stress disorder and MDD comorbid with generalized anxiety disorder -decrease in HRV measures was most pronounced in patients with comorbid generalized anxiety disorder .…”