Unipolar Depressive and Bipolar Disorder and the Autonomic Nervous System in the Netherlands Study of Depression and Anxiety (NESDA).

Krol, H.W. (Hajo) (2014) Unipolar Depressive and Bipolar Disorder and the Autonomic Nervous System in the Netherlands Study of Depression and Anxiety (NESDA). thesis, Medicine.

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Abstract

Background: Unipolar depressive and bipolar disorders are severely disabling disorders. Patients with bipolar disorder are often initially misdiagnosed as suffering from unipolar disorder as diagnostic criteria partly overlap, which delays selecting optimal treatment strategies. Differences in etiology have been suggested before, however, differences in deregulation and especially reactivity of the cardiac autonomic nervous system (ANS) have not extensively been studied before. Objective: Testing differences in cardiac ANS activity and reactivity between participants with current unipolar depression, bipolar disorder and healthy controls, while excluding the confounding effects of antidepressants. Design: Cross-sectional design. Participants: Based on the Diagnostic and Statistical Manual 4, the Composite International Diagnostic Interview and the Inventory of Depressive Symptomatology, participants of the Netherlands Study of Depression and Anxiety were classified as current unipolar disorder (n=275), current bipolar disorder (n=32) and healthy controls (n=426). Main Outcome Measures: Three cardiac ANS variables assessed at rest and stress conditions: Heart Rate (HR), Root Mean Square of Successive Differences (RMSSD) and Pre-Ejection Period (PEP). Values for the rest and task conditions and their differences (reactivity scores) were calculated. Results: HR at rest was higher in healthy controls compared to patients with unipolar depression and HR reactivity was higher in patients with unipolar depression compared to healthy controls. No further differences between the groups were found. Conclusion: While some differences in cardiac ANS activity and reactivity were found between patients with unipolar depression and healthy controls, the effects were small and not in the direction we expected. These findings call the specific role of ANS measures in unraveling the differences in pathophysiology of these mood disorders into question.

Item Type:	Thesis (Thesis)
Supervisor name:	Boschloo, Lynn
Supervisor name:	Licht, Carmilla MM and VU University Medical Center and Amsterdam
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:01
Last Modified:	25 Jun 2020 11:01
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2146

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