Autonomic nervous system activity and psychiatric severity in schizophrenia
Autonomic nervous system activity and psychiatric severity in schizophrenia
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DOI：
10.1111/j.1440-1819.2009.01983.x
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发表时间：
2009-01-01
影响因子：
11.9
通讯作者：
Moritani, Toshio
中科院分区：
文献类型：
--
作者：
Fujibayashi, Mami;Matsumoto, Tamaki;Moritani, Toshio
目的：精神分裂症患者的死亡率是普通人群的两到三倍。尽管这种疾病得到了广泛的认识，但自主神经系统(ANS)活动如何以及在多大程度上对精神分裂症的影响仍然没有定论。因此，本研究的目的是确定与健康、匹配的对照组受试者ANS活动抑制的程度，以及使用全球功能评估(GAF)量表在精神分裂症患者中确定的精神障碍的严重程度，特别参考抗精神病药物的剂量。方法：这项研究包括71名精神分裂症患者和72名健康对照组。采用心率变异性功率谱分析评价ANS活性。结果：ANS相关频谱参数较对照组降低3/4(P<；0.01)。此外，根据GAF值对无心血管并发症的患者进行分类时，低GAF组的ANS(P=0.033)和副交感神经系统活动(PNS)活动(P=0.025)显著低于高GAF组。偏相关分析显示，在剔除年龄、性别、体重指数、抗精神病药物剂量和患者血脂谱的影响后，ANS活性与GAF评分显著相关。结论：低GAF组ANS活性显著降低，提示这种自主神经功能抑制可能与精神分裂症的严重程度有关。目前的数据进一步表明，总体ANS和PNS活动更抑郁的精神分裂症患者可能会遇到更高的心血管事件风险，如猝死。
Aims: Schizophrenia patients have a mortality rate two to three-fold higher than that of the general population. Despite the disorder's widespread recognition, how and to what extent autonomic nervous system (ANS) activity contributes to schizophrenia remains inconclusive. The aim of the present study, therefore, was to determine the extent of ANS activity depression with respect to healthy, well-matched control subjects and the severity of psychiatric disorders as determined using the Global Assessment of Functioning (GAF) scale among schizophrenia patients with special reference to antipsychotic dose.Methods: This study included 71 schizophrenia patients and 72 healthy controls. ANS activity was assessed by means of heart rate variability power spectral analysis.Results: ANS-related spectral parameters were three four-fold lower in the patients compared to the control group (P < 0.01). Furthermore, when the patients without cardiovascular complications were classified according to GAF score, overall ANS (P = 0.033) and parasympathetic nervous system (PNS) activity (P = 0.025) were significantly reduced in the low-GAF as compared to the high-GAF group. Partial correlation analyses demonstrated that ANS activity was significantly correlated with GAF score while statistically eliminating the effects of age, gender, body mass index, antipsychotic dose, and lipid profiles of the patient population.Conclusion: The significantly lower ANS activity in the low-GAF group suggests that such autonomic functional depression could be associated with the severity of schizophrenia. The present data further imply that schizophrenia patients with more depressed overall ANS and PNS activity might encounter increasing risks for cardiovascular events such as sudden death.