Autonomic Dysfunction in Psychiatric Disorders

Year 2024, , 401 - 409, 30.09.2024

Hande Besna Göçen , Ali Veysel Özden

https://doi.org/10.18863/pgy.1329118

Abstract

The autonomic nervous system and its dysfunction are associated with many diseases. For a healthy individual, it is essential that the sympathetic and parasympathetic systems are balanced and functioning at a high capacity. Psychiatric disorders often exhibit disruptions in the activity of the vagus nerve, which can lead to autonomic dysfunction. People with psychiatric disorders, including panic disorder, depression, bipolar disorder, schizophrenia, post-traumatic stress disorder, anxiety disorders, and substance addiction, often show reduced heart rate variability. Heart rate variability is a reliable marker for assessing autonomic functions, and decreased heart rate variability in individuals with psychiatric disorders can lead to an increased risk of sudden cardiac death. Autonomic dysfunction is observed in psychiatric disorders, and it occurs during the course of the illness, not necessarily at its onset. Autonomic dysfunction accelerates the progression of the disease. Therefore, controlling autonomic functions is crucial. This can help reduce disease symptoms and decrease the morbidity and mortality caused by autonomic dysfunction."

Keywords

psychiatric disorders, autonomic dysfunction, heart rate variability

Psikiyatrik Bozukluklarda Otonom Disfonksiyon

Abstract

Otonom sinir sistemi ve disfonksiyonu birçok hastalıkla ilişkilidir. Sağlıklı bir birey için sempatik ve parasempatik sistemin dengede olması ve kapasitesinin yüksek olması gerekir. Psikiyatrik hastalıklarda vagus sinirinin aktivitesinde bozulmalar vardır. Bu bozulmalar otonom disfonksiyona sebep olabilir. Panik bozukluğu, depresyon, bipolar bozukluk, şizofreni, travma sonrası stres bozukluğu, anksiyete bozuklukları ve madde bağımlılığı dahil olmak üzere psikiyatrik bozuklukları olan kişilerde kalp atış hızı değişkenliğinde azalmalar görülmektedir. Kalp atış hızı değişkenliği otonom fonksiyonların belirlenmesinde güvenilir bir belirteçtir ve kalp atış hızındaki azalmalar psikiyatrik bozuklukları olan hastalarda ani kardiyak ölüm riskine neden olmaktadır. Psikiyatrik hastalıklarda otonom disfonksiyon görülmektedir. Otonom disfonksiyon hastalığın başlangıcında değil hastalık sürecinde gerçekleşmektedir. Otonom disfonksiyon hastalık progresyonunu hızlandırmaktadır. Bu yüzden otonom fonksiyonlar kontrol edilmelidir. Böylece hastalık semptomları bu sayede azalabilir ve otonom disfonksiyonun neden olduğu morbidite ve mortalite azaltılabilir.

Keywords

otonom disfonksiyon, kalp hızı değişkenliği, psikiyatrik bozukluklar

References

• Alvares GA, Quintana DS, Hickie IB, Guastella AJ (2016) Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis. J Psychiatry Neurosci, 41:89–104.
• Anderson EA, Sinkey C, Lawton W (1989) Elevated sympathetic nerve activity in borderline hypertensive humans. Evidence from direct intraneural recordings. Hypertension, 14:177-260.
• APA (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed (DSM-5). Washington DC, American Psychiatric Assocition
• Bailey R, Dana D, Bailey E, Davis F (2020) The application of tahe polyvagal theory to high conflict co‐parenting cases. Fam Court Rev, 58:525-543.
• Beauchaine TP, Gatzke-Kopp L, Mead HK (2007) Polyvagal theory and developmental psychopathology: emotion dysregulation and conduct problems from preschool to adolescence. Biol Psychol, 74:174–258.
• Berger S, Boettger MK, Tancer M, Guinjoan SM, Yeragani VK, Bär KJ (2010) Reduced cardiorespiratory coupling indicates suppression of vagal activity in healthy relatives of patients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry, 34:406–411.
• Bonaz B, Sinniger V, Pellissier S (2016) Vagal tone: effects on sensitivity, motility, and inflammation. Neurogastroenterol Motil, 28:455–462.
• Brewin CR (2001) A cognitive neuroscience account of posttraumatic stress disorder and its treatment. Behav Res Ther, 39:373-393.
• Buchhorn R, Conzelmann A, Willaschek C, Störk D, Taurines R, Renner TJ (2012) Heart rate variability and methylphenidate in children with ADHD. Atten Defic Hyperact Disord, 4:85–91.
• Carnevali L, Mancini M, Koenig J, Makovac E, Watson DR., Meeten F et al. (2019) Cortical morphometric predictors of autonomic dysfunction in generalized anxiety disorder. Auton Neurosci, 217:41–48.
• De Zwart, PL, Jeronimus BF, de Jonge P (2019) Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review. Epidemiol Psychiatr Sci, 28:544–562.
• Faraone SV, Asherson P, Banaschewski T, Biederman J, Buitelaar JK, Ramos-Quiroga JA et al. (2015) Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers, 1:15020.
• Fonkoue IT, Michopoulos V, Park J (2020) Sex differences in post-traumatic stress disorder risk: autonomic control and inflammation. Clin Auton Res, 30:409-421.
• Goldner EM, Hsu L, Waraich P, Somers JM (2002) Prevalence and incidence studies of schizophrenic disorders: a systematic review of the literature. Can J Psychiatry, 47:833–876.
• Guyton AC, Hall JE, Tuan DXA, Coquery S (2003) Précis de Physiologie Médicale. Paris, Piccin.
• Gündüz N, Akpınar Aslan E, Eren F, Sodan Turan H, Öztürk M, Tural Ü (2019) Analysis of 24-hour heart rate variability among panic disorder patients without previous drug treatment and comorbid disorders. Turk Psikiyatri Derg, 30:236–244.
• Herbsleb M, Schulz S, Ostermann S, Donath L, Eisenträger D, Puta CW et al. (2013) The relation of autonomic function to physical fitness in patients suffering from alcohol dependence. Drug Alcohol Depend, 132:505–512.
• Hong S, Park DH, Ryu SH, Ha JH, Jeon, HJ (2022) Association between heart rate variability indices and depressed mood in patients with panic disorder. Clin Psychopharmacol Neurosci, 20:737–746.
• La Rovere MT, Pinna GD, Maestri R (2003) Short-term heart rate variability strongly predicts sudden cardiac death in chronic heart failure patients. Circulation, 107:565-635
• Lee JS, Kim B, Hong Y, Joo YH (2012) Heart rate variability in the subsyndromal depressive phase of bipolar disorder. Psychiatry Clin Neurosci, 66:361–366.
• Licht CMM, de Geus EJC, van Dyck R, Penninx BW. (2009) Association between anxiety disorders and heart rate variability in The Netherlands Study of Depression and Anxiety (NESDA). Psychosom Med, 71:508-518.
• Lin HP, Lin HY, Lin WL, Huang AC (2011) Effects of stress, depression, and their interaction on heart rate, skin conductance, finger temperature, and respiratory rate: sympathetic-parasympathetic hypothesis of stress and depression. J Clin Psychol, 67:1080–1091.
• Kemp AH, Quintana DS, Gray MA (2010) Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis. Biol Psychiatry, 67:1067-1141.
• Koenen KC, Ratanatharathorn A, Ng L (2017) Posttraumatic stress disorder in the world mental health surveys. Psychol Med, 47:2260-2274.
• Quintana DS, McGregor IS, Guastella AJ (2013) A meta-analysis on the impact of alcohol dependence on short-term resting-state heart rate variability: implications for cardiovascular risk. Alcohol Clin Exp Res, 37:23-32.
• Mennin DS, Heimberg RG, Fresco DM, Ritter MR (2008) Is generalized anxiety disorder an anxiety or mood disorder? Considering multiple factors as we ponder the fate of GAD. Depress Anxiety, 25:289–299.
• Miglis MG (2016) Autonomic dysfunction in primary sleep disorders. Sleep Med, 19:40–49.
• Mulkey SB, du Plessis AJ (2019) Autonomic nervous system development and its impact on neuropsychiatric outcome. Pediatr Res, 85:120–126.
• Montagna A, Nosarti C. (2016) Socio-emotional development following very preterm birth: pathways to psychopathology. Front Psychol, 7:80.
• Montaquila JM, Trachik BJ, Bedwell JS (2015) Heart rate variability and vagal tone in schizophrenia: A review. J Psychiatr Res, 69:57–66.
• Porges SW, Furman SA. (2011) The early development of the autonomic nervous system provides a neural platform for social behavior: A polyvagal perspective. Infant Child Dev, 20:106–124
• Rukmani MR, Seshadri SP, Thennarasu K, Raju TR, Sathyaprabha TN (2016) Heart rate variability in children with attention-deficit/hyperactivity disorder: A pilot study. Ann Neurosci, 23:81–88.
• Robson D, Gray R (2007) Serious mental illness and physical health problems: a discussion paper. Int J Nurs Stud, 44:457–466.
• Schneider M, Schwerdtfeger A (2020) Autonomic dysfunction in posttraumatic stress disorder indexed by heart rate variability: a meta-analysis. Psychol Med, 50:1937–1948.
• Sekaninova N, Mestanik M, Mestanikova A, Hamrakova A, Tonhajzerova I. (2019). Novel approach to evaluate central autonomic regulation in attention deficit/hyperactivity disorder (ADHD). Physiol Res, 68:531–545.
• Sgoifo A, Carnevali L, Alfonso M deL, Amore M (2015) Autonomic dysfunction and heart rate variability in depression. Stress, 18:343–352.
• Stogios N, Gdanski A, Gerretsen P, Chintoh AF, Graff-Guerrero A, Rajji TK et al. (2021) Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and met abolic health. NPJ Schizophr, 7:22.
• Taylor EC, Livingston LA, Callan MJ, Ashwin C, Shah P (2021) Autonomic dysfunction in autism: The roles of anxiety, depression, and stress. Autism, 25:744–752.
• Thayer JF, Brosschot JF (2005) Psychosomatics and psychopathology: looking up and down from the brain. Psychoneuroendocrinology, 30:1050–1058
• Vahia VN (2013) Diagnostic and Statistical Manual of Mental Disorders 5: A quick glance. Indian J Psychiatry, 55:220–223.
• Wang T-S, Huang W-L, Kuo TB, Lee G-S, Yang CC (2013) Inattentive and hyperactive preschool-age boys have lower sympathetic and higher parasympathetic activity. J Physiol Sci, 63:87-94.
• Waxenbaum JA, Reddy V, Varacallo M (2023) Anatomy, Autonomic Nervous System. In: StatPearls. Treasure Island (FL), StatPearls Publishing.
• Wei M, Kampert JB, Barlow CE, Nichaman MZ, Gibbons LW, Paffenbarger RS et al. (1999) Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese men. JAMA, 282:1547–1553.