Analysis of heart rate variability in college students with depression and suicidal ideation
-
摘要:
目的 比较抑郁伴自杀意念大学生与抑郁不伴自杀意念大学生心率变异性(HRV)指标的差异,为高校大学生自杀筛查与预防工作提供客观生理依据。 方法 于2023年3—4月通过网络及校园招募的形式招募黑龙江省大庆市3所高校的60名17~25岁在校抑郁大学生为研究对象,根据是否存在自杀意念,分为抑郁伴自杀意念组(30例)与抑郁不伴自杀意念组(30例)。应用自编一般资料调查表、汉密尔顿抑郁量表(HAMD)、贝克自杀意念问卷(SSI)对大学生进行调查,并于2023年5月对两组被试进行5 min静息HRV数据采集,采用t检验或Mann-Whitney U检验进行统计学分析。 结果 抑郁伴自杀意念组大学生的SSI和HAMD得分[7.00(4.25,16.00),40.73±12.88]均高于抑郁不伴自杀意念组[4.50(1.75,6.00),29.17±8.15](Z/t值分别为-6.64,4.16,P值均 < 0.01)。抑郁伴自杀意念组大学生HRV时域指标中的正常心搏R-R间期标准差(SDNN)、正常R-R心搏间期每隔5 min平均值的标准差(SDANN)、正常R-R间期每隔5 min标准差的平均值(SDNN Index)[42.75(35.03, 60.75)ms,32.75(26.65, 46.88)ms,(298.82±61.61)ms]均低于抑郁不伴自杀意念组[50.80(46.15, 59.68)ms,38.80(34.50, 45.80)ms,(329.20±50.80)ms](Z/t值分别为-2.43,-2.20,-2.08,P值均 < 0.05)。抑郁伴自杀意念组大学生频域指标中的极低频功率(VLF)[0.02(0.02, 0.02)Hz]高于抑郁不伴自杀意念组[0.02(0.01, 0.02)Hz](Z=-2.19,P < 0.05)。 结论 抑郁伴自杀意念大学生的抑郁水平较高、自主神经功能失衡,HRV或可能成为识别自杀意念的客观生理指标。 Abstract:Objective To compare the differences in heart rate variability (HRV) indicators between depressive college students with and without suicidal ideation, so as to provide a reliable objective physiological basis for suicide screening and prevention among college students. Methods From March to April 2023, a total of 60 college students with depression aged 17-25 years old were recruited from three universities in Daqing City, Heilongjiang Province through online and campus recruitment. They were divided into the depression with suicidal ideation group (30 cases) and the depression without suicidal ideation group (30 cases) based on the presence of suicidal ideation. A screening survey was conducted on college students using a self-designed general information questionnaire, Hamilton Depression Scale (HAMD), and Scale for Suicide Ideation (SSI). In May 2023, 5-minute resting HRV data was collected from the two groups of participants, and statistical analysis was conducted using t-tests or Mann-Whitney U tests. Results The SSI and HAMD scores of college students in the depression group with suicidal ideation [7.00(4.25, 16.00), 40.73±12.88] were higher than those in the depression group without suicidal ideation [4.50(1.75, 6.00), 29.17±8.15] (Z/t=-6.64, 4.16, P < 0.01). The standard deviation of the NN (SDNN), standard deviation of the average NN intervals (SDANN) and standard deviation of the NN interval every 5 minutes (SDNN Index) in the HRV time-domain indicators of college students with depression and suicidal ideation [42.75(35.03, 60.75)ms, 32.75(26.65, 46.88)ms, (298.82±61.61)ms] were lower than those in the depression without suicidal ideation group [50.80(46.15, 59.68)ms, 38.80(34.50, 45.80)ms, (329.20±50.80)ms] (Z/t=-2.43, -2.20, -2.08, P < 0.05). The very low frequency (VLF) in frequency domain indicators of college students with depression and suicidal ideation [0.02(0.02, 0.02)Hz] was higher than that in the depression group without suicidal ideation [0.02(0.01, 0.02)Hz] (Z=-2.19, P < 0.05). Conclusions College students with suicidal ideation have higher levels of depression and imbalanced autonomic nervous system function, and HRV may become an objective physiological indicator for identifying suicidal ideation. -
Key words:
- Depression /
- Suicide /
- Heart rate /
- Mental health /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 两组大学生HRV时域指标比较[M(P25, P75), ms]
Table 1. Comparison of HRV Time-Domain Indicators among two groups[M(P25, P75), ms]
组别 人数 SDNN SDANN pNN50 RMSSD SDNN Index* 抑郁伴自杀意念组 30 42.75(35.03, 60.75) 32.75(26.65, 46.88) 1.15(0.20, 4.15) 33.05(24.20,44.55) 298.82±61.61 抑郁不伴自杀意念组 30 50.80(46.15, 59.68) 38.80(34.50, 45.80) 1.80(0.98, 9.60) 35.05(30.28, 46.83) 329.20±50.80 Z/t值 -2.43 -2.20 -1.80 -1.46 -2.08 P值 0.02 0.03 0.07 0.14 0.04 注: *符合正态分布,用(x±s)表示。 表 2 两组大学生HRV频域分析指标比较[M(P25, P75)]
Table 2. Comparison of HRV Frequency-Domain Indicators among two groups[M(P25, P75)]
组别 人数 LF/HF VLF/Hz LF/Hz HF/Hz* 抑郁伴自杀意念组 30 1.30(0.88, 1.80) 0.02(0.02, 0.02) 0.85(0.07, 0.09) 0.26±0.06 抑郁不伴自杀意念组 30 1.24(0.70,2.32) 0.02(0.01, 0.02) 0.08(0.07, 0.09) 0.28±0.06 Z/t值 -0.36 -2.19 -0.28 -1.29 P值 0.72 0.03 0.78 0.20 注: *符合正态分布,用(x±s)表示。 -
[1] 张芮, 杨晨韵, 张耀东. 中国大学生抑郁影响因素的Meta分析[J]. 中国全科医学, 2020, 23(35): 4497-4502. doi: 10.12114/j.issn.1007-9572.2020.00.135ZHANG R, YANG C Y, ZHANG Y D. Influencing factors of depression in Chinese college students: a Meta-analysis[J]. Chin Gen Pract, 2020, 23(35): 4497-4502. (in Chinese) doi: 10.12114/j.issn.1007-9572.2020.00.135 [2] 吴冉. 大学生的自杀风险及短时冥想的干预效果[D]. 上海: 中国人民解放军海军军医大学, 2019.WU R. Suicide risk of college students and the effect of brief meditation training[D]. Shanghai: Naval Medical University, 2019. (in Chinese) [3] 张春妹, 夏梦雅. 自杀成因的心理学理论研究[J]. 理论月刊, 2012(12): 163-167. https://www.cnki.com.cn/Article/CJFDTOTAL-LLYK201212038.htmZHANG C M, XIA M Y. Psychological theoretical research on the causes of suicide[J]. Theor Monthly, 2012(12): 163-167. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-LLYK201212038.htm [4] 吴才智, 周忠英, 于丽霞, 等. 询问自杀会不会"诱发"自杀风险?自杀筛查和风险评估的医源性影响[J]. 中国临床心理学杂志, 2023, 31(5): 1140-1144, 1149. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY202305022.htmWU C Z, ZHOU Z Y, YU L X, et al. Asking suicide can't induce suicidal risk: the latrogenic effects of suicide screening and suicide risk assessment[J]. Chin J Clin Psychol, 2023, 31(5): 1140-1144, 1149. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY202305022.htm [5] ZENG W W, YANG F, SHEN W L, et al. Interactions between central nervous system and peripheral metabolic organs[J]. Sci China Life Sci, 2022, 65(10): 1929-1958. doi: 10.1007/s11427-021-2103-5 [6] 孙造诣, 陈思恬, 徐云. 心率变异性与抑郁关系的研究新进展[J]. 中国临床心理学杂志, 2022, 30(6): 1394-1397. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY202206024.htmSUN Z Y, CHEN S T, XU Y. New advance in research on the relationship between heart rate variability and depression[J]. Chin J Clin Psychol, 2022, 30(6): 1394-1397. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY202206024.htm [7] ARAKAKI X, ARECHAVALA R J, CHOY E H, et al. The connection between heart rate variability (HRV), neurological health, and cognition: a literature review[J]. Front Neurosci, 2023, 17: 1055445. doi: 10.3389/fnins.2023.1055445 [8] 刘文娜, 李榕, 王晓明, 等. 老年焦虑抑郁情绪及睡眠障碍对心率变异性的影响[J]. 空军军医大学学报, 2023, 44(5): 444-448. https://www.cnki.com.cn/Article/CJFDTOTAL-DSJY202305012.htmLIU W N, LI R, WANG X M, et al. Effects of anxiety, depression and sleep disorders on heart rate variability in the elderly[J]. J Air Force Med Univ, 2023, 44(5): 444-448. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-DSJY202305012.htm [9] ESTRELA C, MCGRATH J, BOOIJ L, et al. Heart rate variability, sleep quality, and depression in the context of chronic stress[J]. Ann Behav Med, 2021, 55(2): 155-164. doi: 10.1093/abm/kaaa039 [10] 汪向东, 王希林, 马弘. 心理卫生评定量表手册(增订版)[M]. 北京: 中国心理卫生杂志社, 1999: 220-223.WANG X D, WANG X L, MA H. Handbook of Mental Health Assessment Scales (Revis Edit)[M]. Beijing: China Journal of Mental Health, 1999: 220-223. (in Chinese) [11] BECK A T, BROWN G K, STEER R A. Psychological characteristics of the Scale for Suicide Ideation with psychological patients[J]. Behav Res Ther, 1997, 35: 1039-1046. doi: 10.1016/S0005-7967(97)00073-9 [12] 况丹妮. 基于心率变异性的抑郁症辅助诊断技术研究[D]. 广州: 华南理工大学, 2020.KUANG D N. Assisted diagnosis technology of depression using heart rate variability[D]. Guangzhou: South China University of Technology, 2020. (in Chinese) [13] 蒋颖, 袁勇贵. 自主神经功能评定的研究进展[J]. 实用老年医学, 2018, 32(12): 1179-1182. https://www.cnki.com.cn/Article/CJFDTOTAL-SYLA201812022.htmJIANG Y, YUAN Y G. Research progress in the assessment of autonomic nervous function[J]. Pract Geriatr, 2018, 32(12): 1179-1182. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SYLA201812022.htm [14] 辛颖. "交感神经副交感神经迷走神经植物神经"相关概念辨析[J]. 生物学教学, 2021, 46(10): 73-74. https://www.cnki.com.cn/Article/CJFDTOTAL-SWJX202110032.htmXIN Y. Differentiation and analysis of the related concepts of sympathetic nerve, parasympathetic nerve, vagus nerve, and autonomic nerve[J]. Biol Teach, 2021, 46(10): 73-74. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SWJX202110032.htm [15] 王春乐, 陈炜, 唐晓鸿. 交感神经功能的评价方法[J]. 中华高血压杂志, 2014, 22(9): 888-891. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGZ201409032.htmWANG C L, CHEN W, TANG X H. Evaluation methods for sympathetic nerve function[J]. Chin J Hypertens, 2014, 22(9): 888-891. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGZ201409032.htm [16] 王婷婷, 马语晗, 冯梓侨, 等. 大学生焦虑抑郁状态下心率变异性特点的分析[J]. 校园心理, 2019, 17(3): 177-179. https://www.cnki.com.cn/Article/CJFDTOTAL-YXXL201903004.htmWANG T T, MA Y H, FENG Z Q, et al. Analysis of the characteristics of heart rate variability in anxiety and depression among college students[J]. Camp Psychol, 2019, 17(3): 177-179. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXXL201903004.htm [17] CHEN W L, ZHONG Q, CHEN H, et al. Heart rate variability in children and adolescents with major depressive disorder: a systematic review and Meta-analysis[J]. J Affect Disord, 2023, 335: 204-215. [18] 王双喜, 包呼格吉乐图. 积极和消极情绪对大学生心率变异性时域的影响[J]. 内蒙古师范大学学报(哲学社会科学版), 2012, 41(3): 16-19. https://www.cnki.com.cn/Article/CJFDTOTAL-NMGS201203004.htmWANG S X, BAOHUGE J L T. Effect of positive and negative emotion on time domain of heart rate variability of university students[J]. J Inner Mongolia Norm Univ (Philos Soc Sci), 2012, 41(3): 16-19. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-NMGS201203004.htm [19] 林君瑜, 王婷婷. 大学生抑郁自杀意念及影响因素的路径分析[J]. 心理月刊, 2022, 17(1): 43-45. https://www.cnki.com.cn/Article/CJFDTOTAL-XLYK202201015.htmLIN J Y, WANG T T. Path analysis of depression and suicide ideation and influencing factors of college students[J]. Psychol Magaz, 2022, 17(1): 43-45. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XLYK202201015.htm [20] VAN BENTUM J S, VAN BRONSWIJK S C, SIJBRANDIJ M, et al. Cognitive therapy and interpersonal psychotherapy reduce suicidal ideation independent from their effect on depression[J]. Depress Anx, 2021, 38(9): 940-949. [21] CAMERON S, BROWN V J, DRITSCHEL B, et al. Understanding the relationship between suicidality, current depressed mood, personality, and cognitive factors[J]. Psychol Psychother, 2017, 90(4): 530-549. [22] 杨权. 下丘脑-垂体-肾上腺皮质轴应激反应的中枢控制[J]. 生理科学进展, 2000, 31(3): 222-226. https://www.cnki.com.cn/Article/CJFDTOTAL-SLKZ200003006.htmYANG Q. Central control of the hypothalamic-pituitary-adrenocortical axis for stress response[J]. Progress Physiol Sci, 2000, 31(3): 222-226. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SLKZ200003006.htm [23] KOX M, VAN EIJK L T, ZWAAG J, et al. Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans[J]. Proc Natl Acad Sci USA, 2014, 111(20): 7379-7384. [24] 袁源. 局部神经刺激降低心脏交感神经活性的作用及机制研究[D]. 上海: 上海交通大学, 2016.YUAN Y. Study on the effect and mechanism of local nerve stimulation on reducing cardiac sympathetic nervous activity[D]. Shanghai: Shanghai Jiao Tong University, 2016. (in Chinese) [25] 周祁娜, 蒋华, 周贤惠, 等. 导管消融去肾交感神经抑制星状神经节刺激诱发的心房颤动[J]. 中山大学学报(医学科学版), 2014, 35(2): 242-249. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSYK201402013.htmZHOU Q N, JIANG H, ZHOU X H, et al. Catheter-based renal sympathetic denervation significantly inhibits atrial fibrillation induced by electrical stimulation of left stellate ganglion and rapid atrial pacing[J]. J Sun Yat-sen Univ(Med Sci), 2014, 35(2): 242-249. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZSYK201402013.htm -

计量
- 文章访问数: 389
- HTML全文浏览量: 201
- PDF下载量: 42
- 被引次数: 0