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Anxiety and Depression Are Related to Autonomic Nervous System Function in Women with Irritable Bowel Syndrome

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Abstract

This study compared women with irritable bowel syndrome who had a history of an anxiety or depressive disorder to those without symptoms of either disorder on indicators of cardiac parasympathetic activity, autonomic nervous system balance, and general autonomic activity. The Diagnostic Interview Schedule was used to determine anxiety or depressive disorders, and a Holter monitor was used to record R-R intervals over 24 hr. A similar comparison was done with healthy controls. Among women with irritable bowel syndrome, those with a positive history had lower parasympathetic and general activity throughout the 24-hr period than did women without a diagnosis. Indicators of autonomic balance were slightly higher in women with a positive history compared to those without a history. Similar differences were seen in controls. Thus, a history of anxiety and depressive disorders is associated with lower parasympathetic activity, both in women with IBS and healthy controls. Further exploration is needed to understand if lower parasympathetic activity influences the pain and stool pattern changes seen in persons with irritable bowel syndrome.

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References

  1. Drossman D, Creed F, Olden K, Svedlund J, Toner B, Whitehead WE: Psychosocial aspects of the functional gastrointestinal disorders. Gut 45:1125-1130, 1999

    Google Scholar 

  2. Mayer EA, Chang L, Lembo T: Brain-gut interactions: implications for newer therapy. Eur J Surg 582:50-55, 1998

    Google Scholar 

  3. Adeyemi EO, Desai KD, Towsey M, Ghista D: Characterization of autonomic dysfunction in patients with irritable bowel syndrome by means of heart rate variability studies. Am J Gastroenterol 94:816-823, 1999

    Google Scholar 

  4. Lee C, Chuang T, Lu C, Chen C, Chang F, Lee S: Abnormal vagal cholinergic function and psychological behaviors in irritable bowel syndrome patients: a hospital-based Oriental study. Dig Dis Sci 43:1794-1799, 1998

    Google Scholar 

  5. Aggarwal A, Cutts T, Abell T, Cardosa S, Familoni B, Bremer J: Predominant symptoms in irritable bowel syndrome correlate with specific autonomic nervous system abnormalities. Gastroenterology 106:945-950, 1994

    Google Scholar 

  6. Lee K, Rhee P, Kim J, Koh K, Paik S, Rhee J, Kim J: Assessment of autonomic tone over a 24-hour period in patients with irritable bowel syndrome. Gastroenterology 112:A773, 1997

    Google Scholar 

  7. Heitkemper M, Jarrett M, Cain KC, Burr R, Levy RL, Feld A, Hertig V: Autonomic nervous system function in women with irritable bowel syndrome. Dig Dis Sci 46:1276-1284, 2001

    Google Scholar 

  8. Cohen H, Kotler M, Matar M, Kaplan Z: Normalization of heart rate variability in post-traumatic stress disorder patients following fluoxentine treatment: preliminary results. Isr Med Assoc J 2:296-301, 2000

    Google Scholar 

  9. Rechlin T, Weis M, Spitzer A, Kaschka WP: Are affective disorders associated with alterations of heart rate variability? J Affect Disord 32:271-275, 1994

    Google Scholar 

  10. Yeragani VK, Pohl R, Balon R, Ramesh C, Glitz D, Jung I, Sherwood P: Heart rate variability in patients with major depression. Psychiatry Res 37:35-46, 1991

    Google Scholar 

  11. Agelink MW, Majewski T, Wurthmann C, Postert T, Linka T, Rotterdam S, Klieser E: Autonomic neurocardiac function in patients with major depression and effects of antidepressive treatment with nefazodone. J Affect Disord 62:187-198, 2001

    Google Scholar 

  12. Moser M, Lehofer M, Hoehn-Saric R, McLeod DR, Hildebrandt G, Steinbrenner B, Voica M, Liebmann P, Zapotoczky HG: Increased heart rate in depressed subjects in spite of unchanged autonomic balance? J Affect Disord 48:115-124, 1998

    Google Scholar 

  13. Hudson JI, Goldenberg DL, Pope HGJ: Comorbidity of fibromyalgia with medical and psychiatric disorders. Am J Med 92:363-367, 1992

    Google Scholar 

  14. McCrathy R, Atkinson M, Tiller W, Rein G, Watkins A: The effects of emotions on short-term power spectrum analysis of heart rate variability. Am J Cardiol 76:1089-1093, 1995

    Google Scholar 

  15. Sloan R, Shapiro P, Bigger T, Bagiella E, Steinman R, Gorman J: Cardiac autonomic control and hostility in healthy subjects. Am J Cardiol 74:298-300, 1994

    Google Scholar 

  16. Watkins LL, Grossman P, Krishnan R, Sherwood A: Anxiety and vagal control of heart rate. Psychosom Med 60:498-502, 1998

    Google Scholar 

  17. Dishman R, Nakamura Y, Garcia M, Thompson R, Dunn A, Blair S: Heart rate varilabilty, trait anxiety, and perceived stress among physically fit men and women. Int J Psychophysiol 37:121-133, 2000

    Google Scholar 

  18. Drossman DA: Do psychosocial features define sympton severity and patient status in irritable bowel syndrome? Am J Med 107:41S-50S, 1999

    Google Scholar 

  19. Thompson W, Dotevall G, Drossman D, Heaton K, Kruis W: Irritable bowel syndrome: Guidelines for the diagnosis. Gastroenterology Int 2:92-95, 1989

    Google Scholar 

  20. Robins LN, Helzer JE, Croughan J, Ratcliff KS: National institute of mental health diagnostic interview schedule. Arch Gen Psychiatry 38:381-389, 1981

    Google Scholar 

  21. Walker EA, Roy-Byrne PP, Katon WJ, Li L, Amos D, Jiranek G: Psychiatric illness and irritable bowel syndrome: a comparison with inflammatory bowel disease. Am J Psychiatry 147:1656-1661, 1990

    Google Scholar 

  22. Helzer JE, Robins LN, McEvoy LT, Spitznagel EL, Stoltzman RK, Farmer A, Brockington IF: A comparison of clinical and diagnostic interview schedule diagnoses. Physician reexamination of lay-interviewed cases in the general population. Arch Gen Psychiatry 42:657-666, 1985

    Google Scholar 

  23. Wells KB, Burnam MA, Rogers W, Hays R, Patti C: The course of depression in adult outpatients. Results from the medical outcomes study. Arch Gen Psychiatry 49:788-794, 1992

    Google Scholar 

  24. Derogatis LR, Cleary PA: Factorial invariance across gender for the primary symptom dimensions of the SCL-90. Br J Soc Clin Psychol 16:347-356, 1977

    Google Scholar 

  25. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology: Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17:354-381, 1996

    Google Scholar 

  26. Ori Z, Monir G, Weiss J, Sayhouni X, Singer DH: Heart rate variability. Frequency domain analysis. Cardiol Clin 10:499-537, 1992

    Google Scholar 

  27. Kleiger RE, Stein PK, Bosner MS, Rottman JN: Time domain measurements of heart rate variability. Cardiol Clin 10:487-498, 1992

    Google Scholar 

  28. Talley N, Phillips S, Wiltgen C, Zinsmeister A, Melton Lr: Assessment of functional gastrointestinal disease: the bowel disease questionnaire. Mayo Clin Proc 65:1456-1479, 1990

    Google Scholar 

  29. Drossman D, Corazziari E, Thompson W, Talley N, Whitehead WE. Rome II: The Functional gastrointestinal disorders. McLean, Virginia: Degnon Associates, 2000.

    Google Scholar 

  30. O'Brien PC: Procedures for comparing samples with multiple endpoints. Biometrics 40:1079-1087, 1984

    Google Scholar 

  31. Umetani K, Singer D, McCraty R, Atkinson M: Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. J Am Coll Cardiol 31:593-601, 1998

    Google Scholar 

  32. Karason K, Molgaard H, Wikstrand J, Sjostrom L: Heart rate variability in obesity and the effect of weight loss. Am J Cardiol 83:1242-1247, 1999

    Google Scholar 

  33. Hughes J, Stoney C: Depressed mood is related to high-frequency heart rate variability during stressors. Psychosom Med 62:796-803, 2000

    Google Scholar 

  34. Cohen H, Neumann L, Alhosshle A, Kotler M, Abu-Shakra M, Buskila D: Abnormal sympathovagal balance in men with fibromyalgia. J Rheumatol 28:581-589, 2001

    Google Scholar 

  35. Cohen H, Neumann L, Shore M, Amir M, Cassuto Y, Buskila D: Autonomic dysfunction in patients with fibromyalgia: application of power spectral analysis of heart rate variability. Semin Arthritis Rheum 29:217-227, 2000

    Google Scholar 

  36. Drossman DA: Review article: an integrated approach to the irritable bowel syndrome. Aliment Pharmacol Ther 13 (suppl 2):3-14, 1999

    Google Scholar 

  37. Tougas G: The autonomic nervous system in functional bowel disorders. Gut 47 (suppl 4):78-80, 2000

    Google Scholar 

  38. Watanabe M, Shimada Y, Sakai S, Shibahara N, Matsuda H, Umeno K, Asanoi H, Terasawa K: Effects of water ingestion on gastric electrical activity and heart-rate variability in healthy human subjects. J Auton Nerv Syst 58:44-50, 1996

    Google Scholar 

  39. Malik M, Camm AJ: Components of heart rate variability—what they really mean and what we really measure. Am J Cardiol 72:821-822, 1993

    Google Scholar 

  40. Nolan J, Flapan AD, Goodfield NE, Prescott RJ, Bloomfield P, Neilson JM, Ewing DJ: Measurement of parasympathetic activity from 24-hour ambulatory electrocardiograms and its reproducibility and sensitivity in normal subjects, patients with symptomatic myocardial ischemia, and patients with diabetes mellitus. Am J Cardiol 77:154-158, 1996

    Google Scholar 

  41. Van Hoogenhuyze D, Weinstein N, Martin GJ, Weiss JS, Schaad JW, Sahyouni XN, Fintel D, Remme WJ, Singer DH: Reproducibility and relation to mean heart rate of heart rate variability in normal subjects and in patients with congestive heart failure secondary to coronary artery disease. Am J Cardiol 68:1668-1676, 1991

    Google Scholar 

  42. Elsenbruch S, Orr WC: Diarrhea-and constipation-predominant IBS patients differ in postprandial autonomic and cortisol responses. Am J Gastroenterol 96:460-466, 2001

    Google Scholar 

  43. Mayer EA, Naliboff BD, Chang L, Coutinho SV: V. Stress and irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol 280:G519-G524, 2001

    Google Scholar 

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Jarrett, M.E., Burr, R.L., Cain, K.C. et al. Anxiety and Depression Are Related to Autonomic Nervous System Function in Women with Irritable Bowel Syndrome. Dig Dis Sci 48, 386–394 (2003). https://doi.org/10.1023/A:1021904216312

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