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Autonomic dysregulation, cognition and fatigue in people with depression and in active and healthy controls: observational cohort study

BACKGROUND: Autonomic nervous system (ANS) dysregulation might be relevant to the pathophysiology of fatigue and cognitive impairment in depression and perhaps should be considered when making prescribing decisions. AIMS: To determine the relationship of self-reported ANS symptoms with fatigue, cogn...

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Autores principales: Costa, Tiago, Taylor, Abigail, Black, Francesca, Hill, Sean, McAllister-Williams, R. Hamish, Gallagher, Peter, Watson, Stuart
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305035/
https://www.ncbi.nlm.nih.gov/pubmed/37313995
http://dx.doi.org/10.1192/bjo.2023.68
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author Costa, Tiago
Taylor, Abigail
Black, Francesca
Hill, Sean
McAllister-Williams, R. Hamish
Gallagher, Peter
Watson, Stuart
author_facet Costa, Tiago
Taylor, Abigail
Black, Francesca
Hill, Sean
McAllister-Williams, R. Hamish
Gallagher, Peter
Watson, Stuart
author_sort Costa, Tiago
collection PubMed
description BACKGROUND: Autonomic nervous system (ANS) dysregulation might be relevant to the pathophysiology of fatigue and cognitive impairment in depression and perhaps should be considered when making prescribing decisions. AIMS: To determine the relationship of self-reported ANS symptoms with fatigue, cognition and prescribed medication in people with a diagnosis of depression, in comparators without depression but with other mental health, neurodevelopmental or neurodegenerative disorders (active controls) and in healthy controls. METHOD: Cross-sectional analysis of an opportunistic sample from England. Self-reported data were collected on demographics, diagnosis, medication, ANS symptoms (Composite Autonomic Symptom Scale-31, COMPASS-31) and fatigue (Visual Analogue Scale for Fatigue, VAS-F). A subsample completed cognitive tests (THINC-it), including the subjective Perceived Deficits Questionnaire five-item version (PDQ-5). Spearman's correlation and mediation models were used to explore the relationship between COMPASS-31, VAS-F and PDQ-5 scores. RESULTS: Data were obtained for 3345 participants, 22% with depression. The depression group had significantly (P < 0.01) more severe autonomic dysregulation as measured by COMPASS-31 scores (median 30) than active (median 23) and healthy controls (median 10). The depression group had significantly higher symptom severity (P < 0.01) than both control groups on the VAS-F and PDQ-5. Overall, there was a significantly positive correlation (P < 0.01) between COMPASS-31, VAS-F scores (Spearman's rho r(s) = 0.44) and PDQ-5 scores (r(s) = 0.56). COMPASS-31 scores mediated greater symptom severity on the VAS-F and PDQ-5 for those with depression. COMPASS-31 scores remained significantly different between the depression group and both control groups independently of medication. CONCLUSIONS: People with a diagnosis of depression report worse fatigue and cognition than active and healthy comparators; this appears to be mediated by ANS dysregulation.
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spelling pubmed-103050352023-06-29 Autonomic dysregulation, cognition and fatigue in people with depression and in active and healthy controls: observational cohort study Costa, Tiago Taylor, Abigail Black, Francesca Hill, Sean McAllister-Williams, R. Hamish Gallagher, Peter Watson, Stuart BJPsych Open Paper BACKGROUND: Autonomic nervous system (ANS) dysregulation might be relevant to the pathophysiology of fatigue and cognitive impairment in depression and perhaps should be considered when making prescribing decisions. AIMS: To determine the relationship of self-reported ANS symptoms with fatigue, cognition and prescribed medication in people with a diagnosis of depression, in comparators without depression but with other mental health, neurodevelopmental or neurodegenerative disorders (active controls) and in healthy controls. METHOD: Cross-sectional analysis of an opportunistic sample from England. Self-reported data were collected on demographics, diagnosis, medication, ANS symptoms (Composite Autonomic Symptom Scale-31, COMPASS-31) and fatigue (Visual Analogue Scale for Fatigue, VAS-F). A subsample completed cognitive tests (THINC-it), including the subjective Perceived Deficits Questionnaire five-item version (PDQ-5). Spearman's correlation and mediation models were used to explore the relationship between COMPASS-31, VAS-F and PDQ-5 scores. RESULTS: Data were obtained for 3345 participants, 22% with depression. The depression group had significantly (P < 0.01) more severe autonomic dysregulation as measured by COMPASS-31 scores (median 30) than active (median 23) and healthy controls (median 10). The depression group had significantly higher symptom severity (P < 0.01) than both control groups on the VAS-F and PDQ-5. Overall, there was a significantly positive correlation (P < 0.01) between COMPASS-31, VAS-F scores (Spearman's rho r(s) = 0.44) and PDQ-5 scores (r(s) = 0.56). COMPASS-31 scores mediated greater symptom severity on the VAS-F and PDQ-5 for those with depression. COMPASS-31 scores remained significantly different between the depression group and both control groups independently of medication. CONCLUSIONS: People with a diagnosis of depression report worse fatigue and cognition than active and healthy comparators; this appears to be mediated by ANS dysregulation. Cambridge University Press 2023-06-14 /pmc/articles/PMC10305035/ /pubmed/37313995 http://dx.doi.org/10.1192/bjo.2023.68 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Paper
Costa, Tiago
Taylor, Abigail
Black, Francesca
Hill, Sean
McAllister-Williams, R. Hamish
Gallagher, Peter
Watson, Stuart
Autonomic dysregulation, cognition and fatigue in people with depression and in active and healthy controls: observational cohort study
title Autonomic dysregulation, cognition and fatigue in people with depression and in active and healthy controls: observational cohort study
title_full Autonomic dysregulation, cognition and fatigue in people with depression and in active and healthy controls: observational cohort study
title_fullStr Autonomic dysregulation, cognition and fatigue in people with depression and in active and healthy controls: observational cohort study
title_full_unstemmed Autonomic dysregulation, cognition and fatigue in people with depression and in active and healthy controls: observational cohort study
title_short Autonomic dysregulation, cognition and fatigue in people with depression and in active and healthy controls: observational cohort study
title_sort autonomic dysregulation, cognition and fatigue in people with depression and in active and healthy controls: observational cohort study
topic Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305035/
https://www.ncbi.nlm.nih.gov/pubmed/37313995
http://dx.doi.org/10.1192/bjo.2023.68
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