Mediating Effect Of Heart Rate Variability On The Risk Of Impulsive Aggression And Depression And Gender Differences

Objectives:Major Depressive Disorder(MDD)is a common mental disorder with high incidence,high mortality and high recurrence rate.Depression is a disease with significant international public health and economic implications,not only a waste of medical resources,but also a huge family and social burden.In-depth exploration and discussion of the risk and influencing factors of depression can provide biomarkers for identifying high-risk groups and conducting prevention and intervention,which has important clinical significance for the prevention of depression and the treatment of depression.This study explored the relationship between impulsive aggression,heart rate variability and the risk and severity of depression,and examined the mediating effect of heart rate variability on the risk of depression and gender differences.Methods:A cross-sectional study was conducted in 514 patients who met the Diagnostic and Statistical Manual of Mental Disorders,Fifth edition(DSM-V)criteria for depression and 112 healthy controls.The eleventh edition of the Impulsivity Scale(BIS-11)and Buss-Perry Aggression questionnaire(BPAQ)were used to evaluate impulsive aggression traits,the Hamilton Depression Scale(HAMD-24)was used to evaluate the severity of depression symptoms,and the frequency domain index of heart rate variability was used to evaluate autonomic nervous function.In the first step,a binary Logistics regression model and a linear regression model were established to screen the related factors of depression risk(or depression severity),with impulse-aggression trait as the independent variable,age as the dependent variable,and depression status(or depression severity)as the dependent variable.In the second step,the HRV frequency domain index was used as the independent variable,and the age variable and depression(or depression severity)were used as the dependent variable to establish a binary Logistics regression model and a linear regression model to screen the related factors of depression risk(or depression severity).In the third step,the positive indicators of the screened impulsive aggression characteristics were used as independent variables,and the positive indicators of HRV were used as dependent variables to observe whether HRV could mediate the effect of impulsive aggression on depression.Hayes’ Process procedure was used to examine the mediating effect of HRV on gender specific depression risk and severityA cross-sectional study included 514 patients who met the diagnostic criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders 5th Edition(DSM-V)and 112 healthy subjects as controls.The 11th edition of the impulsivity Scale(BIS-11),Buss-Perry Aggression Questionnaire(BPAQ),Hamilton Depression Scale(HAMD-24)and frequency domain index of heart rate variability were used to assess impulsive aggression traits.Binary logistic regression analysis and linear regression analysis were used to analyze the related factors of depression risk and severity.Hayes’ Process was used to test the mediating effect of heart rate variability on the risk and severity of depression of different genders.Results:(1)The higher the impulsive aggression,the higher the risk of depression in different genders(male:cognitive impulsivity(OR=1.292,P=0.001),hostility(OR=1.148,P<0.001);Female:cognitive impulse(OR=1.358,P=0.001),anger(OR=1.147,P=0.004),hostility(OR=1.203,P<0.001)and severity(male:cognitive impulse(P=0.019),hostility(P=0.001);Female:The higher the cognitive impulse(P=0.010)and hostility(P=0.003).(2)No mediating effect of heart rate variability was found between impulsive aggression and depression risk and severity(P>0.05).(3)The relationship between heart rate variability and impulsive aggression,depression risk and severity was different between different genders.The lower the HF-HRV,the higher the risk of depression in women,with statistical significance(p<0.05).The higher the LF-HRV,the higher the depression severity in women(p<0.05).The higher the female hostility,the higher the LF-HRV(p<0.05).There was no mediating effect between hostility and depression severity in women(P>0.05).No significant differences were seen among men.Conclusions:Heart rate variability may not be the mediating factor of impulsive aggression affecting the risk and severity of depression,but the relationship between impulsive aggression,heart rate variability,and depression risk and severity is significantly different between different genders.