| There were overlaps of symptoms between depression and anxiety disorder. Depression with anxiety symptoms, anxiety disorder with depressive symptoms were very common phenomenon. There were three points in current domestic and international research for the relationship of these two types of diseases:(1) monism:continuum theory, anxiety and depression were the same disease in different forms; (2) two sub-theory:anxiety and depression were two different types of diseases; (3) comorbidity:when anxiety and depression coexist, it was a different disease entity distincted from anxiety or depression [1-2]. Among them, two sub-theory was supported by most people, it was also the important feature of the 3 types of diagnostic criteria, U. S. Diagnostic and Statistical Manual of mental disorders 4th edition, International Classification of Diseases 10th edition and the Chinese Classification of Mental Disorders and Diagnostic Criteria version 3, and was confirmed by many studies. So, whether the depressive and anxiety symptoms were the same between depression and anxiety disorder? whether the physiological indicators could be the objective basis for identifying the two? In this study, we selected the widely used and reliable Psychological indicators and physiological indicators to analyze the characteristics of depression and anxiety disorder, then study the links and differences between the two.ObjectiveMeasure the characteristics of symptoms, autonomic nerve function and neuroendocrine levels in depression and anxiety disorder. Explore the relationship among symptoms, autonomic nervous function and the neuroendocrine level. Discover whether there was significant difference of symptoms, autonomic nerve function and neuroendocrine level in depression and anxiety disorder. There was important theoretical and practical significance of this research in understanding the psychological and physiological changes in depression and anxiety disorder, identification and diagnosis of these two diseases and more effective targeted therapy.Methods60 depression and 60 anxiety disorder patients as research subjects were randomly selected from the psychiatric department in a top three hospital from march 2010 to september 2010, tested by the self-rating depression scale (SDS), and the self-rating anxiety scale (SAS), collected blood at 8:00am to test the plasma COR, T3, T4, TSH level and examined the heart rate variability (HRV) on the same day, Collected the indicators like standard deviation of RR intervals (SDNN), average heart rate (Mean HRT), low frequency power (LF), very low frequency power (VLF), high frequency power (HF), low power and high frequency power ratio (LF/ HF) etc.; 60 health controls were selected from health staff of the same hospital during the same period, also tested by the self-rating depression scale (SDS), and the self-rating anxiety scale (SAS), collected blood at 8:00am to test the plasma COR, T3, T4, TSH level and examined the heart rate variability (HRV) on the same day. Use descriptive analysis, frequency statistics, two independent samples t test and correlation analysis to measure the characteristics of symptoms, autonomic nerve function and neuroendocrine level in depression and anxiety disorder.Results1. The features of symptoms, autonomic nerve function and neuroendocrine levels in depression1) The frequency statistics of the self-rating depression scale showed that the most common symptoms of depression were difficult determination, loss of libido, empty feeling, more serious in the morning, sleep disturbance, and interest waned, the rare symptoms of depression were constipation and suicidal ideation. The frequency statistics of the self-rating anxiety scale showed thatthe most common symptoms of depression were sleep disturbance, unfortunately feeling and anxiety, the rare symptoms of depression were sense of syncope, facial flushing.2) Comparison of physiological index between depression and the control group showed that, the mean HRT, plasma COR level in depression was significantly higher, while SDNN, LF, HF index were significantly lower than the control group.3) Correlation analysis of the psychological and physical indexes in depression showed that, SDS score and psychological obstacle score were significantly positively correlated with plasma COR level. Affective symptom score was significantly negatively correlated with HF index.2. The features of symptoms, autonomic nerve function and neuroendocrine levels in anxiety disorder1) The frequency statistics of the self-rating anxiety scale showed that, the most common symptoms of anxiety disorder were sweating and frequent urinate, the rare symptoms of anxiety disorder were crazy feeling, foot tingling. The frequency statistics of the self-rating depression scale showed that, the most common symptoms of anxiety disorder were sleep disturbance, diminished capacity, difficult determination, loss of libido and interest waned, the rare symptoms of anxiety disorder were cry easily, weight loss and suicidal ideation.2) Comparison of physiological index between anxiety disorder and the control group showed that, the mean HRT, LF/HF index, plasma COR level and TSH level in anxiety disorder were significantly higher, while SDNN, VLF, LF, HF index were significantly lower than the control group.3) Correlation analysis of the psychological and physical indexes in anxiety disorder showed that, the SDNN index was significantly negatively correlated with SDS total score and psychological obstacle score, the LF index was significantly negatively correlated with SDS total score,SAS total score,somatic symptom score and mental anxiety score, the HF index was significantly negatively correlated with SAS total score and mental anxiety score, there were weakly positive correlations among SDS total score, psychological obstacle score and plasma COR level, TSH level.3. Comparison of symptoms, autonomic nerve function and neuroendocrine levels in depression and anxiety disorder1) Comparison of SDS factors between depression and anxiety disorder showed that, the total score, affective symptoms and psychological disorders in depression were significantly higher than that of anxiety disorder. Comparison of SAS factors between depression and anxiety disorder showed that, the total score and somatic anxiety in anxiety disorder were significantly higher than that of depression. Comparison of the frequency of SDS and SAS between depression and anxiety disorder showed that, the difference of the urinary frequency, palpitations, unfortunately feeling, Hand-foot-shaking and feeling faint items in SAS were the largest between depression and anxiety disorder, while, the panic and sleep disorder items in SAS were the smallest between depression and anxiety disorder. The difference of the the crying easily and suicidal ideation item in SDS were the largest between depression and anxiety disorder, while loss of appetite, constipation and restlessness items in SDS were the smallest between depression and anxiety disorder.2) Comparison of the physical indexes between depression and anxiety disorder showed that, the mean HRT, plasma COR level and TSH level in anxiety disorder were significantly higher, while the SDNN and the HF index were significantly lower than that of depression.Conclusion1) The main features of depressive symptoms were interest waned, empty feeling, difficult decisions, showing more serious in the morning and loss of libido. The anxiety symptoms in depression were mostly the mental anxiety. The sympathetic and vagus nerve function were significantly reduced in depression, while HPA axis activity in depression increased. The core symptoms of depression, had a significant effect on the neuroendocrine and autonomic nerve function, while the physical or anxiety symptoms had little effect on the neuroendocrine and autonomic nerve function.2) Somatic symptoms were more obvious than psychological symptoms in anxiety disorder. The urinary system and the autonomic system symptoms were the most common somatic symptoms in anxiety disorder. The depressive symptoms in anxiety disorder were rarely the emotional symptoms. The sympathetic and vagus nerve function were significantly reduced in anxiety disorder, and the vagal nerve function was more obviously decreased, the sympathetic nerve function showed relatively hyperactivity. The HPT and HPA axis were significantly activated in anxiety disorder. Anxiety symptoms of anxiety disorder had significant effects on the sympathetic and vagal nerve function, depressive symptoms also had significant effects on the sympathetic nerve function. 3) The anxiety symptoms in anxiety disorder were more serious than that in depression, which showed significant physical symptoms. The depressive symptoms in depression were more serious than that in anxiety disorder, which showed significant affective symptoms. Anxiety disorder showed higher HPA and HPT axis activity, more serious autonomic nervous dysfunction, especially the Vagus nerve dysfunction than depression.4) There were significant differences in symptoms, neuroendocrine, and autonomic nerve function between depression and anxiety disorder... |
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