Top

Journal of Clinical Psychology in Medical Settings

Published in:

01-06-2020 | Mood Disorders

Association Between Hospital Anxiety Depression Scale and Autonomic Recovery Following Exercise

Authors: Milana D. R. Santana, David M. Garner, Yasmim M. de Moraes, Luana B. Mangueira, Guilherme C. Alcantara, José R. A. da Silva, Rodrigo D. Raimundo, Fernando R. Oliveira, Vitor E. Valenti

Published in: Journal of Clinical Psychology in Medical Settings | Issue 2/2020

Abstract

The hospital anxiety depression scale (HADS) is a benchmark used to investigate possible and probable cases of psychosomatic illness. Its affiliation with autonomic recovery after exercise is unclear and, as a technique applied to evaluate cardiovascular risk. We assessed a possible link between HADS and autonomic recovery after exercise. We studied healthy subjects split into two groups: Low HADS (n = 20) and High HADS (n = 21). Subjects consented to moderate aerobic exercise on a treadmill at 60% to 65% of the maximum heart rate (HR) for 30 min. We studied HR variability (HRV) before and during 30 min after exercise. Subjects with higher HADS values presented delayed recovery of HR and root-mean square of differences between adjacent normal RR intervals (RMSSD) after submaximal exercise. RMSSD during recovery from exercise had a significant association with HADS. In summary, subjects with higher HADS presented slower vagal recovery following exercise.

Al Bannay, R., Böhm, M., & Husain, A. (2013). Heart rate differentiates urgency and emergency in hypertensive crisis. Clinical Research in Cardiology,102, 593–598.CrossRef

Augeri, A. L., Tsongalis, G. J., Van Heest, J. L., Maresh, C. M., Thompson, P. D., & Pescatello, L. S. (2009). The endothelial nitric oxide synthase − 786 T > C polymorphism and the exercise-induced blood pressure and nitric oxide responses among men with elevated blood pressure. Atherosclerosis,204, e28–e34.CrossRef

Bai, X., Li, J., Zhou, L., & Li, X. (2009). Influence of the menstrual cycle on nonlinear properties of heart rate variability in young women. American Journal of Physiology-Heart and Circulatory Physiology,297, H765–H774.CrossRef

Barth, J., Schumacher, M., & Herrmann-Lingen, C. (2004). Depression as a risk factor for mortality in patients with coronary heart disease: A meta-analysis. Psychosomatic Medicine,66, 802–813.CrossRef

Blanchard, B. E., Tsongalis, G. J., Guidry, M. A., LaBelle, L. A., Poulin, M., Taylor, A. L., … Pescatello, L. S. (2006). RAAS polymorphisms alter the acute blood pressure response to aerobic exercise among men with hypertension. European Journal of Applied Physiology, 97, 26–33.

Bruneau, M. L., Jr., Johnson, B. T., Huedo-Medina, T. B., Larson, K. A., Ash, G. I., & Pescatello, L. S. (2016). The blood pressure response to acute and chronic aerobic exercise: A meta-analysis of candidate gene association studies. Journal of Science and Medicine in Sport,19, 424–431.CrossRef

Camarda, S. R., Tebexreni, A. S., Páfaro, C. N., Sasai, F. B., Tambeiro, V. L., & Juliano, Y. (2008). Comparison of maximal heart rate using the prediction equations proposed by Karvonen and Tanaka. Arquivos Brasileiros de Cardiologia,91, 311–314.CrossRef

Camm, A. J., Malik, M., Bigger, J. T., Breithardt, G., Cerutti, S., & Cohen, R. J. (1996). Heart rate variability: Standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation,93, 1043–1065.CrossRef

Chen, S. C., Huang, J. C., Tsai, Y. C., Hsiu-Chin Mai, R. N., Jui-Hsin Chen, R. N., Kuo, P. L., … Chen, H. C. (2016). Heart rate variability change before and after hemodialysis is associated with overall and cardiovascular mortality in hemodialysis. Scientific Reports, 6, 20597.

Cosco, T. D., Doyle, F., Ward, M., & McGee, H. (2012). Latent structure of the Hospital Anxiety and Depression Scale: A 10-year systematic review. Journal of Psychosomatic Research,72, 180–184.CrossRef

de Carvalho, T. D., Wajnsztejn, R., de Abreu, L. C., Marques Vanderlei, L. C., Godoy, M. F., Adami, F., … Ferreira, C. (2014). Analysis of cardiac autonomic modulation of children with attention deficit hyperactivity disorder. Neuropsychiatric Disease and Treatment, 10, 613–618.

Doyle, F., Conroy, R., McGee, H., & Delaney, M. (2010). Depressive symptoms in persons with acute coronary syndrome: Specific symptom scales and prognosis. Journal of Psychosomatic Research,68, 121–130.CrossRef

Doyle, F., McGee, H. M., La, De, Harpe, D., Shelley, E., & Conroy, R. (2006). The Hospital Anxiety and Depression Scale depression subscale, but not the Beck Depression Inventory-Fast Scale, identifies patients with acute coronary syndrome at elevated risk of 1-year mortality. Journal of Psychosomatic Research,60, 461–467.CrossRef

Fangauf, S. V., Meyer, T., Albus, C., Binder, L., Deter, H. C., Ladwig, K. H., … SPIRR-CAD Group. (2019). Longitudinal relationship between B-type natriuretic peptide and anxiety in coronary heart disease patients with depression. Journal of Psychosomatic Research, 123, 109728.

Fritz, C. O., Morris, P. E., & Richler, J. J. (2012). Effect size estimates: Current use, calculations, and interpretation. Journal of Experimental Psychology: General,141, 2–18.CrossRef

Gibbons, R. J., Balady, G. J., Beasley, J. W., Bricker, J. T., Duvernoy, W. F., Froelicher, V. F., … Ryan, T. J. (1997). ACC/AHA guidelines for exercise testing. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Exercise Testing). Journal of the American College of Cardiology, 30, 260–311.

Goessl, V. C., Curtiss, J. E., & Hofmann, S. G. (2017). The effect of heart rate variability biofeedback training on stress and anxiety: A meta-analysis. Psychological Medicine,47, 2578–2586.CrossRef

Gonzaga, L. A., Vanderlei, L. C. M., Gomes, R. L., & Valenti, V. E. (2017). Caffeine affects autonomic control of heart rate and blood pressure recovery after aerobic exercise in young adults: A crossover study. Scientific Reports,7, 14091.CrossRef

Guinjoan, S. M., Vigo, D. E., Castro, M. N., Tateosian, N., Chuluyan, E., Costanzo, E., & Cardinali, D. P. (2004). Cardiac parasympathetic dysfunction related to depression in older adults with acute coronary syndrome. Journal of Psychosomatic Research, 56, 83–88.

Hamilton, J. L., & Alloy, L. B. (2016). Atypical reactivity of heart rate variability to stress and depression across development: Systematic review of the literature and directions for future research. Clinical Psychology Review,50, 67–79.CrossRef

Hinz, A., Finck, C., Gómez, Y., Daig, I., Glaesmer, H., & Singer, S. (2014). Anxiety and depression in the general population in Colombia: Reference values of the Hospital Anxiety and Depression Scale (HADS). Social Psychiatry and Psychiatric Epidemiology,49, 41–49.CrossRef

Imai, K., Sato, H., Hori, M., Kusuoka, H., Ozaki, H., Yokoyama, H., … Kamada, T. (1994). Vagally mediated heart rate recovery after exercise is accelerated in athletes but blunted in patients with chronic heart failure. Journal of the American College of Cardiology, 24, 1529–1535.

Janszky, I., Ahnve, S., Lundberg, I., & Hemmingsson, T. (2010). Early-onset depression, anxiety, and risk of subsequent coronary heart disease: 37-year follow-up of 49,321 young Swedish men. Journal of the American College of Cardiology,56, 31–37.CrossRef

Kaufmann, T., Sütterlin, S., Schulz, S. M., & Vögele, C. (2011). ARTiiFACT: A tool for heart rate artifact processing and heart rate variability analysis. Behavior Research Methods,43, 1161–1170.CrossRef

Kleiger, R. E., Miller, J. P., Bigger, J. T., Jr., & Moss, A. J. (1987). Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. American Journal of Cardiology,59, 256–262.CrossRef

Kokkinos, P., Myers, J., Doumas, M., Faselis, C., Pittaras, A., Manolis, A., … Fletcher, R. (2012). Heart rate recovery, exercise capacity, and mortality risk in male veterans. European Journal of Preventive Cardiology, 19, 177–184.

Koopman, J. J., van Bodegom, D., Maan, A. C., Li, Z., Ziem, J. B., Westendorp, R. G., & Jukema, J. W. (2015). Heart rate variability, but not heart rate, is associated with handgrip strength and mortality in older Africans at very low cardiovascular risk: A population-based study. International Journal of Cardiology,187, 559–561.CrossRef

Laukkanen, J. A., Willeit, P., Kurl, S., Mäkikallio, T. H., Savonen, K., Ronkainen, K., & Rauramaa, R. (2014). Elevated systolic blood pressure during recovery from exercise and the risk of sudden cardiac death. Journal of Hypertension,32, 659–666.CrossRef

Martinez-Tellez, B., Sanchez-Delgado, G., Amaro-Gahete, F. J., Acosta, F. M., & Ruiz, J. R. (2019). Relationships between cardiorespiratory fitness/muscular strength and 18F-fluorodeoxyglucose uptake in brown adipose tissue after exposure to cold in young, sedentary adults. Scientific Reports,9, 11314.CrossRef

Myers, J., Buchanan, N., Walsh, D., Kraemer, M., McAuley, P., HamiltonWessler, M., & Froelicher, V. F. (1991). Comparison of the ramp versus standard exercise protocols. Journal of the American College of Cardiology,17, 1334–1342.CrossRef

Nabi, H., Hall, M., Koskenvuo, M., Singh-Manoux, A., Oksanen, T., Suominen, S., … Vahtera, J. (2010). Psychological and somatic symptoms of anxiety and risk of coronary heart disease: The health and social support prospective cohort study. Biological Psychiatry, 67, 378–385.

Pardini, R., Matsudo, S. M. M., Matsudo, V. K. R., Araujo, T., Andrade, E., Braggion, G. F., … Raso, Y. (2001). Validation of the international questionnaire on the level of physical activity (IPAQ-version6): A pilot study in young Brazilian adults. Revista Brasileira de Ciencias e Movimento, 9, 45–51.

Pearson, M. J., & Smart, N. A. (2018). Exercise therapy and autonomic function in heart failure patients: A systematic review and meta-analysis. Heart Failure Reviews,23, 91–108.CrossRef

Peçanha, T., Silva-Júnior, N. D., & Forjaz, C. L. (2014). Heart rate recovery: Autonomic determinants, methods of assessment and association with mortality and cardiovascular diseases. Clinical Physiology and Functional Imaging,34, 327–339.CrossRef

Qiu, S., Cai, X., Sun, Z., Li, L., Zuegel, M., Steinacker, J. M., & Schumann, U. (2017). Heart rate recovery and risk of cardiovascular events and all-cause mortality: A meta-analysis of prospective cohort studies. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.117.005505.CrossRefPubMedPubMedCentral

Raimundo, R. D., de Abreu, L. C., Adami, F., Vanderlei, F. M., de Carvalho, T. D., Moreno, I. L., … Sato, M. A. (2013). Heart rate variability in stroke patients submitted to an acute bout of aerobic exercise. Translational Stroke Research, 4, 488–499.

Rossi, D. M., Valenti, V. E., & Navega, M. T. (2011). Exercise training attenuates acute hyperalgesia in streptozotocin-induced diabetic female rats. Clinics,66, 1615–1619.CrossRef

Sadlonova, M., Meyer, T., Binder, L., Wachter, R., Edelmann, F., & Herrmann-Lingen, C. (2019). Higher plasma levels of CT-proAVP are linked to less anxiety in men but not women with cardiovascular risk factors: Results from the observational Diast-CHF study. Psychoneuroendocrinology,101, 272–277.CrossRef

Silverman, A. L., Herzog, A. A., & Silverman, D. I. (2018). Hearts and minds: Stress, anxiety, and depression. Unsung risk factors for cardiovascular disease. Cardiology Reviews. https://doi.org/10.1097/crd.0000000000000228.CrossRef

Stuckey, M. I., Tulppo, M. P., Kiviniemi, A. M., & Petrella, R. J. (2014). Heart rate variability and the metabolic syndrome: A systematic review of the literature. Diabetes Metabolic Research Review,30, 784–793.CrossRef

Tarvainen, M. P., Niskanen, J. A., Lipponen, P. O., Ranta-aho, & Karjalainen, P. A. (2008). Kubios HRV: A software for advanced heart rate variability analysis. In J. V. Sloten, P. Verdonck, M. Nyssen, & J. Haueisen (Eds.), 4th European conference of the International Federation for Medical and Biological Engineering (pp. 1022–1025). Berlin: Springer.

Tully, P. J., Cosh, S. M., & Baune, B. T. (2013). A review of the affects of worry and generalized anxiety disorder upon cardiovascular health and coronary heart disease. Psychology, Health & Medicine,18, 627–644.CrossRef

Valenti, V. E., Guida, H. L., Frizzo, A. C., Cardoso, A. C., Vanderlei, L. C., & Abreu, L. C. (2012). Auditory stimulation and cardiac autonomic regulation. Clinics,67, 955–958.CrossRef

Vanderlei, L. C., Pastre, C. M., Hoshi, R. A., Carvalho, T. D., & Godoy, M. F. (2009). Basic notions of heart rate variability and its clinical applicability. Brazilian Journal of Cardiovascular Surgery,24, 205–217.CrossRef

von Känel, R., Saner, H., Kohls, S., Barth, J., Znoj, H., Saner, G., & Schmid, J. P. (2009). Relation of heart rate recovery to psychological distress and quality of life in patients with chronic heart failure. European Journal of Cardiovascular Prevention and Rehabilitation,16, 645–650.CrossRef

Watanabe, J., Thamilarasan, M., Blackstone, E. H., Thomas, J. D., & Lauer, M. S. (2001). Heart rate recovery immediately after treadmill exercise and left ventricular systolic dysfunction as predictors of mortality: The case of stress echocardiography. Circulation,104, 1911–1916.CrossRef

Wegner, M., Helmich, I., Machado, S., Nardi, A. E., Arias-Carrion, O., & Budde, H. (2014). Effects of exercise on anxiety and depression disorders: Review of meta-analyses and neurobiological mechanisms. CNS & Neurological Disorders: Drug Targets,13, 1002–1014.CrossRef

Zigmond, A., & Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica,67, 361–370.CrossRef

Title: Association Between Hospital Anxiety Depression Scale and Autonomic Recovery Following Exercise
Authors: Milana D. R. Santana
David M. Garner
Yasmim M. de Moraes
Luana B. Mangueira
Guilherme C. Alcantara
José R. A. da Silva
Rodrigo D. Raimundo
Fernando R. Oliveira
Vitor E. Valenti
Publication date: 01-06-2020
Publisher: Springer US
Keywords: Mood Disorders
Affective Disorder
Anxiety
Published in: Journal of Clinical Psychology in Medical Settings / Issue 2/2020
Print ISSN: 1068-9583
Electronic ISSN: 1573-3572
DOI: https://doi.org/10.1007/s10880-019-09683-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Association Between Hospital Anxiety Depression Scale and Autonomic Recovery Following Exercise

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2020

Comparing MMPI-2-Restructured Form Scores by Service Era for Veterans Assessed Within the Veteran Affairs Healthcare System

Adherence and Glycemic Control in Adolescents with Type 1 Diabetes: The Moderating Role of Age, Gender, and Family Support

Presurgical Psychological Evaluation: Risk Factor Identification and Mitigation

Implementing and Evaluating SBIRT for Alcohol Use at a Level 1 Trauma Center: A Behavioral Medicine Approach

Personality and Psychopathology in Adults with Noonan Syndrome

Associations Between Depressive Symptoms, Fear of Hypoglycemia, Adherence to Management Behaviors and Metabolic Control in Children and Adolescents with Type 1 Diabetes