title: Illness severity, trait anxiety, cognitive impairment and heart rate variability in bipolar disorder.
abstract: Numerous studies have documented a significant association between symptom severity and cognitive functioning in bipolar disorder (BD). These findings advanced speculations about a potential link between the physiological stress associated with illness severity and cognitive dysfunction. To explore this hypothesis, the current study employed heart rate variability (HRV) as a physiological measure that is sensitive to the effects of chronic stress, and a scale of trait anxiety for assessing a psychological condition that is correlated with hyper sympathetic arousal. Analyses indicated that BD patients with High Illness Severity reported more symptoms of trait-anxiety (i.e., State Trait Anxiety Inventory), performed more poorly on a computerized neuropsychological battery (i.e., CNS Vital Signs), and exhibited a more constricted HRV profile (i.e., lower SDNN with elevated LF/HF ratio) than patients with Low Illness Severity. Illness severity was determined by a history of psychosis, illness duration, and number of mood episodes. A third group of healthy controls (n=22) performed better on the neuropsychological battery and exhibited a healthier HRV profile than the BD groups. This study provides preliminary evidence that illness severity and cognitive impairment in BD may be associated with state anxiety and neuro-cardiac alterations that are sensitive to physiological stress.
authors.affiliation: Department of Counseling and School Psychology, University of Massachusetts Boston, Wheatley Building, Second Floor, Room 143-9, 100 Morriseey Boulevard, Boston, MA 02125, USA. Electronic address: boaz.levy@umb.edu.
authors.forename: Boaz
authors.initials: B
authors.lastname: Levy
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D001143:Arousal / Q000502:physiology; D001714:Bipolar Disorder / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D013564:Sympathetic Nervous System / Q000503:physiopathology; D055815:Young Adult
keywords: Bipolar disorder; Cognitive impairment; Heart rate variability; Stress; Trait anxiety