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Depression and stress reactivity in metastatic breast cancer.
Psychosom Med. 2006 Sep-Oct; 68(5):675-83.PM

Abstract

OBJECTIVE

Cancer-related distress due to the psychological and physical challenges of metastatic breast cancer (MBC) may result in symptoms of depression, which negatively affects quality and may influence quantity of life. This study investigated how depression affects MBC stress reactivity, including autonomic (ANS) and hypothalamic-pituitary-adrenal (HPA) axis function.

METHOD

Forty-five nondepressed and 45 depressed patients with MBC underwent a modified Trier Social Stress Test (TSST) while affect, cardiovascular, respiratory, and cortisol responses were measured.

RESULTS

At study entry, depressed compared with nondepressed patients had significantly lower log cortisol waking rise levels (p = .005) but no other HPA differences. Positive affect (p = .025) and high-frequency heart-rate variability (lnHF) (p = .002) were significantly lower at TSST baseline in depressed patients. In response to the TSST, depressed patients reported significantly lower positive (p = .050) and greater negative affect (p = .037) and had significantly reduced lnHF (p = .031). In secondary analyses, at TSST baseline both low-frequency (lnLF) (p = .002) and very-low-frequency (lnVLF) (p = .0001) heart rate variability were significantly lower in the depressed group. In secondary analyses during the TSST, those who were depressed had significantly lower lnVLF (p = .008) and did not increase aortic impedance reactivity as much as did the nondepressed during the stressor (p = .005).

CONCLUSION

Depression in patients with MBC was associated with alterations in autonomic regulation, particularly reductions in respiratory sinus arrhythmia, a measure of cardiac vagal control, at baseline and during the TSST. In addition, depression was associated with blunted HPA response to awakening. Both MBC groups had relative cortisol hyporesponsiveness to acute stress.

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Authors+Show Affiliations

Giese-Davis J
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305, USA. jgiese@stanford.edu
Wilhelm FH
No affiliation info available
Conrad A
No affiliation info available
Abercrombie HC
No affiliation info available
Sephton S
No affiliation info available
Yutsis M
No affiliation info available
Neri E
No affiliation info available
Taylor CB
No affiliation info available
Kraemer HC
No affiliation info available
Spiegel D
No affiliation info available

MeSH

Adrenal CortexAdultAffectAgedAutonomic Nervous SystemBlood PressureBreast NeoplasmsCarbon DioxideCircadian RhythmDepressionElectric ImpedanceElectrocardiographyFemaleHeart RateHumansHydrocortisoneHypothalamo-Hypophyseal SystemMathematicsMiddle AgedMonitoring, PhysiologicNeoplasm MetastasisPartial PressurePituitary-Adrenal SystemRespirationSalivaSocioeconomic FactorsSpeechStress, PhysiologicalStress, PsychologicalVagus Nerve

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17012520

Citation

Giese-Davis, Janine, et al. "Depression and Stress Reactivity in Metastatic Breast Cancer." Psychosomatic Medicine, vol. 68, no. 5, 2006, pp. 675-83.
Giese-Davis J, Wilhelm FH, Conrad A, et al. Depression and stress reactivity in metastatic breast cancer. Psychosom Med. 2006;68(5):675-83.
Giese-Davis, J., Wilhelm, F. H., Conrad, A., Abercrombie, H. C., Sephton, S., Yutsis, M., Neri, E., Taylor, C. B., Kraemer, H. C., & Spiegel, D. (2006). Depression and stress reactivity in metastatic breast cancer. Psychosomatic Medicine, 68(5), 675-83.
Giese-Davis J, et al. Depression and Stress Reactivity in Metastatic Breast Cancer. Psychosom Med. 2006 Sep-Oct;68(5):675-83. PubMed PMID: 17012520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depression and stress reactivity in metastatic breast cancer. AU - Giese-Davis,Janine, AU - Wilhelm,Frank H, AU - Conrad,Ansgar, AU - Abercrombie,Heather C, AU - Sephton,Sandra, AU - Yutsis,Maya, AU - Neri,Eric, AU - Taylor,C Barr, AU - Kraemer,Helena C, AU - Spiegel,David, PY - 2006/10/3/pubmed PY - 2006/11/10/medline PY - 2006/10/3/entrez SP - 675 EP - 83 JF - Psychosomatic medicine JO - Psychosom Med VL - 68 IS - 5 N2 - OBJECTIVE: Cancer-related distress due to the psychological and physical challenges of metastatic breast cancer (MBC) may result in symptoms of depression, which negatively affects quality and may influence quantity of life. This study investigated how depression affects MBC stress reactivity, including autonomic (ANS) and hypothalamic-pituitary-adrenal (HPA) axis function. METHOD: Forty-five nondepressed and 45 depressed patients with MBC underwent a modified Trier Social Stress Test (TSST) while affect, cardiovascular, respiratory, and cortisol responses were measured. RESULTS: At study entry, depressed compared with nondepressed patients had significantly lower log cortisol waking rise levels (p = .005) but no other HPA differences. Positive affect (p = .025) and high-frequency heart-rate variability (lnHF) (p = .002) were significantly lower at TSST baseline in depressed patients. In response to the TSST, depressed patients reported significantly lower positive (p = .050) and greater negative affect (p = .037) and had significantly reduced lnHF (p = .031). In secondary analyses, at TSST baseline both low-frequency (lnLF) (p = .002) and very-low-frequency (lnVLF) (p = .0001) heart rate variability were significantly lower in the depressed group. In secondary analyses during the TSST, those who were depressed had significantly lower lnVLF (p = .008) and did not increase aortic impedance reactivity as much as did the nondepressed during the stressor (p = .005). CONCLUSION: Depression in patients with MBC was associated with alterations in autonomic regulation, particularly reductions in respiratory sinus arrhythmia, a measure of cardiac vagal control, at baseline and during the TSST. In addition, depression was associated with blunted HPA response to awakening. Both MBC groups had relative cortisol hyporesponsiveness to acute stress. SN - 1534-7796 UR - https://www.unboundmedicine.com/medline/citation/17012520/Depression_and_stress_reactivity_in_metastatic_breast_cancer_ L2 - https://doi.org/10.1097/01.psy.0000238216.88515.e5 DB - PRIME DP - Unbound Medicine ER -