Abstract
BackgroundSchizophrenia is associated with autonomic dysfunction and this may increase cardiovascular mortality. Past studies on autonomic modulation of schizophrenic patients focused on inpatients rather than individuals in a community setting, especially those receiving non-intensive case management (non-ICM). Besides, autonomic modulation and its association with health-related quality of life (HRQoL) in this population remain unexplored.MethodsA total of 25 schizophrenic patients treated by non-ICM and 40 healthy volunteers were matched by age, gender and body mass index; smokers were excluded. Between the two groups, we compared the individuals' 5 min resting assessments of heart rate variability and their HRQoL, which was measured using EuroQoL-5D (EQ-5D). Patients with schizophrenia were assessed for psychopathology using the Positive and Negative Syndrome Scale for Schizophrenia (PANSS). We examined the relationship between heart rate variability measurements, HRQoL scores, PANSS scores, and other clinical variables among the schizophrenic patients treated by non-ICM.ResultsCompared to the controls, patients with schizophrenia showed a significant impairment of autonomic modulation and a worse HRQoL. Cardiovagal dysfunction among the schizophrenic patients could be predicted independently based on lower educational level and more negative symptoms. Sympathetic predominance was directly associated with anticholinergics use and EQ-5D using a visual analogue scale (EQ-VAS).ConclusionPatients with schizophrenia treated by non-ICM show a significant impairment of their autonomic function and HRQoL compared to the controls. Since the sympathovagal dysfunction is associated with more negative symptoms or higher VAS score, the treatment of the negative symptoms as well as the monitoring of HRQoL might help to manage cardiovascular risk among these individuals. In addition, EQ-VAS scores must be interpreted more cautiously in such a population.
Highlights
Schizophrenia is a chronic, debilitating mental disorder that affects approximately 1% of the general population [1]
We further examined the relationship between heart rate variability (HRV), health-related quality of life (HRQoL), psychopathology and other clinical variables in the schizophrenia group
The age of the schizophrenia group ranged from 23 years to 55 years and their illness duration varied from 6 years to 34 years
Summary
Schizophrenia is a chronic, debilitating mental disorder that affects approximately 1% of the general population [1] It is associated with central autonomic system abnormalities and these may influence heart rate variability (HRV) [2,3], baroreflex sensitivity [4], pupillary light reflex [5], and electrodermal activity [6]. The psychopathology of schizophrenia has been found to be associated with decreased vagal modulation [4,5,8,9,10,11,12,13,14] or overactive sympathetic function [6,8,12] This autonomic dysfunction might be exacerbated by antipsychotic use [15,16]. Autonomic modulation and its association with health-related quality of life (HRQoL) in this population remain unexplored
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