P-469 - Investigation of the functional activity of autonomic nervous system and endogenous opioid system in endogenomorphic depression

Abstract

Introduction Investigation of the pathogenesis mechanisms in depression remains an actual task of modern psychiatry. Objectives The analysis of clinical-psychopathological characteristics, functional activity of autonomic nervous system and endogenous opioid system in endogenomorphic depression. The main group included 72 patients diagnosed with depressive episode. Methods Clinico- psychopathological, clinico-anamnestic, Hamilton Depression Rating Scale (HDRS-17), the analysis of heart rate variability (HRV) for evaluation of autonomic regulation. In 9 patients plasma levels of beta-endorphin were obtained. Patients were investigated 3 times - at baseline, and then during 2nd–3d and 4th–6th weeks of antidepressant therapy. Results The reduction of total HRV was observed at rest and in orthostatic test during evaluation of autonomic regulation in depressive patients. The hyperactivation of suprasegmental ergotropic systems was observed in depressive patients before treatment. In responders subgroup despite on positive dynamics of clinico-psychopathological and psychometric characteristics, in the 2nd–3d week of therapy increase in general HRV was observed, in the 4th–6th week parameters come back to baseline level. The balance of sympathetic, parasympathetic and suprasegmental parts of autonomic nervous system did not change. The plasma endorphin levels were rising to 2nd–3d treatment week, and come back to baseline level at the 4th–6th treatment week. Conclusion Obtained data confirm evidence that the therapeutic dynamics of depression is characterized by a faster reduction of clinical symptoms, whereas changes in functional activity of stress-realizing and stress-limiting mechanisms can be kept much longer. Acknowledgments This research is supported by grant provided by Russian Humanitarian Research Foundation project 11-06-00869а