Association between major depressive disorder and heart rate variability in the Netherlands Study of Depression and Anxiety (NESDA).

Context: It has been hypothesized that depression is associated with lower heart rate variability and decreased cardiac vagal control. This may play an important role in the risk of cardiovascular diseaseamongdepressed individuals. Objective: To determine whether heart rate variability was lower in depressed individuals than in healthy controls in a large adult sample. Design: Cross-sectional analyses from a large depression cohort study. Setting: The Netherlands Study of Depression and Anxiety. Participants: Two thousand three hundred seventy-three individuals (mean age, 41.8 years; 66.8% female) who participated in the Netherlands Study of Depression and Anxiety. Included were 524 controls, 774 individuals with a diagnosis of major depressive disorder (MDD) earlier in life (remitted MDD), and 1075 individuals with current MDD based on the Composite International Diagnostic Interview. This sample was sufficiently powered to examine the confounding effects of lifestyle, comorbid anxiety, and antidepressants. Main Outcome Measures: The standard deviation of normal-to-normal beats (SDNN) and cardiac vagal control, as indexed by respiratory sinus arrhythmia (RSA), were measured during 11/2 hours of ambulatory recording of electrocardiograms and thorax impedance. Multivariate analyses were conducted to compare SDNN and RSA across depression groups after adjustment for demographics, health, lifestyle, comorbid anxiety, and psychoactive medication. Results: Individuals with remitted and current MDD had a lower mean SDNN and RSA compared with controls (SDNN, 3.1-5.7 milliseconds shorter, P ≤ .02; RSA, 5.1-7.1 milliseconds shorter, P < .001; effect size, 0.125-0.269). Comorbid anxiety and lifestyle did not reduce these associations. However, accounting for psychoactive medication removed the association with SDNN and strongly attenuated the association with RSA. Depressed individuals who were using selective serotonin reuptake inhibitors, tricyclic antidepressants, or other antidepressants had significantly shorter SDNNs and RSAs (effect size, 0.207-0.862) compared with controls and depressed individuals not taking medication. Conclusions: This study shows that depression is associated with significantly lowered heart rate variability. However, this association appears to be mainly driven by the effect of antidepressants. ©2008 American Medical Association. All rights reserved

High Resolution Imaging and the Formation of Stars and Planets

Understanding the formation of stellar and planetary systems is one of the great challenges of contemporary astrophysics. This thesis describes progress towards understanding these processes, through advancement of techniques to enable high resolution imaging of faint companions and other structures in the immediate environs of young stars. To ensure optimal performance in an era of large segmented telescopes, techniques to precisely cophase the mirror segments are required. In this thesis we propose the Fizeau Interferometric Cophasing of Segmented Mirrors algorithm, and present the results of testing both numerically and through experiment. We help to rectify a lack of observational evidence with which to test brown dwarf evolutionary models, by laying the foundation for an orbital monitoring survey of 19 brown dwarf binary systems and reporting the discovery of an additional 7 low mass companions to intermediate mass stars. We perform a Non-Redundant Masking (NRM) survey targeting the 1\,Myr old Ophiuchus star forming region. Both binary statistics and the relationship between multiplicity and the presence of a circumstellar disk are explored, providing many results similar to those from older regions. This helps frame the time evolution of effects related to dynamical interactions in binary systems, and the timescale of disk dissipation, with profound implications for giant planet formation. In thesis we also present the results of commissioning for the Gemini Planet Imager Non-Redundant Masking mode. These results indicate that the addition of an Extreme Adaptive Optics systems has substantially improved the performance of NRM compared to previous instruments. Finally, the transition disk T Cha is studied with multi-epoch NRM data, showing that the signal previously interpreted as a planetary companion is more likely to be the result of forward scattering from the inclined outer disk

Depression is associated with decreased blood pressure, but antidepressant use increases the risk for hypertension

The present study compared blood pressure levels between subjects with clinical anxiety and depressive disorders with healthy controls. Cross-sectional data were obtained in a large cohort study, the Netherlands Study of Depression and Anxiety (N=2981). Participants were classified as controls (N=590) or currently or remittedly depressed or anxious subjects (N=2028), of which 1384 were not and 644 were using antidepressants. Regression analyses calculated the contributions of anxiety and depressive disorders and antidepressant use to diastolic and systolic blood pressures, after controlling for multiple covariates. Heart rate and heart rate variability measures were subsequently added to test whether effects of anxiety/depression or medication were mediated by vagal control over the heart. Higher mean diastolic blood pressure was found among the current anxious subjects (β=0.932; P=0.03), although anxiety was not significantly related to hypertension risk. Remitted and current depressed subjects had a lower mean systolic blood pressure (β=-1.74, P=0.04 and β=-2.35, P=0.004, respectively) and were significantly less likely to have isolated systolic hypertension than controls. Users of tricyclic antidepressants had higher mean systolic and diastolic blood pressures and were more likely to have hypertension stage 1 (odds ratio: 1.90; 95% CI: 0.94 to 3.84; P=0.07) and stage 2 (odds ratio: 3.19; 95% CI: 1.35 to 7.59; P=0.008). Users of noradrenergic and serotonergic working antidepressants were more likely to have hypertension stage 1. This study shows that depressive disorder is associated with low systolic blood pressure and less hypertension, whereas the use of certain antidepressants is associated with both high diastolic and systolic blood pressures and hypertension. (Hypertension. 2009;53:631-638.) © 2009 American Heart Association, Inc

Dentistry handbook

1999 handbook for the faculty of Dentistr

The effects of a diet enriched with a-lactalbumin on mood and cortisol response in unmedicated recovered depressed subjects and controls

De samenhang tussen somatische en psychische (dys)functie