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Preadolescents' Somatic and Cognitive-Affective Depressive Symptoms Are Differentially Related to Cardiac Autonomic Function and Cortisol: The TRAILS Study

From the Interdisciplinary Center for Psychiatric Epidemiology and Graduate Schools for Behavioral and Cognitive Neurosciences and for Health Research (N.M.B., H.R., J.O., A.J.O.), University Medical Center Groningen, University of Groningen, Groningen, Netherlands; Unit of Genetic Epidemiology and Bioinformatics (H.R.), Department of Epidemiology, University Medical Center Groningen, Groningen, Netherlands; Department of Child- and Adolescent Psychiatry (A.D.), University Medical Center Groningen, Groningen, Netherlands; and Department of Child and Adolescent Psychiatry (F.V., A.J.O.), Erasmus University Medical Center - Sophia Children's Hospital Rotterdam, Rotterdam, Netherlands.

Address correspondence and reprint requests to Albertine J. Oldehinkel, Interdisciplinary Center for Psychiatric Epidemiology, University Medical Center Groningen, CC72, P.O. Box 30001, 9700 RB Groningen, Netherlands. E-mail: a.j.oldehinkel{at}med.umcg.nl

Objective: To examine in a nonclinical sample of preadolescents the possibility that somatic and cognitive-affective depressive symptoms are differentially related with the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis. Depression is a well-known risk factor for cardiovascular disease and mortality. Dysregulation of the ANS and the HPA axis have been proposed as underlying mechanisms. Several studies suggest that only a subset of the depression symptoms account for associations with cardiovascular prognosis.

Methods: Self-reported somatic and cognitive-affective depressive symptoms were examined in relationship to heart rate variability (HRV), spontaneous baroreflex sensitivity (BRS), and the cortisol awakening response (CAR) in 2049 preadolescents (mean age = 11.1 years; 50.7% = girls) from the Tracking Adolescents' Individual Lives Survey (TRAILS).

Results: Physiological measurements were not associated with the overall measure of depressive symptoms. Somatic depressive symptoms were negatively related to HRV and BRS, and positively to the CAR; cognitive-affective depressive symptoms were positively related to HRV and BRS, and negatively to the CAR. Associations with the CAR pertained to boys only.

Conclusions: Somatic and cognitive-affective depressive symptoms differ in their association with both cardiac autonomic and HPA axis function in preadolescents. Particularly, somatic depression symptoms may mark cardiac risk.

Key Words: depressive symptoms • autonomic function • heart rate • baroreflex • cortisol • children

Abbreviations: ANS = autonomic nervous system; BP = blood pressure; BRS = baroreflex sensitivity; CAR = cortisol awakening response; CVD = cardiovascular disease; HPA = hypothalamic-pituitary-adrenal; HR = heart rate; HRV = heart rate variability; HRV-LF = heart rate variability in the low-frequency band; HRV-HF = heart rate variability in the high-frequency band; MI = myocardial infarction; SD = standard deviation; YSR = Youth Self-Report.