TY - JOUR
T1 - Physiological stress markers, mental health and objective physical function
AU - Lever-van Milligen, Bianca A
AU - Lamers, Femke
AU - Smit, Johannes H
AU - Penninx, Brenda W J H
N1 - Copyright © 2020 Elsevier Inc. All rights reserved.
PY - 2020/6
Y1 - 2020/6
N2 - Objective: The observed poorer physical function in persons with mental disorders could partly be due to dysregulation in physiological stress systems. However, an integrated picture of the role of physiological stress systems on objective physical function is lacking. This study examined the association of multiple physiological stress systems with objective physical function, and explored whether these stress systems contribute to the relationship between depression/anxiety and poorer physical function. Methods: Data of 2860 persons of the Netherlands Study of Depression and Anxiety was used. Physical function was indicated by hand grip strength assessed using a hand-held dynamometer and lung function assessed using a peak flow meter. Inflammatory markers (CRP, IL-6, TNF-α), salivary cortisol (cortisol awakening response (AUCg, AUCi), evening cortisol) and ANS markers (heartrate, PEP, RSA) were determined. Depression/anxiety disorders were determined using psychiatric interviews. Linear regression analyses were adjusted for sociodemographics, health and lifestyle factors. Results: Higher inflammation levels were associated with lower hand grip strength (B CRP = -0.21(SE = 0.06), p < .001) and lower lung function (B CRP = -2.07(SE = 0.66), p = .002), B TNF-α = −3.35(SE = 1.42), p = .022). Higher salivary cortisol levels were associated with lower lung function (B evening cortisol = −2.22(SE = 0.59), p < .001). The association, in women, between depression/anxiety disorders and poorer physical function did not significantly diminish after adjustment for physiological stress markers. Conclusion: This large cohort study showed that stress system dysfunction (especially the immune-inflammatory system and HPA-axis) contributes to poorer objective physical function. Stress system dysfunction did not explain the poorer physical function observed in persons with depression/anxiety disorders, suggesting that other pathways are involved to explain that association.
AB - Objective: The observed poorer physical function in persons with mental disorders could partly be due to dysregulation in physiological stress systems. However, an integrated picture of the role of physiological stress systems on objective physical function is lacking. This study examined the association of multiple physiological stress systems with objective physical function, and explored whether these stress systems contribute to the relationship between depression/anxiety and poorer physical function. Methods: Data of 2860 persons of the Netherlands Study of Depression and Anxiety was used. Physical function was indicated by hand grip strength assessed using a hand-held dynamometer and lung function assessed using a peak flow meter. Inflammatory markers (CRP, IL-6, TNF-α), salivary cortisol (cortisol awakening response (AUCg, AUCi), evening cortisol) and ANS markers (heartrate, PEP, RSA) were determined. Depression/anxiety disorders were determined using psychiatric interviews. Linear regression analyses were adjusted for sociodemographics, health and lifestyle factors. Results: Higher inflammation levels were associated with lower hand grip strength (B CRP = -0.21(SE = 0.06), p < .001) and lower lung function (B CRP = -2.07(SE = 0.66), p = .002), B TNF-α = −3.35(SE = 1.42), p = .022). Higher salivary cortisol levels were associated with lower lung function (B evening cortisol = −2.22(SE = 0.59), p < .001). The association, in women, between depression/anxiety disorders and poorer physical function did not significantly diminish after adjustment for physiological stress markers. Conclusion: This large cohort study showed that stress system dysfunction (especially the immune-inflammatory system and HPA-axis) contributes to poorer objective physical function. Stress system dysfunction did not explain the poorer physical function observed in persons with depression/anxiety disorders, suggesting that other pathways are involved to explain that association.
KW - Anxiety
KW - Depression
KW - Hand grip strength
KW - Lung function
KW - Physical function
KW - Physiological stress
UR - http://www.scopus.com/inward/record.url?scp=85082407274&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jpsychores.2020.109996
DO - https://doi.org/10.1016/j.jpsychores.2020.109996
M3 - Article
C2 - 32229341
SN - 0022-3999
VL - 133
SP - 109996
JO - Journal of psychosomatic research
JF - Journal of psychosomatic research
M1 - 109996
ER -