Habituation and sensitization processes in depressive disorders

A Naturalistic, European Multi-Center Clinical Study of Electrodermal Reactivity and Suicide Risk Among Patients With Depression

Background: Electrodermal hyporeactivity has been proposed as a marker of suicidal risk. The EUDOR-A study investigated the prevalence of electrodermal hyporeactivity among patients with depression and its association with attempted and completed suicide. Methods: Between August 2014 and March 2016, 1,573 in- and outpatients with a primary diagnosis of depression (active or remission phase) were recruited at 15 European psychiatric centers. Each patient was followed-up for 1 year. Electrodermal activity was assessed at baseline with the ElectroDermal Orienting Reactivity Test. Data on the sociodemographic characteristics, clinical diagnoses, and treatment of the subjects were also collected. The severity of the depressive symptoms was assessed through the Montgomery-Asberg Depression Rating Scale. Information regarding number, time, and method of suicide attempts was gathered at baseline and at the end of the 1-year follow-up. The same data were collected in case of completed suicide. Results: Hyporeactive patients were shown to be significantly more at risk of suicide attempt compared to reactive patients, both at baseline and follow-up. A sensitivity of 29.86% and a positive predictive value (PPV) of 46.77% were found for attempted suicide at baseline, while a sensitivity of 35.36% and a PPV of 8.92% were found for attempted suicide at follow-up. The sensitivity and PPV for completed suicide were 25.00 and 0.61%, respectively. However, when controlled for suicide attempt at baseline, the association between hyporeactivity and follow-up suicide attempt was no longer significant. The low number of completed suicides did not allow any analysis.

The association between electrodermal activity (EDA), depression and suicidal behaviour: A systematic review and narrative synthesis

BACKGROUND

Electrodermal activity (EDA) and other peripheral autonomic electrical parameters have been used as indicators of emotional states, including depressive states and suicidal state. We aimed to review EDA research systematically, focusing on EDA's usefulness as a biomarker for depression and suicidal behaviour.

METHODS

We searched MEDLINE, Scopus, Cochrane Library, and Web of Science databases, following PRISMA guidelines. The initial screening of articles was based on titles and abstracts; then the full text was reviewed. A preliminary synthesis of findings was developed using tables, thematic analysis and quality ratings.

RESULTS

1287 articles were screened and 77 relevant studies were identified and included in the systematic review. The studies were fairly consistent in maintaining that hypoactive electrodermal response is an established feature of patients affected by depression. There is also preliminary evidence that monitoring EDA may help to differentiate the phases of mood disorders. A few studies provided evidence that EDA can be used to differentiate acutely suicidal subjects from depressed patients who are not severely suicidal. Although EDA has been shown to be a valid, sensitive marker of suicidal ideation, suicide attempts and violent suicidal behaviour, it also seems to be influenced to some extent by antidepressant treatment.

CONCLUSIONS

Most of the studies summarised in this review are quite outdated and employed a variety of designs and methods to evaluate EDA. This limits the generalisability of the results and makes it difficult to draw clear conclusions about the role of EDA in real-world settings. Electrodermal hypoactivity seems to be a reliable feature of depression and a valid marker of suicidal risk. Nevertheless, the potential utility of EDA in diagnosis, prevention, and treatment planning for depression and suicidal behaviour, should be thoroughly studied.

Blunted Electrodermal and Psychological Response to Acute Stress in Family Caregivers of People with Eating Disorders

Caring for an offspring with an eating disorder (ED) is associated with high levels of distress, and health problems. Indeed, ED caregivers have to cope with a range of challenges related to their caring role, which represents a chronic stress situation. This tends to alter body homeostasis and caregivers' health status. This study aimed to analyse the electrodermal reactivity and psychological response to acute stress in ED caregivers compared to non-caregivers. As expected, caregivers showed lower electrodermal (p < .001, η2partial = .269 for SCL and p < .01, η2partial = .214 for NSCRs) and psychological response (p < .05, η2partial = .198) to acute stress than non-caregivers. The findings suggest the existence of physiological adaptation to chronic stress in family caregivers of people with EDs.

Valid electrodermal hyporeactivity for depressive suicidal propensity offers links to cognitive theory

OBJECTIVE

Studies from three independent laboratories report varying relationships between electrodermal hyporeactivity and suicidal behavior in depressed patients. The aims of this study were to explain that variation, to assess the discriminative validity of electrodermal hyporeactivity for suicide and suicide attempts and to suggest a tentative explanation model.

METHOD

A meta-analysis was performed of 279 depressed patients and 59 healthy subjects.

RESULTS

The sensitivity was 96.6% and specificity 92.9% of electrodermal hyporeactivity for suicide and 83.3% and 92.7%, respectively, for suicide and/or violent attempts. The shares of hyporeactives were strongly significantly and greatly larger in high than in low suicidal propensity groups, P-value ranging from 4.7 x 10(-8) to 1.1 x 10(-14).

CONCLUSION

The high discriminative validity and the emerging links over a proposed interest-limiting precognitive set to cognitive theory of suicide encourage clinical application of tests of electrodermal reactivity. The study offers a series of testable hypotheses constituting a new platform for suicidological research in depression.

Gender differences in cardiovascular and electrodermal responses to public speaking task: the role of anxiety and mood states

Gender moderates psychophysiological responses to stress. In addition to the hormonal background, different psychological states related to social stressors, such as anxiety and mood, could affect this response. The purpose of this study was to examine the existence of gender differences in the cardiovascular and electrodermal responses to a speech task and their relationship with anxiety and the mood variations experienced. For this, non-specific skin conductance responses (NSRs), heart rate (HR), and finger pulse volume (FPV) were measured at rest, and during preparation, task and recovery periods of an academic career speech in undergraduate men (n=15) and women (n=23), with assessment of changes in the state version of the State-Trait Anxiety Inventory (STAI-S) and in the Profile of Mood States (POMS) questionnaires. Men and women did not differ in trait anxiety, hostility/aggressiveness, or in the appraisal of the task, which were evaluated with the trait version of the State-Trait Anxiety Inventory (STAI-T), the Buss and Durkee Hostility Inventory (BDHI), and a self-report elaborated by ourselves, respectively. Women had higher FPV in all periods except during the task, and were more reactive to the stressor in state anxiety, and in the amplitude of NSRs. No gender differences for HR and for the frequency of NSRs were found. Anxiety and mood states were differently related to cardiovascular and electrodermal measurements in men and women. Further studies should consider the hormonal variations in addition to the psychological dimensions, in order to offer a more integrative perspective of the complex responses to stress.