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Symptoms of depression and impaired endothelial function in healthy adolescent women

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Abstract

Depression is related to increased morbidity and mortality from coronary heart disease (CHD), but the underlying mechanisms are unclear. One possibility is that depressive symptoms influence CHD pathogenesis by fostering endothelial dysfunction. To evaluate this possibility, we studied one hundred and two adolescent women with no known or suspected major health problems. Depressive symptoms were assessed using the Beck Depression Inventory (BDI) and endothelial function with a non-invasive beat-to-beat plethysmographic recording of the finger arterial pulse-wave amplitude (PWA) before and after occlusion of the brachial artery. Regression analysis revealed a significant inverse relationship between depressive symptoms and endothelial function. This persisted after controlling for age, ethnicity, health practices and waist circumference. Depression explained 4–6% of the variance in endothelial function above and beyond the effects of covariates. Most patients in our sample had subclinical depressive symptoms, suggesting that even mild affective difficulties are capable of negatively influencing endothelial function in otherwise healthy youngsters.

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Notes

  1. Two reviewers of this paper noted that the association between depressive symptoms and endothelial dysfunction could be a result of confounding by menstrual status. Unfortunately, we did not have hormonal samples available to determine exactly where in her cycle each participant was at the time of assessment. However, we did collect self-reports of cycle length, timing, and regularity. Using the methods outlined by Holding and Minkoff (1973), we used these data to categorize participants as currently menstruating versus in the follicular or luteal phases of their cycle. Because some of these data were missing, and other participants reported irregular cycles, these analyses could only be done on about half of the sample (n = 52). Nonetheless, among these participants there was no evidence of a relationship between menstrual status and either depressive symptoms (r = .04, P = .79) or endothelial function (r = −.01, P = .95). There also were no significant associations between these variables and cycle regularity (r’s < .12, P’s > .26). This pattern of findings suggests that menstrual status is unlikely to be acting as a confound in our sample. However, we recognize that our approach to these analyses has limitations, and in future research a more rigorous assessment of menstrual status using hormonal data would be valuable.

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Acknowledgements

Supported by the Michael Smith Foundation for Health Research; the Canadian Institutes of Health Research; the Heart & Stroke Foundation of Canada; and the National Alliance for Research on Schizophrenia and Depression. The authors thank Jasmen Sze for coordinating and collecting data in the reliability study. We are also grateful to Ekin Blackwell for her assistance in performing EndoPAT examinations. Finally, we thank Doron Dinstein for his help setting up the EndoPAT and answering innumerable questions.

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  1. Department of Psychology, University of British Columbia, Vancouver, BC, Canada

    Lianne M. Tomfohr, Tara M. Martin & Gregory E. Miller

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  1. Lianne M. Tomfohr
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  2. Tara M. Martin
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  3. Gregory E. Miller
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Correspondence to Lianne M. Tomfohr.

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Tomfohr, L.M., Martin, T.M. & Miller, G.E. Symptoms of depression and impaired endothelial function in healthy adolescent women. J Behav Med 31, 137–143 (2008). https://doi.org/10.1007/s10865-007-9141-4

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  • DOI: https://doi.org/10.1007/s10865-007-9141-4

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