Povezanost simptoma anksioznosti, depresije i stresa sa simptomima poremećaja autonomnog živčanog sustava

doctoral thesis

• Title (english): The influence of the simptoms of depression, anxiety and stress on the result of COMPASS-31
• Author: Anamari Junaković
• Mentor: Mario Habek (mentor)
• Mentor: Milena Skočić Hanžek (komentor)
• Committee member: Branko Malojčić (predsjednik povjerenstva)
• Committee member: Goran Šimić (član povjerenstva)
• Committee member: Marina Šagud (član povjerenstva)
• Committee member: Magdalena Krbot Skorić (član povjerenstva)
• Committee member: Arijana Lovrenčić-Huzjan (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-05-21, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Ciljevi: Istražili smo utjecaj simptoma depresije, anksioznosti i stresa na rezultate upitnika COMPASS-31 u velikoj populaciji ispitanika upućenih na tilt table test i zdravih ispitanika (HC).
Metode: Uključeno je 959 uzastopnih ispitanika upućenih na tilt table test i 518 HC. Svi ispitanici su ispunili hrvatsku verziju upitnika Composite autonomic symptom score-31 (COMPASS-31). Simptomi depresije, anksioznosti i stresa procijenjeni su hrvatskom verzijom upitnika Depression, anxiety and stress scale-21 (DASS-21). Korigirali smo rezultat COMPASS-31 s neovisnim prediktorima kako bismo poboljšali specifičnost testa.
Rezultati: U obje skupine (ispitanici upućeni na TTT i HC) COMPASS-31 bio je viši u ispitanika sa simptomima depresije, anksioznosti i stresa (svi p < 0,001). U multivarijabilnoj linearnoj regresijskoj analizi, HC je bio negativan, dok su ženski spol, simptomi depresije, anksioznosti i stresa bili nezavisni pozitivni prediktori COMPASS-31. COMPASS-31 u zdravih ispitanika imao je medijan od 7,913, a ovu smo vrijednost koristili kao referentnu točku za analizu osjetljivosti i specifičnosti s pitanjem kako se ova vrijednost razlikuje između HC i ispitanika upućenih na TTT. COMAPSS-31 je imao visoku osjetljivost od 87% i nisku specifičnost od 50%. Kako bismo prilagodili vrijednost COMPASS-31 s parametrima koji su bili značajni u modelu multivarijabilne linearne regresije, izračunali smo novi korigirani COMAPSS-31 (cCOMPASS-31), koji je imao usporedivu osjetljivost od 77%, ali povećanu specifičnost 73%.
Zaključak: Ovo je istraživanje pokazalo da simptomi depresije, anksioznosti i stresa pogoršavaju percipiranu ozbiljnost autonomnih simptoma kod ljudi sa simptomima ortostatske intolerancije i zdrave populacije. cCOMPASS-31 je vrijedan alat koji može pomoći kliničarima u prepoznavanju prave autonomne pozadine kod osoba sa pritužbom na simptome poremećaja autonomnog živčanog sustava.

Abstract (english)

Objectives: We evaluated the influence of symptoms of depression, anxiety, and stress on the results of COMPASS-31 in a large population of people referred to tilt table testing and healthy controls (HC).
Methods: 959 consecutive patients referred to tilt table testing and 518 HC were enrolled. All participants completed Composite Autonomic Symptom Score-31 (COMPASS-31). Depression, anxiety and stress symptoms were evaluated by Depression, Anxiety and Stress Scale-21 (DASS-21) questionnaire. We corrected the result of the COMPASS-31 with the independent predictors in order to improve the specificity of the test.
Results: In both groups (patients and HC) COMPASS-31 was higher in participants with depression, anxiety, and stress symptoms (all p<0.001). In a multivariable linear regression analysis, HC was negative, while female sex, symptoms of depression, anxiety, and stress were independent positive predictors of COMPASS-31. COMPASS-31 in healthy controls had a median of 7.913, and we used this value as a reference point for sensitivity and specificity analysis with a question of how this value differentiates between HC and patients. COMAPSS-31 had a high sensitivity of 87% and low specificity of 50%. In order to adjust the value of COMPASS-31 with the parameters that were significant in the multivariable linear regression model, we calculated the new corrected COMAPSS-31 (cCOMPASS-31), which had comparable sensitivity of 77%, but an increased specificity of 73%.
Conclusion: This study has shown that symptoms of depression, anxiety, and stress worsen the perceived severity of autonomic symptoms in people with symptoms of orthostatic intolerance and healthy population. cCOMPASS-31 is a valuable tool that can help clinicians in discerning the true autonomic background of patients’ complaints.

• Keywords: COMPASS-31; depresija; anksioznost; stress
• Keywords (english): COMPASS-31; depression; anxiety; stress
• Language: croatian
• URN:NBN: urn:nbn:hr:105:960236
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 94 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-03 07:51:34