Low peripheral arousal in psychiatric patients with inadequate response to pharmaco-therapy

Background and Aim : Arousal and its eminences in psychology and neurosciences has been linked to the psychiatric pathologies such as anxiety and attention deficit hyperactivity disorder in children. The Low arousal theory is now proposed for explaining complexmechanisms of some psychiatric disorders. The aim of the current study is to introduce association of peripheral arousal which is mostly eminent in autonomic function of psychiatric patients with inadequate response to pharmaco-therapy.Methods : Ten psychiatric patients, aged 20-60 years, with diagnoses of depression, Obsessive-compulsive disorder (OCD), anger attacks and sustained chronic fatigue syndrome who showed inadequate response to pharmacotherapy for 6 months or more were studied. Psychophysiology parameters of the autonomic function were recorded, analyzed, and compared with values presented for normal population.Results : All the ten patients showed very reduced autonomic function both in sympathetic and parasympathetic activities. Skin conductance or skin galvanic response, heart rate variability (HRV), low frequency to high frequency measure of heart rate and other related parameters showed that functional autonomic failure may exist in these patients.Conclusion : Arousal and specifically low peripheral arousal in the autonomic system is proposed to have relations with the resistance to neuro-pharmaco-therapies. These findings could be promising for farther advances in researches and treatments.

Keywords:

Low arousal theory , Neurosciences , Neuropsychiatry , Treatment resistance