410 - Role of mood disorders and emotion regulation on cardiovascular disease risk in youth

Publication Number: 1393.410

Claire Wilson, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Carisa Parrish, Children's Mercy Hospital, Kansas City, MO, United States; Kevin Psoter, Johns Hopkins University School of Medicine, Ba;timore, MD, United States; Tammy Brady, Johns Hopkins Children's Center, Baltimore, MD, United States

Background: Mood disorders (MDO) and emotion regulation have emerged as potential contributors to cardiovascular disease (CVD) risk. Depression, anxiety, and maladaptive coping are associated with heightened physiological stress responses and unhealthy behaviors that may accelerate CVD development.

Objective: We aimed to determine the impact of MDO and maladaptive coping on CVD risk factors among youth.

Design/Methods: Youth were recruited from the pediatric medical psychology clinic, the CHAMPION trial, and the Be-HealthY study at Johns Hopkins University. MDO were defined by clinical diagnosis or positive PHQ-9 screen, and coping was evaluated with the Children's Emotion Management Scale (CEMS). Endorsement of coping strategies in the domains of worry, anger, and sadness were given a score of 1 (hardly ever), 2 (sometimes), 3 (often). CEMS scores were summed and dichotomized at the median split. Participants underwent standardized anthropometric and blood pressure (BP) measurements and wore an actigraph for 1 week to assess activity level, sleep quality, and sleep duration. Demographic, clinical, and activity/sleep level measures from youth with/without MDO and with high/low coping scores were compared using student's t-tests, Fishers exact tests, and Wilcoxon Rank sum as appropriate. Multivariable analyses explored the independent association of MDO and coping with CVD risk factors.

Results: 78 youth, 4-21 years (mean 15 years, SD 3.4), 51% female participated. Youth with MDO (n=54) were older and a greater proportion were non-Black race, had a mother who completed high school or greater, had lower area deprivation index, and had greater adversity than those without MDO (Table 1). Children with MDO had lower adiposity, higher wake diastolic BP (mmHg and index; BP index=measured BP/hypertensive threshold), lower sleep efficiency, and lower activity than those without MDO. Youth with higher coping scores had greater adiposity, higher clinic and wake systolic BP (mmHg and index) and wake diastolic BP (mmHg), fewer nighttime awakenings, and lower activity levels than those with lower coping scores. Both MDO and higher coping scores were independently associated with lower activity levels (Table 2).

Conclusion(s): In this sample, children with MDO and higher CEMS coping scores had lower activity than their counterparts and exhibited modifiable CVD risk factors (adiposity, suboptimal sleep, BP). More work is needed to determine the impact of targeted interventions aimed at individuals with anxiety, depression, and difficulties in emotion regulation on CVD risk reduction.

Association of mood disorders and coping scores with demographics, anthropometrics, blood pressure, and sleep quality among youth 4-21 years.
Abbreviations - ACE: adverse childhood experiences. SBP: systolic blood pressure. DBP: diastolic blood pressure. ABPM: ambulatory blood pressure measurement. BP index = measured BP/hypertensive threshold. Sleep Efficiency = sleep time/time in bed.

Association of mood disorders and coping scores with daily activity in minutes.