Key result
A recent suicide attempt was associated with lower parasympathetic and higher sympathetic activity compared to healthy controls, with HRV parameters showing acceptable to excellent clinical accuracy.
Why the study?
Most studies linking lower parasympathetic activity to suicidality involved healthy participants, patients without suicide attempt history, or patients with a single diagnosis.
Are heart rate variability parameters altered in in-patients with a recent suicide attempt compared to healthy controls?
Case-Control (n=95)
Are heart rate variability parameters altered in in-patients with a recent suicide attempt compared to healthy controls?
Heart rate variability parameters show potential as discriminative biomarkers for recent suicide attempts, reflecting lower parasympathetic and higher sympathetic activity.
HRV parameters may support biomarker identification of recent suicide attempts; leaves open predictive value and clinical utility pending prospective studies.
Suicidal behavior is influenced by a multitude of factors, making prediction and prevention of suicide attempts (SA) a challenge. A useful tool to uncover underlying pathophysiology or propose new therapy approaches are biomarkers, especially within the context of point-of-care tests. Heart rate variability (HRV) is a well-established biomarker of mental health, and measures the activity of the sympathetic and parasympathetic nervous system (PNS). Previous studies reported a correlation between lower PNS activity and suicidality. However, most studies involved participants from a healthy population, patients without history of suicide attempts, or patients with a single diagnosis. 52 in-patients with a recent suicide attempt (<6 months), and 43 controls without history of SA or psychiatric diagnoses confirmed study participation. The included patients age ranged between 18 and 65 years, 65% had psychiatric comorbidities. Patients with dementia, cognitive impairments, acute psychosis, chronic non suicidal self-harming behavior, or current electroconvulsive therapy were excluded. A 15-min resting state electrocardiography was recorded with two bipolar electrodes attached to the right and left insides of the wrists. The multiple regression analyses showed lower parasympathetic, and higher sympathetic activity in patients compared to controls. Partial correlation found a positive trend result between self-reported suicidality and the very low frequency band. ROC curve analysis revealed an acceptable to excellent clinical accuracy of HRV parameters. Therefore, HRV parameters could be reliable discriminative biomarkers between in-patients with a recent SA and healthy controls. One limitation is the lack of a control group consisting of in-patients without life-time suicidal ideation or attempts.
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Rüesch et al. (2022) conducted a case-control in Recent suicide attempt (n=95). Recent suicide attempt vs. Healthy controls without history of suicide attempts or psychiatric diagnoses was evaluated on Parasympathetic and sympathetic activity (HRV parameters). A recent suicide attempt was associated with lower parasympathetic and higher sympathetic activity compared to healthy controls, with HRV parameters showing acceptable to excellent clinical accuracy.
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