What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Psychiatric disorders (Schizophrenia, Bipolar disorder, PTSD, Major Depressive Disorder) (n=171). Intervention: Psychiatric disorders vs. Healthy controls. Primary outcome: High frequency (HF) heart rate variability (bipolar disorder vs healthy controls) (p=<0.001).

December 28, 2013Clinical Psychopharmacology and Neuroscience119 citationsOpen Access

Comparative Study of Heart Rate Variability in Patients with Schizophrenia, Bipolar Disorder, Post-traumatic Stress Disorder, or Major Depressive Disorder

Q: What are the key findings of this study?

Patients with bipolar disorder demonstrated the most pronounced reductions in heart rate variability, including significantly decreased high-frequency power compared to healthy controls.

EMEunok Moon SLSeung‐Hwan Lee DKDo‐Hyung Kim

Key Result

Patients with bipolar disorder demonstrated the most pronounced reductions in heart rate variability, including significantly decreased high-frequency power compared to healthy controls.

Study Design

Type

Cross-Sectional (n=171)

Multicenter

Structured PICO

Does heart rate variability differ among patients with various psychiatric disorders and healthy controls?

Population

171 adults aged 18 to 60 years with schizophrenia, bipolar disorder, PTSD, or major depressive disorder, along with healthy controls, underwent resting-state heart rate variability assessment.

Comparator

Healthy controls and cross-comparisons among psychiatric groups

Outcome

Heart rate variability (HRV) parameters including time-domain (SDNN, RMSSD), frequency-domain (VLF, LF, HF, TP), and non-linear complexity (approximate entropy)surrogate

Heart rate variability, particularly high frequency power, is reduced in various psychiatric disorders compared to healthy controls but cannot reliably discriminate between different psychiatric illnesses.

Main Result

Absolute Event Rate: 121.35% vs 332.83%

p-value: p=<0.001

Limitations

Medication effects were not excluded, as psychotropic drugs have varying effects on heart rate variability.
Age and sex differences could not be strictly controlled due to differing demographic characteristics among the psychiatric groups.
The study did not recruit separate groups of healthy controls matched to each specific psychiatric disorder.

Abstract

OBJECTIVE: Heart rate variability (HRV) changes as a function of psychiatric illness. This study aimed to evaluate HRV among patients with various psychiatric disorders. METHODS: The present study recruited patients with schizophrenia (n=35), bipolar disorder (n=41), post-traumatic stress disorder (PTSD; n=34), or major depressive disorder (n=34) as well as healthy controls (n=27). The time-domain analysis (the standard deviation of all RR intervals SDNN and the square root of the mean squared differences of successive normal sinus intervals RMSSD), the frequency-domain analysis (very low frequency, low frequency LF, high frequency HF, and total power TP), and a non-linear complexity measure the approximate entropy were computed. RESULTS: SDNN and HF were significantly reduced in patients with schizophrenia compared with healthy controls. SDNN, RMSSD, TP, LF, and HF were significantly reduced in bipolar patients compared with healthy controls. HF was significantly reduced in PTSD patients compared with healthy controls. CONCLUSION: Our findings indicate that HRV is not sufficiently powerful to discriminate among various psychiatric illnesses. However, our results suggest that HRV, particularly HF, could be used as a tool for discriminating between psychiatric patients and healthy controls.

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