Key result
A 25% or greater decrease in suicide severity scores among acutely suicidal adolescents was associated with a significant increase in the nighttime high frequency component of heart rate variability (mean difference 11.89 ms/Hz).
Why the study?
Suicide is the second leading cause of death in adolescence and acute pediatric mental health ED visits have doubled, prompting evaluation of the relationship between physiologic parameters and suicide severity.
Does heart rate variability measured by wearable technology correlate with suicide severity in acutely suicidal adolescents?
Observational (n=51)
Yes
Does heart rate variability measured by wearable technology correlate with suicide severity in acutely suicidal adolescents?
Mean Difference: 11.89 (95% CI 3.7–20.1)
p-value: p=0.005
Wearable technology measuring heart rate variability demonstrates an inverse correlation between parasympathetic activity and suicidality in adolescents, suggesting potential utility for objective outpatient monitoring.
HF HRV rise signals suicidality improvement in adolescents; hypothesis-generating for wearable monitoring, prospective trials needed before adoption.
OBJECTIVE: Suicide is the 2nd leading cause of death in adolescence, and acute pediatric mental health emergency department (ED) visits have doubled in the past decade. The objective of this study was to evaluate physiologic parameters relationship to suicide severity. METHODS: This was a prospective, observational study from April 2018 thru November 2019 in a tertiary care pediatric emergency department (ED) and inpatient pediatric psychiatric unit enrolling acutely suicidal adolescent patients. Patients wore a wrist device that used photoplethysmography for 7 days during their acute hospitalization to measure heart rate variability (HRV). During that time, Columbia Suicide Severity Scores (CSSRS) were assessed at 3 time points. RESULTS: There was complete device data and follow-up for 51 patients. There was an increase in the high frequency (HF) component of HRV in patients that had a 25% or greater decrease in their CSSRS (mean difference 11.89 ms/ Hz ; p-value 0.005). Patients with a CSSRS≥15 on day of enrollment had a lower, although not statistically significant, HF component (mean difference -8.34 ms/ Hz; p-value 0.071). CONCLUSION: We found an inverse correlation between parasympathetic activity measured through the HF component and suicidality in an acutely suicidal population of adolescents. Wearable technology may have the ability to improve outpatient monitoring for earlier detection and intervention.
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Sheridan et al. (2021) conducted an observational in Acute suicidality (n=51). Decrease in Columbia Suicide Severity Score (CSSRS) ≥25% vs. Decrease in CSSRS <25% was evaluated on Change in nighttime high frequency (HF) component of heart rate variability (MD 11.89 ms/Hz, 95% CI 3.70 to 20.10, p=0.005). A 25% or greater decrease in suicide severity scores among acutely suicidal adolescents was associated with a significant increase in the nighttime high frequency component of heart rate variability (mean difference 11.89 ms/Hz).
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