Depression, anxiety, and heart rate variability: A case-control study in Taiwan

Li Fen Chen, Chuan Chia Chang, Nian Sheng Tzeng, Terry B J Kuo, Yu Chen Kao, San Yuan Huang, Hsin An Chang

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Objective: Decreased heart rate variability (HRV) has been reported in persons with major depressive disorder (MDD), but the results obtained are inconsistent. Little is known about the impact of comorbid anxiety disorders on HRV in MDD patients. Both issues necessitate further investigation. Materials and Methods: Forty-nine unmedicated, physically healthy, MDD patients without comorbidity, 21 MDD patients with comorbid generalized anxiety disorder (GAD), 24 MDD patients with comorbid panic disorder (PD), and 81 matched controls were recruited. The Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale are employed to assess the severity of depression and anxiety, respectively. The cardiac autonomic function was evaluated by measuring the HRV parameters. The frequency-domain indices of HRV were obtained. Results: MDD patients without comorbidity had lower high-frequency (HF)-HRV (which reflected vagal control of HRV) than controls. Any comorbid anxiety disorder (GAD or PD) was associated with significantly faster heart rates, relative to the controls, and caused greater reductions in HF-HRV among MDD patients. MDD participants with comorbid GAD displayed the greatest reductions in HF-HRV, relative to controls. Correlation analyses revealed that the severity of both depression and anxiety were significantly associated with the mean R wave to R wave (R-R) intervals, variance, low-frequency (LF)-HRV, and HF-HRV. Conclusion: The present results show decreased HRV in MDD patients, suggesting that reduction in HRV is a psychophysiological marker of MDD. MDD patients with comorbid GAD had the greatest reductions in HRV. Further investigation of the links between MDD and comorbid GAD, HRV, and cardiovascular disease is warranted.

Original languageEnglish
Pages (from-to)9-18
Number of pages10
JournalJournal of Medical Sciences (Taiwan)
Volume34
Issue number1
DOIs
Publication statusPublished - 2014
Externally publishedYes

Keywords

  • Anxiety disorder
  • Cardiac autonomic function
  • Comorbidity
  • Heart rate variability
  • Major depressive disorder

ASJC Scopus subject areas

  • Medicine(all)

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