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Heart rate variability (HRV) in adolescent females with anxiety disorders and major depressive disorder
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
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2010 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 4, 604-611 p.Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to investigate heart rate variability (HRV) in a clinical sample of female adolescents with anxiety disorders (AD) and/or major depressive disorder (MDD) compared with healthy controls and to assess the effect of selective serotonin reuptake inhibitors (SSRI) on HRV. METHODS: Heart rate variability was measured in adolescent female psychiatric patients with AD and/or MDD (n = 69), mean age 16.8 years (range: 14.5-18.4), from 13 out-patient clinics and in healthy controls (n = 65), mean age 16.5 years (range: 15.9-17.7). HRV was registered in the sitting position during 4 min with no interventions. RESULTS: Logarithmically transformed high frequency HRV (HF), low frequency HRV (LF) and standard deviation of inter beat intervals (SDNN) were lower in the clinical sample compared with the controls (Cohen's d for HF = 0.57, LF = 0.55, SDNN = 0.60). This was not explained by body mass index, blood pressure or physical activity. Medication with SSRI explained 15.5% of the total variance of HF, 3.0% of LF and 6.5% of SDNN. CONCLUSIONS: Adolescent female psychiatric patients with AD and/or MDD show reduced HRV compared with healthy controls. Medication with SSRI explained a part of this difference.

Place, publisher, year, edition, pages
2010. Vol. 99, no 4, 604-611 p.
Keyword [en]
Adolescent females, Anxiety disorders, Autonomic regulation, Heart rate variability, Major depressive disorder, Selective serotonin reuptake inhibitors
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-129884DOI: 10.1111/j.1651-2227.2009.01657.xISI: 000274951200029PubMedID: 20121706OAI: oai:DiVA.org:uu-129884DiVA: diva2:345545
Available from: 2010-08-25 Created: 2010-08-25 Last updated: 2010-12-27Bibliographically approved
In thesis
1. Heart Rate Variability in Stress-related Fatigue, Adolescent Anxiety and Depression and its Connection to Lifestyle
Open this publication in new window or tab >>Heart Rate Variability in Stress-related Fatigue, Adolescent Anxiety and Depression and its Connection to Lifestyle
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Heart rate varies constantly as a consequence of activity in the sympathetic and parasympathetic autonomic nervous systems (SNS and PNS). In short-term recordings, heart rate variability (HRV) is mostly related to the inhibitory activity of the vagal nerves, which are part of the PNS. HRV is lower when under stress as well as in several illnesses and psychiatric conditions. Decreased HRV is also related to cardiac disease, which is the leading cause of death worldwide. Autonomic imbalance, measured as HRV, is suggested as a mediator between psychosocial distress and cardiovascular disease.

The aim of the present thesis was to investigate the connection between HRV and psychosocial distress, including psychiatric problems (studies I and II), and lifestyle factors (study III). In study I, additional physiological measures sensitive to autonomic activity and results from a continuous attention test were investigated in parallel with HRV. In studies II and III the participants were adolescents.

The results show that HRV is lower in women with stress-related fatigue and adolescent girls with a psychiatric diagnosis compared to healthy control groups. However, these groups did not exhibit an increase in physiological measures of SNS origin, which supports the assumption that the observed hyperarousal is related to decreased vagal activity rather than increased SNS activity. Women with stress-related fatigue made more impulsive errors and had a “risky” response style in the continuous attention test. There was a negative correlation between test performance and HRV. Decreased vagal activity is thus associated with deficient behavioural inhibition. In study III, HRV in a group of healthy adolescent boys and girls was positively associated with physical activity but not with other lifestyle measures.

Even at young age HRV is a sensitive marker of autonomic imbalance resulting from psychosocial stress. Future longitudinal research will show whether HRV can be used for early identification of people at risk of cardiovascular disease and whether such interventions will lower the risk of cardiac morbidity.

Place, publisher, year, edition, pages
Uppsala: Acta Universtatis Upsaliensis, 2010. 66 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 61
heart rate variability, autonomic nervous system, vagal tone, allostatic load, stress, fatigue, anxiety, depression, continuous performance, attention, cardiovascular risk, lifestyle, physical activity
urn:nbn:se:uu:diva-129910 (URN)978-91-554-7874-2 (ISBN)
Public defence
2010-10-15, Sal IV, Universitetshuset, Uppsala, 10:00 (Swedish)
Available from: 2010-09-24 Created: 2010-08-25 Last updated: 2010-12-22

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