Heart rate variability in bipolar mania and schizophrenia

• Published in: Journal of psychiatric research 2010-02, Vol.44 (3), p.168-176
• Main Authors: Henry, Brook L, Minassian, Arpi, Paulus, Martin P, Geyer, Mark A, Perry, William
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aggression; Biological and medical sciences; Bipolar affective disorder; Bipolar disorder; Bipolar Disorder - physiopathology; Bipolar disorders; Brief Psychiatric Rating Scale; Case-Control Studies; Dysfunction; Entropy; Female; Heart - physiopathology; Heart Rate; Heart rate variability; Humans; Hygiene; Male; Mania; Medical sciences; Mood disorders; Parasympathetic Nervous System - physiopathology; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Schizophrenia; Schizophrenia - physiopathology
• ISSN: 0022-3956; 1879-1379
• DOI: 10.1016/j.jpsychires.2009.07.011

Abstract Background Autonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been reported in a wide variety of psychiatric disorders, but have not been well characterized in bipolar mania. We recorded cardiac activity and assessed HRV in acutely hospitalized manic bipolar (BD) and schizophrenia (SCZ) patients compared to age- and gender-matched healthy comparison (HC) subjects. Method HRV was assessed using time domain, frequency domain, and nonlinear analyses in 23 manic BD, 14 SCZ, and 23 HC subjects during a 5 min rest period. Psychiatric symptoms were assessed by administration of the Brief Psychiatric Rating Scale (BPRS) and the Young Mania Rating Scale (YMRS). Results Manic BD patients demonstrated a significant reduction in HRV, parasympathetic activity, and cardiac entropy compared to HC subjects, while SCZ patients demonstrated a similar, but non-significant, trend towards lower HRV and entropy. Reduction in parasympathetic tone was significantly correlated with higher YMRS scores and the unusual thought content subscale on the BPRS. Decreased entropy was associated with increased aggression and diminished personal hygiene on the YMRS scale. Conclusion Cardiac function in manic BD individuals is characterized by decreased HRV, reduced vagal tone, and a decline in heart rate complexity as assessed by linear and nonlinear methods of analysis. Autonomic dysregulation is associated with more severe psychiatric symptoms, suggesting HRV dysfunction in this disorder may be dependent on the phase of the illness.