Heart rate variability in bipolar mania and schizophrenia
Open accessAbstract
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 5min 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.
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Patients with schizophrenia have relatively preserved sympathetic functioning and do not differ significantly from healthy controls.
“Consistent with the findings of several previous studies31–34, these results imply that patients with SCZ have relatively preserved sympathetic functioning and do not differ significantly with HCs.”
From Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health (2021) · cites this paper as [32]
The Introduction reports no difference in LF power between unmedicated schizophrenia patients and controls, consistent with relatively preserved sympathetic functioning. The Results (§3.1) found no significant difference on other HRV measures, but schizophrenia patients did have significantly elevated heart rates versus healthy controls. The unqualified claim that they did not differ significantly from controls therefore overstates the finding. (LLM, conf=0.88)
Experimental — accuracy not yet measuredHenry et al. failed to note any correlations between HRV and BPRS scores among a group of schizophrenia patients.
“However, while Henry et al.32 failed to note any correlations between HRV and BPRS scores among a group of SCZ patients, they did find a significant negative correlation between HF-HRV as well as a significant positive correlation with the total score on the Young Mania Rating Score (YMRS).”
From Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health (2021) · cites this paper as [32]
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- Authors
- Henry, B. L., Minassian, A., Paulus, M. P., Geyer, M. A., & Perry, W.
- Affiliations
- University of California San Diego (US)
- Corresponding author
- Henry, Brook L.
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2010-02
- Volume
- 44
- Issue
- 3
- Pages
- 168-176
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC2822123
- OpenAlex
- W2055618902
- Cited by
- 197
- References
- 80
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 5 · 2023: 12 · 2022: 10 · 2021: 14 · 2020: 11 · 2019: 17 · 2018: 12 · 2017: 21 · 2016: 19 · 2015: 14 · 2014: 10 · 2013: 15 · 2012: 8
- FWCI
- 4.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH071916)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- heart rate variability, bipolar mania, schizophrenia, autonomic dysfunction, parasympathetic activity, vagal tone, heart rate complexity, nonlinear HRV analysis, manic symptoms, aggression, personal hygiene
- MeSH terms
- Adult, Aggression, Bipolar Disorder, Female, Heart, Heart Rate, Humans, Hygiene, Male, Brief Psychiatric Rating Scale, Parasympathetic Nervous System, Schizophrenia, Case-Control Studies
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