The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.
Effects of Depression, Anxiety, Comorbidity, and Antidepressants on Resting-State Heart Rate and Its Variability: An ELSA-Brasil Cohort Baseline Study
Abstract
OBJECTIVE: Increases in resting-state heart rate and decreases in its variability are associated with substantial morbidity and mortality, yet contradictory findings have been reported for the effects of the mood and anxiety disorders and of antidepressants. The authors investigated heart rate and heart rate variability in a large cohort from Brazil, using propensity score weighting, a relatively novel method, to control for numerous potential confounders. METHOD: A total of 15,105 participants were recruited in the Brazilian Longitudinal Study of Adult Health. Mood and anxiety disorders were ascertained using the Portuguese version of the Clinical Interview Schedule-Revised. Heart rate and its variability were extracted from 10-minute resting-state electrocardiograms. Regressions weighted by propensity scores were carried out to compare participants with and without depressive or anxiety disorders, as well as users and non-users of antidepressants, on heart rate and heart rate variability. RESULTS: Use of antidepressants was associated with increases in heart rate and decreases in its variability. Effects were most pronounced for the tricyclic antidepressants (Cohen's d, 0.72-0.81), followed by serotonin and norepinephrine reuptake inhibitors (Cohen's d, 0.42-0.95) and other antidepressants (Cohen's d, 0.37-0.40), relative to participants not on antidepressants. Only participants with generalized anxiety disorder showed robust, though small, increases in heart rate and decreases in its variability after propensity score weighting. CONCLUSIONS: The findings may, in part, underpin epidemiological findings of increased risk for cardiovascular morbidity and mortality. Many factors that have an adverse impact on cardiac activity were controlled for in this study, highlighting the importance of cardiovascular risk reduction strategies. Further study is needed to examine whether, how, and when such effects contribute to morbidity and mortality.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“Novel analytical methods such as propensity score weighting using generalized boosted modeling may help to overcome the limitations of traditional analysis (e.g., Kemp et al., 2014), but are yet to be applied to associations between HRV and wellbeing.”
From The Complex Construct of Wellbeing and the Role of Vagal Function (2022) · cites this paper as Kemp et al., 2014
In the citing paper
“Interestingly, the basal heart rate was lower in patients taking SSRIs (mean=65.40 bpm, p=0.003, d=0.161) than in patients taking the placebo (Table 1).”
From Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review (2018) · cites this paper as [28]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Heart Rate Variability: Standards of Measurement, Physiological Interpretation, and Clinical Use
Electrophysiology, T. F. O. T. E. S. O. C. T. N. A. (1996) · Circulation · doi:10.1161/01.cir.93.5.1043 · Cited by 17,159
Heart rate variability: Standards of measurement, physiological interpretation, and clinical use
Malik, M., Bigger, J. T., Camm, A. J., Kleiger, R. E., Malliani, A., Moss, A. J., & Schwartz, P. J. (1996) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a014868 · Cited by 15,289
Kleiger, R. E., Miller, J. P., Bigger, J. T., & Moss, A. J. (1987) · The American Journal of Cardiology · doi:10.1016/0002-9149(87)90795-8 · Cited by 3,995
Thayer, J. F., Yamamoto, S. S., & Brosschot, J. F. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2009.09.543 · Cited by 2,276
Self-citationThayer, J. F., Hansen, A. L., Saus-Rose, E., & Johnsen, B. H. (2009) · Annals of Behavioral Medicine · doi:10.1007/s12160-009-9101-z · Cited by 1,872
Self-citationWhy Most Discovered True Associations Are Inflated
Ioannidis, J. P. A. (2008) · Epidemiology · doi:10.1097/ede.0b013e31818131e7 · Cited by 1,495
Lewis, G., Pelosi, A. J., Araya, R., & Dunn, G. (1992) · Psychological Medicine · doi:10.1017/s0033291700030415 · Cited by 1,487
A tutorial on propensity score estimation for multiple treatments using generalized boosted models
McCaffrey, D. F., Griffin, B. A., Almirall, D., Slaughter, M. E., Ramchand, R., & Burgette, L. F. (2013) · Statistics in Medicine · doi:10.1002/sim.5753 · Cited by 1,450
McCaffrey, D. F., Ridgeway, G., & Morral, A. R. (2004) · Psychological Methods · doi:10.1037/1082-989x.9.4.403 · Cited by 1,317
Kemp, A. H., Quintana, D. S., Gray, M. A., Felmingham, K. L., Brown, K., & Gatt, J. M. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.12.012 · Cited by 1,286
Self-citation
Research works printed but not linked: 3
- Saul JP, 1990, Physiology (Bethesda), 5, 32
- Schmidt MI, Int J Epidemiol
- Nunes MA, 2012, Revista HCPA, 31, 487
Cited by
Sorted by citations
Heart rate variability as a transdiagnostic biomarker of psychopathology
Beauchaine, T. P., & Thayer, J. F. (2015) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2015.08.004 · Cited by 870
“Evidence for low HF-HRV in internalizing disorders is abundant though not universal (e.g., Pittig et al., 2013; Kemp et al., 2014; Licht et al., 2009).”
InfluentialSelf-citationCarvalho, A. F., Sharma, M. S., Brunoni, A. R., Vieta, E., & Fava, G. A. (2016) · Psychotherapy and Psychosomatics · doi:10.1159/000447034 · Cited by 650
Self-citationDepression and cardiovascular disease: Epidemiological evidence on their linking mechanisms
Penninx, B. W. J. H. (2017) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.07.003 · Cited by 576
“Two other recent large-scale studies by Licht et al. (2015) and Kemp et al. (2014) did also not confirm an association between depression and lower HRV.”
InfluentialPhysiological concomitants of perseverative cognition: A systematic review and meta-analysis.
Ottaviani, C., Thayer, J. F., Verkuil, B., Lonigro, A., Medea, B., Couyoumdjian, A., & Brosschot, J. F. (2016) · Psychological Bulletin · doi:10.1037/bul0000036 · Cited by 476
“This would have acted as an important confounding in our meta-analysis, especially in light of the recognized effects of antidepressants on physiological responses such as heart rate and heart rate variability (e.g., Kemp et al., 2014).”
Self-citationFuture Directions in Emotion Dysregulation and Youth Psychopathology
Beauchaine, T. P. (2015) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2015.1038827 · Cited by 394
“…Beauchaine, Mead, & GatzkeKopp, 2009), and with a wide range of psychopathological outcomes, including anxiety (e.g., Hastings et al., 2008; Kemp et al., 2014; Thayer, Friedman, & Borkovec, 1996), phobias (e.g., Åhs, Sollers, Furmark, Fredrikson, & Thayer, 2009), attention problems (see…”
Metadata
- Authors
- Kemp, A. H., Brunoni, A. R., Santos, I. S., Nunes, M. A., Dantas, E. M., Carvalho de Figueiredo, R., Pereira, A. C., Ribeiro, A. L. P., Mill, J. G., Andreão, R. V., Thayer, J. F., Benseñor, I. M., & Lotufo, P. A.
- Affiliations
- The University of Sydney (AU)
- From University Hospital and the Faculty of Medicine, University of São Paulo, São Paulo, Brazil; the School of Psychology and Discipline of Psychiatry, University of Sydney, Sydney, Australia; the Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; the Collegiate of Biological Sciences, Federal University of Vale do São Francisco, Petrolina, Pernambuco, Brazil; Campus Centro Oeste Dona Lindu, Federal University of São João Del-Rei, Brazil; the Laboratory of Genetics and...
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2014-12-01
- Volume
- 171
- Issue
- 12
- Pages
- 1328-1334
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2119976990
- Cited by
- 189
- References
- 41
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 11 · 2023: 17 · 2022: 13 · 2021: 18 · 2020: 15 · 2019: 18 · 2018: 14 · 2017: 16 · 2016: 27 · 2015: 24 · 2014: 2
- FWCI
- 15.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- resting heart rate, heart rate variability, depression, anxiety disorders, antidepressants, tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, generalized anxiety disorder, cardiovascular risk, mood disorders, ELSA-Brasil
- MeSH terms
- Adult, Aged, Antidepressive Agents, Antidepressive Agents, Tricyclic, Anxiety, Anxiety Disorders, Brazil, Cardiovascular Diseases, Depression, Major Depressive Disorder, Female, Heart Rate, Humans, Interview, Psychological, Longitudinal Studies, Male, Middle Aged, Vagus Nerve, Comorbidity, Selective Serotonin Reuptake Inhibitors, Adrenergic Uptake Inhibitors, Mood Disorders, Propensity Score
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
