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Cited by 447

The DOI matches its Crossref record; 11 of the 11 references it cites were found in a registry or an index.

Depression, Comorbid Anxiety Disorders, and Heart Rate Variability in Physically Healthy, Unmedicated Patients: Implications for Cardiovascular Risk

Open access
Kemp, Andrew H., Quintana, Daniel S., Felmingham, Kim L., Matthews, Slade, Jelinek, Herbert F.·2012·PLoS ONE
DOI 10.1371/journal.pone.0030777
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Abstract

CONTEXT: There is evidence that heart rate variability (HRV) is reduced in major depressive disorder (MDD), although there is debate about whether this effect is caused by medication or the disorder per se. MDD is associated with a two to fourfold increase in the risk of cardiac mortality, and HRV is a robust predictor of cardiac mortality; determining a direct link between HRV and not only MDD, but common comorbid anxiety disorders, will point to psychiatric indicators for cardiovascular risk reduction. OBJECTIVE: To determine in physically healthy, unmedicated patients whether (1) HRV is reduced in MDD relative to controls, and (2) HRV reductions are driven by MDD alone, comorbid generalized anxiety disorder (GAD, characterized by anxious anticipation), or comorbid panic and posttraumatic stress disorders (PD/PTSD, characterized by anxious arousal). DESIGN, SETTING, AND PATIENTS: A case-control study in 2006 and 2007 on 73 MDD patients, including 24 without anxiety comorbidity, 24 with GAD, and 14 with PD/PTSD. Seventy-three MDD and 94 healthy age- and sex-matched control participants were recruited from the general community. Participants had no history of drug addiction, alcoholism, brain injury, loss of consciousness, stroke, neurological disorder, or serious medical conditions. There were no significant differences between the four groups in age, gender, BMI, or alcohol use. MAIN OUTCOME MEASURES: HRV was calculated from electrocardiography under a standardized short-term resting state condition. RESULTS: HRV was reduced in MDD relative to controls, an effect associated with a medium effect size. MDD participants with comorbid generalized anxiety disorder displayed the greatest reductions in HRV relative to controls, an effect associated with a large effect size. CONCLUSIONS: Unmedicated, physically healthy MDD patients with and without comorbid anxiety had reduced HRV. Those with comorbid GAD showed the greatest reductions. Implications for cardiovascular risk reduction strategies in otherwise healthy patients with psychiatric illness are discussed.

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Metadata

Authors
Kemp, A. H., Quintana, D. S., Felmingham, K. L., Matthews, S., & Jelinek, H. F.
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2012-02-15
Volume
7
Issue
2
Pages
e30777
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0030777
OpenAlex
W2127912154
Cited by
447
References
11
FWCI
18.22
Type
journal article
Language
en
Open access
gold

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