Clinical and non-clinical depression and anxiety in young people: A scoping review on heart rate variability

Depression and anxiety disrupt daily function and their effects can be long-lasting and devastating, yet there are no established physiological indicators that can be used to predict onset, diagnose, or target treatments. In this review, we conceptualize depression and anxiety as maladaptive responses to repetitive stress. We provide an overview of the role of chronic stress in depression and anxiety and a review of current knowledge on objective stress indicators of depression and anxiety. We focused on cortisol, heart rate variability and skin conductance that have been well studied in depression and anxiety and implicated in clinical emotional states. A targeted PubMed search was undertaken prioritizing meta-analyses that have linked depression and anxiety to cortisol, heart rate variability and skin conductance. Consistent findings include reduced heart rate variability across depression and anxiety, reduced tonic and phasic skin conductance in depression, and elevated cortisol at different times of day and across the day in depression. We then provide a brief overview of neural circuit disruptions that characterize particular types of depression and anxiety. We also include an illustrative analysis using predictive models to determine how stress markers contribute to specific subgroups of symptoms and how neural circuits add meaningfully to this prediction. For this, we implemented a tree-based multi-class classification model with physiological markers of heart rate variability as predictors and four symptom subtypes, including normative mood, as target variables. We achieved 40% accuracy on the validation set. We then added the neural circuit measures into our predictor set to identify the combination of neural circuit dysfunctions and physiological markers that accurately predict each symptom subtype. Achieving 54% accuracy suggested a strong relationship between those neural-physiological predictors and the mental states that characterize each subtype. Further work to elucidate the complex relationships between physiological markers, neural circuit dysfunction and resulting symptoms would advance our understanding of the pathophysiological pathways underlying depression and anxiety.

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Heart Rate Variability as a Measure of Depression and Anxiety during Pregnancy

Heart Rate Variability (HRV) Signal Analysis ◽

10.1201/b12756-30 ◽

2012 ◽

pp. 479-502

Author(s):

Alison Shea ◽

Meir Steiner ◽

Markad Kamath

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Depression And Anxiety

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Resonance breathing is associated with improvements in depression and anxiety symptoms during heart rate variability biofeedback sessions

10.31234/osf.io/7g5q8 ◽

2021 ◽

Author(s):

Adam Khan Pettitt ◽

Benjamin W Nelson ◽

Richard Gevirtz ◽

Paul Lehrer ◽

Kristian Ranta ◽

...

Keyword(s):

Mental Health ◽

Heart Rate ◽

Heart Rate Variability ◽

Resonance Frequency ◽

Treatment Protocol ◽

Anxiety Symptoms ◽

Adjunctive Treatment ◽

Depression And Anxiety ◽

Heart Rate Variability Biofeedback ◽

Item Scale

Heart rate variability (HRV) appears to be a transdiagnostic biomarker for health and disease. Although initial studies using HRV biofeedback (HRVB) to regulate HRV as a potential adjunctive treatment to gold-standard interventions seem promising, more research is needed to determine which aspects of HRVB training provide the most clinical benefits to those suffering from mental health symptoms. In the current study, we sought to investigate whether time spent in resonance, between-person differences in resonance frequency, and/or within-person resonance frequency trajectory across repeated HRVB sessions were related to changes in depression and/or anxiety symptoms during a 12-week digital mental health intervention that contains HRVB as part of the treatment protocol. We used a retrospective cohort study to examine these associations among 387 participants in the Meru Health Program. For depression, we found that average resonance time per HRVB session, but not total time in resonance, was significantly associated with decreased depression as measured by the Patient Health Questionnaire 9-item scale (PHQ-9) across treatment (b=-0.38, 95% CI [-0.76,-0.01], t(377)=-1.99, p=.047). For anxiety symptoms as measured by the Generalized Anxiety Disorder 7-item scale (GAD-7), we found neither association significant. Within-person effects were significant for both depression and anxiety, with steeper slopes of time spent in resonance significantly related to reductions in PHQ-9 and GAD-7 symptoms, respectively. Between-person effects were not significant for either depression or anxiety. Our results demonstrate that improvements in resonance efficiency over time in treatment, independent of how each participant starts, are related to reductions in depression and anxiety symptoms.

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Heart rate and high frequency heart rate variability during stress as biomarker for clinical depression. A systematic review

Psychological Medicine ◽

10.1017/s0033291718001988 ◽

2018 ◽

Vol 49 (2) ◽

pp. 200-211 ◽

Cited By ~ 38

Author(s):

Carmen Schiweck ◽

Deborah Piette ◽

Daniel Berckmans ◽

Stephan Claes ◽

Elske Vrieze

Keyword(s):

Systematic Review ◽

Heart Rate ◽

Heart Rate Variability ◽

Remote Monitoring ◽

High Frequency ◽

Social Stress ◽

Mental Arithmetic ◽

Clinical Depression ◽

Clear Cut ◽

Stress Task

AbstractThe interaction of physical and mental vulnerability and environmental constraints is thought to foster the development of psychiatric disorders such as major depressive disorder (MDD). A central factor in the development of psychopathology is mental stress. Despite some evidence for parasympathetic withdrawal and sympathetic overactivity in MDD, the psychophysiological response to stress in depression is not clear-cut. Given the growing interest in heart rate and heart rate variability as indicators for remote monitoring of patients, it is important to understand how patients with MDD react to stress in a laboratory-controlled environment. We conducted a systematic review of studies using electrocardiography to derive heart rate and heart rate variability during stress in patients with clinical depression. We focused on well-validated stress tasks- the mental arithmetic stress task, the Trier social stress task and public speaking task- to minimize confounding effects due to the nature of the stressor. The majority of studies found hypo-reactivity during stress as a hallmark of depression as evidenced by lower fluctuation in heart rate and heart rate variability in the high-frequency band. We address the potential underlying biological mechanisms, the influence of covariates on these measures and briefly discuss the specificity and potential for remote monitoring by using these variables.

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Association between Anxiety Disorders and Heart Rate Variability in The Netherlands Study of Depression and Anxiety (NESDA)

Psychosomatic Medicine ◽

10.1097/psy.0b013e3181a292a6 ◽

2009 ◽

Vol 71 (5) ◽

pp. 508-518 ◽

Cited By ~ 117

Author(s):

Carmilla M. M. Licht ◽

Eco J. C. de Geus ◽

Richard van Dyck ◽

Brenda W. J. H. Penninx

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

The Netherlands ◽

Anxiety Disorders ◽

Depression And Anxiety

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Relationship among Sleep Quality, Heart Rate Variability, Fatigue, Depression, and Anxiety in Adults

Korean Journal of Adult Nursing ◽

10.7475/kjan.2017.29.1.87 ◽

2017 ◽

Vol 29 (1) ◽

pp. 87 ◽

Cited By ~ 6

Author(s):

Ju Ah Kim ◽

Seung Wan Kang

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Sleep Quality ◽

Depression And Anxiety

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Quality Social Connection as an Active Ingredient in Digital Interventions for Young People With Depression and Anxiety: Systematic Scoping Review and Meta-analysis

Journal of Medical Internet Research ◽

10.2196/26584 ◽

2021 ◽

Vol 23 (12) ◽

pp. e26584

Author(s):

Lindsay H Dewa ◽

Emma Lawrance ◽

Lily Roberts ◽

Ellie Brooks-Hall ◽

Hutan Ashrafian ◽

...

Keyword(s):

Mental Health ◽

Young People ◽

Conceptual Framework ◽

Scoping Review ◽

Meta Analysis ◽

Social Connections ◽

Social Connection ◽

Depression And Anxiety ◽

Digital Interventions ◽

The Impact

Background Disrupted social connections may negatively affect youth mental health. In contrast, sustained quality social connections (QSCs) can improve mental health outcomes. However, few studies have examined how these quality connections affect depression and anxiety outcomes within digital interventions, and conceptualization is limited. Objective The aim of this study is to conceptualize, appraise, and synthesize evidence on QSC within digital interventions (D-QSC) and the impact on depression and anxiety outcomes for young people aged 14-24 years. Methods A systematic scoping review and meta-analysis was conducted using the Joanna Briggs Institute methodological frameworks and guided by experts with lived experience. Reporting was guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The MEDLINE, Embase, PsycINFO, and CINAHL databases were searched against a comprehensive combination of key concepts on June 24, 2020. The search concepts included young people, digital intervention, depression, anxiety, and social connection. Google was also searched. A reviewer independently screened abstracts and titles and full text, and 9.99% (388/3882) of these were screened by a second reviewer. A narrative synthesis was used to structure the findings on indicators of D-QSC and mechanisms that facilitate the connection. Indicators of D-QSC from the included studies were synthesized to produce a conceptual framework. Results Of the 5715 publications identified, 42 (0.73%) were included. Among the included studies, there were 23,319 participants. Indicators that D-QSC was present varied and included relatedness, having a sense of belonging, and connecting to similar people. However, despite the variation, most of the indicators were associated with improved outcomes for depression and anxiety. Negative interactions, loneliness, and feeling ignored indicated that D-QSC was not present. In 24% (10/42) of the applicable studies, a meta-analysis showed a significant decrease in depression (–25.6%, 95% CI –0.352 to –0.160; P<.001) and anxiety (–15.1%, 95% CI –0.251 to –0.051; P=.003) after a D-QSC. Digital mechanisms that helped create a quality connection included anonymity, confidentiality, and peer support. In contrast, mechanisms that hindered the connection included disconnection from the real world and inability to see body language. Data synthesis also identified a 5-component conceptual framework of D-QSC that included rapport, identity and commonality, valued interpersonal dynamic, engagement, and responded to and accepted. Conclusions D-QSC is an important and underconsidered component for youth depression and anxiety outcomes. Researchers and developers should consider targeting improved QSC between clinicians and young people within digital interventions for depression. Future research should build on our framework to further examine relationships among individual attributes of QSC, various digital interventions, and different populations.

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Are Trait Emotional Competencies and Heart Rate Variability Linked to Mental Health of Coronary Heart Disease Patients?

Psychological Reports ◽

10.1177/0033294119898116 ◽

2020 ◽

pp. 003329411989811

Author(s):

Batselé Elise ◽

Sophie Vanden Eynde ◽

Nathalie Egée ◽

Michel Lamotte ◽

Philippe Van de Borne ◽

...

Keyword(s):

Heart Rate ◽

Coronary Heart Disease ◽

Heart Rate Variability ◽

Heart Disease ◽

Cardiac Rehabilitation ◽

Depression Scale ◽

Anxiety Symptoms ◽

Depression Symptoms ◽

Depression And Anxiety ◽

Emotional Competencies

Purpose Depression and anxiety have been extensively associated with adverse outcomes in coronary heart disease patients. However, psychological and physiological processes underlying the persistence of these troubles in coronary heart disease patients attending cardiac rehabilitation are poorly investigated. Trait emotional competencies and heart rate variability could be some of these processes. Thus, the aim of this study was to assess the predictive value of trait emotional competencies and heart rate variability on depression and anxiety symptoms persistence in coronary heart disease patients. Methods Eighty-four patients who recently presented a myocardial infarction were evaluated at the beginning of cardiac rehabilitation. Forty-two patients continued their rehabilitation program and were then assessed three months later. They completed the Profile of Emotional Competence as well as the Hospital Anxiety and Depression Scale and underwent a 5-minute resting heart rate variability measure. Results Low trait emotional competencies score predicted depression symptoms persistence, but unexpectedly, high trait emotional competencies score was also associated with withdrawal from cardiac rehabilitation. Contrary to our expectations, heart rate variability did not predict depression or anxiety symptoms persistence and was not associated with trait emotional competencies. Conclusions This study is the first to report an association between trait emotional competencies and depression symptoms persistence in coronary heart disease patients. However, heart rate variability was not associated with either depression or anxiety supporting the idea of mixed literature and highlighting the need of future research.

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