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

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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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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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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