The Application of Heart Rate Variability Biofeedback to Medical and Mental Health Disorders

Biofeedback ◽  
2017 ◽  
Vol 45 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Donald Moss ◽  
Fredric Shaffer

Heart rate variability (HRV) is a medical index for morbidity and wellness. Lower HRV accompanies many illnesses; high HRV accompanies healthy states, resilience, and optimal functioning. Heart rate variability biofeedback (HRVB) uses real-time electronic feedback of the moment-to-moment changes in HRV to train patients to produce increases in HRV. Outcome studies on HRVB have shown therapeutic benefit for a wide variety of medical and mental health disorders. Lehrer and colleagues have published evidence-based protocols for HRV assessment and HRV treatment. Here, the authors review outcome studies on a sampling of common disorders: asthma, chronic muscle pain, depression, heart failure, hypertension, and posttraumatic stress disorder. HRVB offers promising therapeutic benefit for any medical or mental health disorder known to be accompanied by autonomic nervous system dysregulation.

2021 ◽  
pp. 112067212110676
Author(s):  
Ahmad Abdel-Aty ◽  
Ninani Kombo

Chronic inflammatory diseases can cause significant psychosocial stress in affected patients. Few studies have examined the psychological effects of ocular inflammatory disease and no studies have examined the psychological effects of scleritis. In this study we evaluate the prevalence of mental health disorders in scleritis patients and we conduct a comprehensive review of the literature on the mental health effects of ocular inflammatory diseases. 162 patients (195 eyes) presenting to a tertiary care center with scleritis were identified. At least one comorbid mental health disorder was diagnosed in 35 patients (21.6%), most commonly major depression in 11.7%, generalized anxiety disorder in 9.3%, and substance use disorder in 6.2%. There were no significant differences in the length of an episode of scleritis or in the probability of symptom resolution between patients with a mental health disorder and other patients. In a review of the literature, 30 manuscripts met the inclusion criteria. The majority of manuscripts (83.3%) were focused on uveitis patients. Eight of these studies were focused on patients with uveitis in the context of systemic disease. The most commonly reported mental health disorders reported were anxiety and depression. An average of 31.3% of patients with ocular inflammatory disease had depression and 35.0% had anxiety. Similar to other chronic illnesses, ocular inflammatory disease may be a significant psychosocial stressor. Future studies will further elucidate the relationship between these diseases and mental health.


2021 ◽  
Author(s):  
Adam Khan Pettitt ◽  
Benjamin W Nelson ◽  
Richard Gevirtz ◽  
Paul Lehrer ◽  
Kristian Ranta ◽  
...  

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.


Pain Medicine ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 488-500
Author(s):  
Penny L Brennan ◽  
Sonya SooHoo

Abstract Objective To determine the key classes of nursing home residents’ nine-month pain trajectories, the influence of residents’ mental health disorders on membership in these classes, and nine-month health-related outcomes associated with pain trajectory class membership. Methods Four times over a nine-month period, the MDS 3.0 resident assessment instrument was used to record the demographic characteristics, mental health disorder diagnoses, pain characteristics, and health and functioning outcomes of 2,539 Department of Veterans Affairs Community Living Center (VA CLC) residents. Growth mixture modeling was used to estimate the key classes of residents’ nine-month pain trajectories, the influence of residents’ mental health disorders on their pain trajectory class membership, and the associations of class membership with residents’ health and functioning outcomes at nine-month follow-up. Results Four-class solutions best described nursing home residents’ nine-month trajectories of pain frequency, severity, and interference. Residents with dementia and severe mental illness diagnoses were less likely, and those with depressive disorder, PTSD, and substance use disorder diagnoses more likely, to belong to adverse nine-month pain trajectory classes. Membership in adverse pain frequency and pain severity trajectory classes, and in trajectory classes characterized by initially high but steeply declining pain interference, portended more depressive symptoms but better cognitive and physical functioning at nine-month follow-up. Conclusions Nursing home residents’ mental health disorder diagnoses help predict their subsequent pain frequency, severity, and interference trajectories. This may be clinically useful information for improving pain assessment and treatment approaches for nursing home residents.


Author(s):  
Nan Hu ◽  
Catherine Taylor ◽  
Rebecca Glauert ◽  
Jianghong Li ◽  
Janice Wong

ABSTRACTIntroductionIt is well established that parental mental health disorders increase children’s risk of deliberate self-harm (DSH). However, little is known about how early life exposure to social disadvantage influences DSH among children whose parents have a mental health disorder. AimsTo examine how early life exposure to high neighbourhood socioeconomic disadvantage and having a teen mother influence the DSH risk among children whose parents have a mental health disorder. MethodsThis study was based on the linkage of population-level records routinely collected by government agencies in Western Australia. A birth cohort including 474,860 non-Aboriginal individuals born between 1981 and 2001 was followed up until 2011. A nested case-control sample was compiled from the birth cohort for data analysis. A total of 7,151 people with DSH-related contacts (cases) and 143,020 matched controls were analysed. Conditional logistic regression models were utilised in this study. ResultsExposure to high neighbourhood socioeconomic disadvantage was associated with additionally increased odds of DSH among children exposed to maternal mental health disorders during early childhood (1-4 years) (OR=1.75, 95%CI:1.30-2.36, p<0.001). However, this was not observed for children exposed to maternal mental health disorders during late childhood (5-9 years) or adolescence (10-19 years). Comparatively, exposure to high socioeconomic disadvantage was related to additionally increased odds of DSH among children exposed to paternal mental health disorders during adolescence (10-19 years) (OR=2.25, 95%CI:1.60-3.16, p<0.001), but not childhood. Having a teen mother was significantly associated with additionally increased odds of DSH, regardless of when the parental mental health disorders occurred. Children with a teen mother and early life exposure to socioeconomic disadvantage were at additionally increased odds of DSH, compared to children with only one form of disadvantage (OR=1.51,95%CI:1.07-2.12%,p=0.018) among children exposed to parental mental health disorders during childhood, but not during adolescence. Conclusion Among children of parents with mental health disorders, early life exposure to social disadvantage is not uncommon, and confers additionally increased risk of DSH. Therefore, preventive strategies need to be based on joint actions involving both social and health services, and need to incorporate child mental health interventions into adult mental health services. The cross-cutting efforts would provide a greater positive impact in effectively addressing the multifaceted nature of reducing DSH among children of parents with mental health disorders.


2020 ◽  
Vol 3 (1) ◽  
pp. 1-20
Author(s):  
Khairil Faizal Khairi ◽  
Nur Hidayah Laili ◽  
Aimi Fadzirul Kamarubahrin

This paper investigates the factors influencing Malaysian consumer intention toward takaful scheme for mental health disorders. An applied expanded Theory of Reasoned Action (TRA) model were used in the research and the variables of awareness, perception, attitude, subjective norm and intention toward a takaful scheme for mental health disorders were investigated. It is a pilot research carried out in Malaysia. The respondents are 60 Malaysian takaful consumers based on an online survey inside Klang Valley, Malaysia. This study reveals that the mean of attitude with the score of 4.27 is the highest score. The Pearson correlation is positive for both independent and dependent variables. Analysis of regression indicates a strong positive relationship between subjective norm and intention, thus suggesting that subjective norm is an important area to link to intention against mental health disorder takaful scheme. This is also proposed that future studies will concentrate on the factors that affect the willingness of consumers towards takaful mental health disorder schemes. It is hoped that the results of this study will serve as an informative reference for further development of takaful scheme for mental health disorder.


BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036280
Author(s):  
Akilew A. Adane ◽  
Helen D. Bailey ◽  
Rhonda Marriott ◽  
Brad M. Farrant ◽  
Scott W. White ◽  
...  

IntroductionMaternal mental health disorders such as anxiety and depression are major public health concerns. Evidence shows a link between maternal mental health disorders and preterm birth and low birth weight. However, the impacts of maternal mental health disorders on stillbirth and infant mortality have been less investigated and inconsistent findings have been reported. Thus, using the available literature, we plan to examine whether prenatal maternal mental health disorders impact the risk of stillbirth and infant mortality.Methods and analysisThis systematic review and meta-analysis will adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and will be registered with the International Prospective Register of Systematic Reviews. Systematic searches will be conducted (from database inception to December 2019) in Medline, Embase, PsycINFO and Scopus for studies examining the association of prenatal mental health disorders and stillbirth and infant mortality. The search will be limited to studies published in English language and in humans only, with no restriction on the year of publication. Two independent reviewers will evaluate records and assess the quality of individual studies. The Newcastle–Ottawa scales and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach will be used to assess the methodological quality and bias of the included studies. In addition to a narrative synthesis, a random-effects meta-analysis will be conducted when sufficient data are available. I2 statistics will be used to assess between-study heterogeneity in the estimated effect size.Ethics and disseminationAs it will be a systematic review and meta-analysis based on previously published evidence, there will be no requirement for ethical approval. Findings will be published in a peer-reviewed journal and will be presented at various conferences.PROSPERO registration number159834.


2020 ◽  
Vol 162 (5) ◽  
pp. 754-760
Author(s):  
Yann-Fuu Kou ◽  
Cynthia Wang ◽  
Gopi B. Shah ◽  
Ron B. Mitchell ◽  
Romaine F. Johnson

Objectives Recent evidence suggests that children with mental health disorders are more likely to have postoperative complications. Our aim was to determine if mental health disorders affect postoperative complications after tonsillectomy with or without adenoidectomy (T&A). Setting Cross-sectional analysis of national databases. Subjects and Methods The 2006 to 2016 Kids Inpatient Database and the 2014 Nationwide Readmission Database were used to identify children (age <21 years) who underwent T&A. We compared children with mental health disorders (eg, autism, developmental delays, or mood disorders) to those without a mental health disorder. We contrasted gender, race, length of stay, complications, and 30-day readmissions. Results We estimated that 37,386 children underwent T&A, and there were 2138 (5.7%) diagnosed with a mental health disorder. Children with mental health disorders were older (6.0 vs 5.3 years, P < .001), more commonly males (64% vs 58%, P < .001), had a longer length of stay (3.4 days vs 2.3 days, P < .001), and had higher total charges even after controlling for length of stay ($19,000 vs $14,000, P < .001). Children with a mental health disorder were more likely to have a complication (odds ratio [OR] = 2.1; 95% confidence interval [CI], 1.7 to 3.4; P < .001) including intubation, mechanical ventilation, or both (OR = 3.3; 95% CI, 2.6 to 3.8; P < .001). The 30-day all-cause readmission rate was higher (12% vs 4.0%, P < .001). Conclusion Children with mental health disorders, especially development delays, have more frequent complications, longer lengths of stay, and readmissions than children without mental health disorders. This information should be included in preoperative counseling.


2020 ◽  
Vol 7 ◽  
Author(s):  
Adam D. Brown ◽  
Katharina Schultebraucks ◽  
Meng Qian ◽  
Meng Li ◽  
Danny Horesh ◽  
...  

Abstract Background United Nations (UN) personnel address a diverse range of political, social, and cultural crises throughout the world. Compared with other occupations routinely exposed to traumatic stress, there remains a paucity of research on mental health disorders and access to mental healthcare in this population. To fill this gap, personnel from UN agencies were surveyed for mental health disorders and mental healthcare utilization. Methods UN personnel (N = 17 363) from 11 UN entities completed online measures of generalized anxiety disorder (GAD), major depressive disorder (MDD), posttraumatic stress disorder (PTSD), trauma exposure, mental healthcare usage, and socio-demographic information. Results Exposure to one or more traumatic events was reported by 36.2% of survey responders. Additionally, 17.9% screened positive for GAD, 22.8% for MDD, and 19.9% for PTSD. Employing multivariable logistic regressions, low job satisfaction, younger age (<35 years of age), greater length of employment, and trauma exposure on or off-duty was significantly associated with all the three disorders. Among individuals screening positive for a mental health disorder, 2.05% sought mental health treatment within and 10.01% outside the UN in the past year. Conclusions UN personnel appear to be at high risk for trauma exposure and screening positive for a mental health disorder, yet a small percentage screening positive for mental health disorders sought treatment. Despite the mental health gaps observed in this study, additional research is needed, as these data reflect a large sample of convenience and it cannot be determined if the findings are representative of the UN.


Partner Abuse ◽  
2012 ◽  
Vol 3 (1) ◽  
pp. 59-75 ◽  
Author(s):  
Alison M. Nathanson ◽  
Ryan C. Shorey ◽  
Vanessa Tirone ◽  
Deborah L. Rhatigan

Intimate partner violence (IPV) is a serious, devastating, and prevalent problem. IPV places women at risk for negative health consequences, including increased mental health disorders. The majority of research to date has focused on mental health disorders among women in domestic violence shelters, and research is needed that examines mental health disorders among a broader range of women experiencing IPV. Therefore, this study examined the prevalence of posttraumatic stress disorder (PTSD), depression, and substance abuse disorders in a community sample of IPV victims (N = 94) using diagnostic interviews. Results showed that the majority of women met diagnostic criteria for a mental health disorder, with PTSD being the most common mental health disorder. Furthermore, psychological abuse was a significant predictor of both PTSD and depression, whereas physical aggression did not predict these outcomes. Implications of these findings for treatment and intervention work with battered women are discussed.


2007 ◽  
Vol 41 (3) ◽  
pp. 274-281 ◽  
Author(s):  
Osvaldo P. Almeida ◽  
Jianguo Xiao

Objective: Sparse information is currently available about the incidence of the major psychiatric syndromes following a stroke and their long-term contribution to morbidity and mortality. This study was designed to determine: (1) the incidence of first ever mental health disorder in amongst stroke patients; (2) the 10-year mortality associated with incident post-stroke mental health disorders. Methods: Design: Retrospective cohort study. Setting: Entire Western Australian community. Participants: First-ever stroke in 1990. Subjects with a prior recorded history of any mental health disorder were excluded from the study. Main outcomes of interest: Incident mental health diagnoses and 10-year mortality. Results: 1,129 hospital stroke contacts were recorded in 1990, with 21 people dying on the same day of contact. Between 1990-2002 36.6% of the survivors received a mental health diagnosis (6.1 per 1,000 person-years): alcohol-related disorders (16.2%), dementia (12.1%), delirium (7.6%), psychotic disorders (6.7%), and depression (5.5%). Mental health disorder onset was usually within 6 months of the stroke. Patients with an incident psychotic disorder were twice as likely to die during the subsequent 10 years as post-stroke controls with no mental health disorder (risk ratio = 2.03, 95%CI = 1.39-2.95). Being a widow (HR = 1.61, 95%CI = 1.13-2.30) or having been born in ‘other countries’ as opposed to Australia (HR = 1.56, 95%CI = 1.15-2.11) was also associated with increased death hazard. Conclusions: Approximately 1 in 3 patients develop a mental health disorder after stroke, although incidence estimates are relatively low. Post-stroke psychosis is associated with greater 10-year mortality, but the mechanisms underlying such an association are yet to be determined.


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