Reduction of depressive symptoms during inpatient treatment is not associated with changes in heart rate variability

Sabrina Neyer; Michael Witthöft; Mark Cropley; Markus Pawelzik; Ricardo Gregorio Lugo; Stefan Sütterlin

doi:10.1371/journal.pone.0248686

Reduction of depressive symptoms during inpatient treatment is not associated with changes in heart rate variability

PLoS One. 2021 Mar 23;16(3):e0248686. doi: 10.1371/journal.pone.0248686. eCollection 2021.

Authors

Sabrina Neyer¹, Michael Witthöft², Mark Cropley³, Markus Pawelzik¹, Ricardo Gregorio Lugo^{4

5}, Stefan Sütterlin^{5

6}

Affiliations

¹ Eos-Klinik, Münster, Germany.
² Department for Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Mainz, Germany.
³ School of Psychology, University of Surrey, Guildford, United Kingdom.
⁴ Department for Information Security and Communication Technology, Norwegian University of Science and Technology, Gjøvik, Norway.
⁵ Faculty for Health and Welfare Sciences, Østfold University College, Halden, Norway.
⁶ Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.

Abstract

Vagally mediated heart rate variability (HRV) is a psychophysiological indicator of mental and physical health. Limited research suggests there is reduced vagal activity and resulting lower HRV in patients with Major Depressive Disorder (MDD); however little is actually known about the association between HRV and symptoms of depression and whether the association mirrors symptom improvement following psychotherapy. The aim of this study was to investigate the association between antidepressant therapy, symptom change and HRV in 50 inpatients (68% females; 17-68 years) with a diagnosis of MDD. Severity of depressive symptoms was assessed by self-report (Beck Depression Inventory II) and the Hamilton Rating Scale of Depression. Measures of vagally mediated HRV (root mean square of successive differences and high-frequency) were assessed at multiple measurement points before and after inpatient psychotherapeutic and psychiatric treatment. Results showed an expected negative correlation between HRV and depressive symptoms at intake. Depressive symptoms improved (d = 0.84) without corresponding change in HRV, demonstrating a de-coupling between this psychophysiological indicator and symptom severity. To our knowledge, this study is the first to examine an association between HRV and depressive symptoms before and after psychotherapy. The observed de-coupling of depression and HRV, and its methodological implications for future research are discussed.

MeSH terms

Adolescent
Adult
Aged
Depressive Disorder, Major / pathology*
Female
Heart Rate*
Humans
Inpatients
Male
Middle Aged
Young Adult

Grants and funding

The author(s) received no specific funding for this work. The authors Sabrina Neyer and Markus Pawelzik are employed at the EOS-Klinik Münster, the psychosomatic hospital where the data were collected. The EOS-Clinic Münster is part of the Alexianer GmbH, a health care cooperation, which provided support in the form of salaries for authors MP and SN, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.