Heart rate variability in patients with psychiatric disorders from adolescence to adulthood

Abstract

Objective: Age is associated with changes in autonomic nervous system activity. These changes are assessed using heart rate variability(HRV) indicators; however, the effect of age on HRV in patients with psychiatric disorders remains unclear. Our study aimed to explore this effect and determine its variance across different lifespans.

Method: Consecutive patients(N = 3315), comprising 1833 patients with psychotic disorders, 1040 with mood disorders, and 442 with anxiety disorders, were recruited. The patients were divided into four age groups: adolescence(10-24 years), early adulthood(25-39 years), middle adulthood(40-59 years), and late adulthood(60+ years). HRV indicators were measured during a 5-min rest period.

Results: The heart rate and HRV indices were higher in the adolescent and early adulthood groups than they were in the middle and late adulthood groups(increased HRV is beneficial for health, while reduced HRV is detrimental). Age and all the HRV indices were negatively correlated(r-values 0.153-0.350, p < 0.001), with these correlation patterns being more evident in the adolescent and early adulthood groups than in the middle and late adulthood groups. Stratified by sex, the low-frequency/high-frequency ratio was higher in men than in women across most age groups(p < 0.05), except the late adulthood group(p = 0.085). Stratified by diagnosis, most HRV variables(except very low-frequency) were lower in the psychotic disorder group than they were in the mood and anxiety disorder groups, especially in middle and late adulthood patients. After adjusting for confounders, the HRV variables were significantly associated with age, while older age was associated with lower HRV.

Conclusions: These results indicate that the substantial reduction in HRV with age in patients with psychiatric disorders. The association remains significant after correction for sex, heart rate, and diagnoses; this may prove useful to clinical practice and further research.

Keywords: Age effect; Anxiety disorder; Heart rate variability; Mood disorder; Psychotic disorder.