Research Article
Volume 10 Issue 8 - 2018
Physiological Differences between Mood Disorder Phenotypes Based on Heart Rate Variability
Marie Casey Olseth1,2, Françoise Crevel1,2, Peta Slocombe1,3 and Archie Defillo1,2*
1Medibio, Minnesota, USA
2West End Medical Consulting, Minnesota, USA
3Vital Conversation Psychology Group, Australia
*Corresponding Author: Archie Defillo, Medibio, West End Medical Consulting, Minnesota, USA.
Received: May 18, 2018; Published: June 31, 2018
Citation: Archie Defillo., et al. “Physiological Differences between Mood Disorder Phenotypes Based on Heart Rate Variability”. EC Neurology 10.8 (2018): 811-817.
Abstract
Background: Psychiatric conditions have always been diagnosed by clinical interview of patients. Diagnostic accuracy based on this subjective method of psychiatric diagnosis is limited by many factors including skill of the clinician in interviewing psychiatric patients, patient’s insight into their symptoms and ability to verbalize distinct characteristics of their symptoms. Use of objective measures for diagnosing psychiatric conditions has not been available to clinicians to improve diagnostic accuracy.
Methods: We performed a retrospective analysis on 24-hour heart rate means and variabilities (standard deviations) of 301 consecutive patients with the diagnosis of either normal, anxiety, depression or mixed. Diagnoses were predicted using multinomial logistic regression analysis. Inter-rater agreement prediction was calculated using Kappa. Mean heart rates of the diagnostic groups were compared simultaneously to the normal cohort using Tukey’s range test. Diagnostic accuracy, sensitivity and specificity of the predicted diagnoses compared to the normal cohort were calculated using binomial proportion estimates and ROC curve estimates. Groups were compared to the normal cohort.
Results: Overall Inter-rater agreement was 0.79. Accuracy of diagnosis prediction was 57%. Sensitivities and specificities by diagnoses were: anxiety: 68%, 67%; depression: 35%, 91%; mixed: 0%, 100% (no subjects were diagnosed by the regression as “mixed”). Mean HRs were significantly lower in normal than in the mental illness groups. Standard deviations of the HRs appear to distinguish groups ONLY by the nighttime variation, which is significantly less in the depressed patients than in the normal or anxiety patients. This is especially interesting because it seems to indicate that depressed patients have more consistently higher HRs when compared with anxiety and normal cohort. Equally interesting was the finding of anxiety patients having higher than normal HR, but the same variability as normal patients.
Conclusion: Distinct patterns in mean heart rates and heart rate variability are found that clearly differentiate mood disorder diagnostic groups from normal controls. These reproducible and consistent findings reveal a new opportunity for the improving the accuracy of psychiatric diagnosis through use of these distinct patterns of mean heart rate and heart rate variability.
Keywords: Depression; Anxiety; Heart Rate; Heart Rate Variability
Copyright: © 2018 Eduardo Archie Defillo., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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