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Cardiac autonomic dysregulation in acute schizophrenia

Published online by Cambridge University Press:  31 May 2013

Hsin-An Chang
Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
Chuan-Chia Chang
Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
Nian-Sheng Tzeng
Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
Terry B. J. Kuo
Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, ROC
Ru-Band Lu
Institute of Behavioral Medicine and Department of Psychiatry, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
San-Yuan Huang*
Department of Psychiatry, Tri-Service General Hospital, Taipei, Taiwan, ROC
San-Yuan Huang, Department of Psychiatry, Tri-Service General Hospital, No. 325, Cheng-Kung Road, Sec. 2, Nei-Hu District, Taipei 114, Taiwan, ROC. Tel: 011-886-2-8792-7220; Fax: 011-886-2-8792-7221; E-mail:



Altered cardiac autonomic function has been proposed in schizophrenia, but the results are mixed. Therefore, analyses with larger sample sizes and better methodology are needed.


To examine whether acute schizophrenia is associated with cardiac autonomic dysfunction, 314 unmedicated patients with acute schizophrenia and 409 healthy volunteers, aged 18–65 years, were recruited for a case–control analysis. The severity of schizophrenia symptoms was assessed with the Positive and Negative Syndrome Scale. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters during the supine–standing–supine test. Frequency-domain indices of HRV were obtained.


Unmedicated patients with acute schizophrenia consistently exhibited reduced mean RR interval and HRV levels in a supine rest and standing position compared with healthy volunteers. The severity of psychopathology, in particular positive symptoms, was negatively correlated with cardiac vagal control.


These data suggest that acute schizophrenia is accompanied by cardiac autonomic dysregulation. In view of the higher risk for cardiac complications in these patients, one might also consider the antipsychotic treatment in favour of improving cardiac autonomic modulation. Further studies using larger patient groups and controlled therapeutics may better understand the influence of antipsychotic treatment on cardiac autonomic regulation in schizophrenia.

Original Articles
Copyright © Scandinavian College of Neuropsychopharmacology 2013 

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