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Heart rate variability in patients with fully remitted major depressive disorder

Published online by Cambridge University Press:  22 February 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
Chih-Lun Chen
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: +11-886-2-8792-7220; Fax: +11-886-2-8792-7221; E-mail:



Cardiac autonomic dysregulation has been reported in major depressive disorder (MDD), but scarce studies investigated that in fully remitted MDD.


To examine cardiac autonomic function in remitted MDD, 470 unmedicated individuals with a diagnosis of MDD earlier in life and 462 healthy volunteers, aged 18–65 years, were recruited for a case–control analysis. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters. Frequency-domain indices of HRV were obtained. The obtained results were evaluated in association with personality traits assessed by the Tridimensional Personality Questionnaire.


In patients with remitted MDD, no differences in RR intervals and all frequency-domain indices of HRV could be detected as compared with controls. Stratified analyses by the presence of a history of suicide ideation (the SI+ vs. the SI-subgroup) revealed decreased cardiac vagal control in the SI+ subgroup. The correlation analysis revealed an inverse relation between HRV levels and the harm avoidance score (which has been suggested to be associated with serotonergic activity), mainly attributable to the robust association in the SI+ subgroup.


Our study shows that cardiac autonomic dysregulation is not shown in remitted MDD patients as a whole but is limited to the subgroup of remitted MDD patients with a history of suicidal ideation. In view of the higher risk for cardiac complications in these vulnerable individuals, one might consider the treatment to restore their autonomic function.

Original Articles
Scandinavian College of Neuropsychopharmacology 2013

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